4A (Expenses $ 2181245457 including grants of $ 4467797) (Revenue $ 2324096719)
TRINITY HEALTH-MICHIGAN (TH-MI), A HEALTHCARE AND HOSPITAL SYSTEM, HAS BEEN A LEADER IN PATIENT CARE FOR MORE THAN 100 YEARS, COMMITTED TO THE QUALITY CARE OF PATIENTS AND THEIR FAMILIES. TH-MI OPERATES SEVEN HOSPITALS ACROSS MICHIGAN, CONTAINING 1,705 STAFFED BEDS, AS WELL AS OUTPATIENT HEALTH CENTERS, URGENT CARE FACILITIES, PHYSICIAN OFFICES AND SPECIALTY CENTERS, AND COMMUNITY OUTREACH SITES. DURING FISCAL YEAR 2016, TH-MI HOSPITALS' EMPLOYEES, PHYSICIANS AND VOLUNTEERS PROVIDED OVER 434,000 DAYS OF CARE, AND PROVIDED HEALTH CARE SERVICES FOR OVER 2.6 MILLION OUTPATIENT VISITS, OVER 349,000 EMERGENCY ROOM VISITS, AND OVER 8,600 HOME CARE VISITS.TH-MI OPERATES MERCY PRIMARY CARE CENTER IN DETROIT, PROVIDING MEDICAL SERVICES TO UNINSURED AND UNDERINSURED ADULTS, AS WELL AS SPECIAL PERSONAL ASSISTANCE SERVICES TO THE HOMELESS, INCLUDING SHOWERS AND CLEAN CLOTHING, AND ASSISTANCE IN ACCESSING EXISTING COMMUNITY PROGRAMS FOR HOUSING AND SUBSTANCE ABUSE TREATMENT.EACH YEAR TH-MI HOSPITALS PROVIDE OVER $128 MILLION DOLLARS IN UNCOMPENSATED BENEFITS TO THE COMMUNITY. TH-MI IS ACTIVELY ENGAGED IN THE COMMUNITY THROUGH BUSINESS, CIVIC AND SERVICE ORGANIZATIONS, AND THROUGH ITS FINANCIAL SUPPORT OF OTHER NOT-FOR-PROFIT ORGANIZATIONS AND SOCIAL SERVICES AGENCIES.PLEASE VISIT SCHEDULE H AND OUR WEBSITES FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.STJOESHEALTH.ORG AND WWW.MERCYHEALTHSAINTMARYS.COM

ST. JOSEPH MERCY ANN ARBOR
PART V, SECTION B, LINE 5: IN THE SUMMER OF 2015, ST. JOSEPH MERCY ANN ARBOR (SJMAA), AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH ST. JOSEPH MERCY CHELSEA AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, CONSULTED MANY COMMUNITY ORGANIZATIONS TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH KEY STAKEHOLDER INTERVIEWS AND COMMUNITY SURVEYS, INCLUDING: FOCUS GROUPS OF RURAL OLDER ADULTS, RURAL YOUTH, URBAN OLDER ADULTS, URBAN YOUTH; KEY STAKEHOLDER INTERVIEWS WITH REPRESENTATIVES FROM WASHTENAW COUNTY COMMUNITY MENTAL HEALTH, WASHTENAW COUNTY PUBLIC HEALTH DEPARTMENT, CATHOLIC SOCIAL SERVICES, AND HAMILTON CROSSING FAMILY EMPOWERMENT PROGRAM, HURON VALLEY AMBULANCE, SALINE AREA PUBLIC SCHOOLS, AND WASHTENAW INTERMEDIATE SCHOOL DISTRICT.

MERCY HEALTH SAINT MARY'S
PART V, SECTION B, LINE 5: THE CHNA WAS VERY INCLUSIVE AND COMPREHENSIVE IN INCORPORATING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL. THE QUALITATIVE DATA IS FROM A COLLECTION OF CONSUMER SURVEYS, COMMUNITY FOCUS GROUPS AND FORUMS, AND BRIEF INTERVIEWS WITH COMMUNITY MEMBERS. MORE INFORMATION ON EACH OF THESE METHODS IS DESCRIBED IN GREATER DETAIL IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.IN THE FOCUS GROUPS, A PROFESSIONAL RESEARCHER INTERVIEWED PEOPLE IN SMALL GROUPS. THE RATIONALE FOR THE FOCUS GROUPS IS THAT GROUP DISCUSSION WILL STIMULATE DYNAMIC CONVERSATIONS AND IN-DEPTH CONVERSATIONS ABOUT A PARTICULAR TOPIC. IN THIS CASE, THE PURPOSE WAS TO GENERATE COMMUNITY INPUT FROM VARIOUS POPULATION GROUPS ABOUT HEALTH AND WELL-BEING IN KENT COUNTY. THE FOCUS GROUPS WERE RECORDED, WITH THE KNOWLEDGE OF PARTICIPANTS, AND RESEARCHERS WERE ABLE TO UTILIZE THE WORDS SPOKEN VERBATIM ABOUT A PARTICULAR HEALTH TOPIC TO SUPPORT SPECIFIC THEMES FOUND IN THE QUALITATIVE DATA COLLECTION. TWENTY-EIGHT FOCUS GROUPS WERE CONDUCTED WITH 230 COMMUNITY MEMBERS PARTICIPATING.THE INTERCEPT INTERVIEWS METHOD IS DESIGNED TO ENGAGE PARTICIPANTS WHO MAY NOT BE INCLINED TO ATTEND A FOCUS GROUP OR TOWN HALL MEETING. IT IS TYPICALLY ONE INTERVIEWER AND ONE PARTICIPANT. IT IS ALSO INTENDED TO GENERATE OPEN-ENDED FEEDBACK FROM A BROAD GROUP OF COMMUNITY MEMBERS ON THE TOPIC OF HEALTH AND WELL-BEING. SOME POPULATIONS ARE MORE COMFORTABLE BEING INTERVIEWED BY A COMMUNITY MEMBER OR TRUSTED INDIVIDUAL, THAN BY AN OUTSIDE RESEARCHER, AND INTERCEPT INTERVIEWS ARE USEFUL WITH COLLECTING INPUT FROM THOSE COMMUNITY MEMBERS. THE INTERCEPT INTERVIEWS WERE TRANSLATED INTO SPANISH FOR THE LATINO/HISPANIC COMMUNITY AND OTHER LANGUAGES SPOKEN BY THE ASIAN COMMUNITY. INTERCEPT INTERVIEWS WERE CONDUCTED BY VOLUNTEER INTERVIEWERS (TRAINED BY PROFESSIONAL CONSULTANTS) FROM THE KENT COUNTY HEALTH DEPARTMENT AND OTHER PARTNERS ENGAGED WITH THE CHNA. INTERVIEWERS WERE PROVIDED NECESSARY INTERVIEW MATERIALS, AS WELL AS TECHNICAL ASSISTANCE. COMPLETED INTERVIEWS WERE RETURNED TO PROFESSIONALLY TRAINED CONSULTANTS FOR ANALYSIS. THIRTY INTERCEPT INTERVIEWS WERE CONDUCTED IN THREE LANGUAGES BY TRAINED COMMUNITY MEMBERS.

ST. JOSEPH MERCY OAKLAND
PART V, SECTION B, LINE 5: ST. JOSEPH MERCY OAKLAND (SJMO) CONSULTED MANY COMMUNITY ORGANIZATIONS AND THEIR REPRESENTATIVES TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING REPRESENTATIVES OF:OAKLAND COMMUNITY MENTAL HEALTH, HEALTHY PONTIAC, WE CAN, OAKLAND UNIVERSITY, THE SALVATION ARMY, OAKLAND LIVINGSTON HUMAN SERVICE AGENCY, GARY BURNSTEIN COMMUNITY HEALTH CLINIC, AREA AGENCY ON AGING 1-B OAKLAND CO. CENTRAL OFFICE, RONALD L DUNLAP-LAY PASTOR, TAKEONE COMMUNITY PROGRAM, SOUTHFIELD DOMESTIC VIOLENCE GROUP, HOPE HOSPITALITY AND WARMING CENTER, OAKLAND COUNTY DEPARTMENT OF HEALTH, GLEANERS, CENTRO MULTICULTURAL LA FAMILIA INC., AND OTHERS IN THE COMMUNITY.

ST. MARY MERCY LIVONIA
"PART V, SECTION B, LINE 5: MANY COLLABORATIVE PARTNERS WERE ENGAGED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS OF ST. MARY MERCY LIVONIA (SMML), INCLUDING THE MEMBERSHIP OF A CHNA STEERING COMMITTEE. THESE DEDICATED MEMBERS WERE INVOLVED IN THE TOOL DEVELOPMENT, SURVEY DISTRIBUTION, NEEDS IDENTIFICATION AND PRIORITIZATION AND DEVELOPMENT OF THE CHNA, DESIGN, AND IMPLEMENTATION WORKGROUPS. THESE PARTNERS INCLUDE REPRESENTATIVES FROM AUTHORITY HEALTH (FORMERLY DETROIT WAYNE COUNTY HEALTH AUTHORITY), LIVONIA AND REDFORD SCHOOLS, WAYNE HOPE CLINIC, WAYNE/WESTLAND SALVATION ARMY, MADONNA UNIVERSITY, JOY SOUTHFIELD COMMUNITY DEVELOPMENT CORPORATION, JUDSON CENTER, PLYMOUTH COMMUNITY UNITED WAY, FARMINGTON COSTICK CENTER (SENIOR CENTER), SOUTHEASTERN MICHIGAN HEALTH ASSOCIATION, REDFORD INTERFAITH RELIEF, WESTLAND YOUTH ASSISTANCE, WAYNE COUNTY HEALTH AND HUMAN SERVICES, AND LIVONIA YMCA.THE SMML COMMUNITY HEALTH NEEDS SURVEY WAS BRANDED WITH THE BANNER ""MAKE A DIFFERENCE IN THE HEALTH OF OUR COMMUNITY"". A PAPER AND ON-LINE SURVEY, COMPOSED OF 30 QUESTIONS ABOUT ACCESS TO CARE, PERSONAL HEALTH BEHAVIORS, PERCEIVED COMMUNITY HEALTH NEEDS AND PARTICIPANT DEMOGRAPHICS, WAS PROMOTED AT MANY COMMUNITY EVENTS THROUGH VARIOUS COMMUNITY PARTNERS. OF THE 1,578 RESPONSES, 666 WERE PAPER SURVEYS COMPLETED BY VULNERABLE POPULATIONS AT THE REDFORD INTERFAITH FOOD PANTRY, WAYNE/WESTLAND SALVATION ARMY FOOD PANTRY AND WAYNE HOPE CLINIC. A COMMUNITY FORUM WAS HELD AT THURSTON HIGH SCHOOL IN REDFORD, MICHIGAN TO SHARE THE SURVEY RESULTS, GAIN SOME ADDITIONAL INFORMATION ABOUT 10 OF THE SURVEY QUESTIONS AND ENGAGE COMMUNITY MEMBERS IN DISCUSSION ABOUT PROGRAMS FOR CHANGING BEHAVIORS FOR HEALTHY EATING, INCREASED PHYSICAL ACTIVITY, ACCESS TO CARE, AND MENTAL HEALTH/SUBSTANCE ABUSE PREVENTION AND TREATMENT."

ST. JOSEPH MERCY LIVINGSTON
PART V, SECTION B, LINE 5: ST. JOSEPH MERCY LIVINGSTON (SJML) CONSULTED OTHER COMMUNITY ORGANIZATIONS, INCLUDING THE LIVINGSTON COUNTY DEPARTMENT OF HEALTH, COMMUNITY MENTAL HEALTH SERVICES OF LIVINGSTON COUNTY, OAKLAND LIVINGSTON HUMAN SERVICE AGENCY, AND LIVINGSTON COUNTY CATHOLIC CHARITIES IN CONDUCTING THE MOST RECENT CHNA.

ST. JOSEPH MERCY CHELSEA
PART V, SECTION B, LINE 5: IN THE SUMMER OF 2015, ST. JOSEPH MERCY CHELSEA (SJMC), AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH SJMAA AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, CONSULTED MANY COMMUNITY ORGANIZATIONS TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH KEY STAKEHOLDER INTERVIEWS AND COMMUNITY SURVEYS, INCLUDING: FOCUS GROUPS OF RURAL OLDER ADULTS, RURAL YOUTH, URBAN OLDER ADULTS, URBAN YOUTH; AND KEY STAKEHOLDER INTERVIEWS WITH REPRESENTATIVES FROM WASHTENAW COUNTY COMMUNITY MENTAL HEALTH, WASHTENAW COUNTY PUBLIC HEALTH DEPARTMENT, CATHOLIC SOCIAL SERVICES, HAMILTON CROSSING FAMILY EMPOWERMENT PROGRAM, HURON VALLEY AMBULANCE, SALINE AREA PUBLIC SCHOOLS, AND WASHTENAW INTERMEDIATE SCHOOL DISTRICT.

ST. JOSEPH MERCY ANN ARBOR
PART V, SECTION B, LINE 6A: SJMC AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM

MERCY HEALTH SAINT MARY'S
PART V, SECTION B, LINE 6A: METRO HEALTH HOSPITAL AND SPECTRUM HEALTH

ST. JOSEPH MERCY CHELSEA
PART V, SECTION B, LINE 6A: SJMAA AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM

ST. JOSEPH MERCY ANN ARBOR
PART V, SECTION B, LINE 6B: WASHTENAW COUNTY PUBLIC HEALTH

MERCY HEALTH SAINT MARY'S
PART V, SECTION B, LINE 6B: GRAND RAPIDS AFRICAN AMERICAN HEALTH INSTITUTE (GRAAHI), PINE REST CHRISTIAN MENTAL HEALTH SERVICES, MARY FREE BED REHABILITATION HOSPITAL, YMCA, AND KENT COUNTY PUBLIC HEALTH.

ST. JOSEPH MERCY CHELSEA
PART V, SECTION B, LINE 6B: WASHTENAW COUNTY PUBLIC HEALTH

ST. JOSEPH MERCY ANN ARBOR
PART V, SECTION B, LINE 7D: ANNUALLY, SJMAA PRODUCES A COMMUNITY BENEFIT REPORT INCLUDING FINANCIAL INFORMATION AND STORIES ABOUT THE HOSPITAL'S PROGRAMS. THE REPORT DESCRIBES THE COMMUNITY HEALTH NEEDS ASSESSMENT, AND SJMAA PLANS TO MAKE IT AVAILABLE TO OUR EMPLOYEES AND COMMUNITY MEMBERS IN KIOSKS THROUGHOUT THE HOSPITAL. ADDITIONALLY, AS A UNITE GROUP, SJMAA WILL ASSESS THE MOST FEASIBLE WAY TO INFORM COMMUNITY MEMBERS OF OUR PROGRESS.LINE 7A:HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A:HTTP://WWW.STJOESANNARBOR.ORG/CBM

MERCY HEALTH SAINT MARY'S
PART V, SECTION B, LINE 7D: LINE 7A:HTTP://WWW.MERCYHEALTHSAINTMARYS.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTLINE 10A: HTTP://WWW.MERCYHEALTHSAINTMARYS.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

ST. JOSEPH MERCY OAKLAND
PART V, SECTION B, LINE 7D: LINE 7A: HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A: HTTP://WWW.STJOESANNARBOR.ORG/CBM

ST. MARY MERCY LIVONIA
PART V, SECTION B, LINE 7D: ANNUALLY, SMML PRODUCES A COMMUNITY BENEFIT REPORT INCLUDING FINANCIAL INFORMATION AND STORIES ABOUT THE HOSPITAL'S PROGRAMS. THE REPORT DESCRIBES THE COMMUNITY HEALTH NEEDS ASSESSMENT AND WAS INSERTED IN LOCAL NEWSPAPERS THAT REACHED 58,000 HOUSEHOLDS AND WAS AVAILABLE TO OUR EMPLOYEES AND COMMUNITY MEMBERS IN KIOSKS THROUGHOUT THE HOSPITAL.LINE 7A: HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A: HTTP://WWW.STJOESANNARBOR.ORG/CBM

ST. JOSEPH MERCY LIVINGSTON
PART V, SECTION B, LINE 7D: LINE 7A: HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A: HTTP://WWW.STJOESANNARBOR.ORG/CBM

ST. JOSEPH MERCY CHELSEA
PART V, SECTION B, LINE 7D: ANNUALLY, SJMC PRODUCES A COMMUNITY BENEFIT REPORT INCLUDING FINANCIAL INFORMATION AND STORIES ABOUT THE HOSPITAL'S PROGRAMS. THE REPORT DESCRIBES THE COMMUNITY HEALTH NEEDS ASSESSMENT, AND SJMC PLANS TO MAKE IT AVAILABLE TO OUR EMPLOYEES AND COMMUNITY MEMBERS IN KIOSKS THROUGHOUT THE HOSPITAL. ADDITIONALLY, AS A UNITE GROUP, SJMC WILL ASSESS THE MOST FEASIBLE WAY TO INFORM COMMUNITY MEMBERS OF OUR PROGRESS.LINE 7A: HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A: HTTP://WWW.STJOESANNARBOR.ORG/CBM

ST. JOSEPH MERCY PORT HURON
PART V, SECTION B, LINE 2: (ALSO APPLIES TO PART V, SECTION B, LINE 12A)THE ST. JOSEPH MERCY PORT HURON (SJMPH) HOSPITAL FACILITY WAS OPERATED BY TRINITY HEALTH-MICHIGAN UNTIL AUGUST 31, 2015. EFFECTIVE SEPTEMBER 1, 2015, TRINITY HEALTH-MICHIGAN SOLD THE SJMPH HOSPITAL FACILITY TO PRIME HEALTHCARE.IN ACCORDANCE WITH REG. 1.501(R)-3(D)(4), SJMPH WAS NOT REQUIRED TO MEET THE CHNA REQUIREMENTS BECAUSE TRINITY HEALTH-MICHIGAN TRANSFERRED ALL OWNERSHIP OF THE HOSPITAL FACILITY TO ANOTHER ORGANIZATION (PRIME HEALTHCARE) BEFORE THE END OF THE TAX YEAR. THEREFORE, THE EXCISE TAX UNDER SECTION 4959 WAS NOT INCURRED.

ST. JOSEPH MERCY ANN ARBOR
PART V, SECTION B, LINE 11: AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH SJMC AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, COMMUNITY HEALTH NEEDS PRIORITIZED ARE OBESITY, BEHAVIORAL HEALTH, AND PRECONCEPTUAL/PERINATAL HEALTH. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR EACH SIGNIFICANT HEALTH NEED:OBESITY - SJMAA WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY. SJMAA SUPPORTS THE COMMUNITY THROUGH:- EFFORTS SEEKING TO INCREASE ACCESS TO NUTRITIOUS FOODS THROUGH THE AVAILABILITY OF AFFORDABLE, LOCALLY SOURCED OPTIONS, COUPLED WITH NUTRITION EDUCATION TO ENCOURAGE LONG-TERM BEHAVIOR CHANGE, - OPPORTUNITIES FOR PHYSICAL ACTIVITY THROUGH SUPPORTING POLICY AND ENVIRONMENTAL CHANGE BUILT AROUND ENVIRONMENT STRATEGIES, AND- ENGAGEMENT OF SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND FOOD INSECURITY THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND NUTRITION AND HUNGER RELIEF.BEHAVIORAL HEALTH - SJMAA WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY BY:- CONTRIBUTING TOWARD IMPROVING ACCESS TO AND INTEGRATION OF BEHAVIORAL HEALTH SERVICES ACROSS THE LIFESPAN, SUBSTANCE USE DISORDER TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE,- ADDRESSING ACCESS TO CARE BARRIERS FOR THOSE MOST VULNERABLE IN THE COMMUNITY WE SERVE,- PROVIDING EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS UTILIZING BEST PRACTICE FRAMEWORKS, AND- ENGAGING SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND MENTAL HEALTH AND SUBSTANCE USE DISORDER THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND BEHAVIORAL HEALTH SERVICES.PRECONCEPTUAL/PERINATAL HEALTH THIS HEALTH NEED IS NEWLY PRIORITIZED IN THE 2016 CHNA. STRATEGIES TO ADDRESS THIS COMMUNITY HEALTH NEED ARE IN DEVELOPMENT.

MERCY HEALTH SAINT MARY'S
"PART V, SECTION B, LINE 11: OVER THE NEXT THREE FISCAL YEARS, MERCY HEALTH SAINT MARY'S (MHSM) WILL DIRECTLY ADDRESS ALL FOUR OF THE HIGH PRIORITY COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA. THESE HIGH PRIORITY NEEDS INCLUDE: MENTAL HEALTH, NUTRITION AND OBESITY, SUBSTANCE USE, AND SAFETY AND VIOLENCE.MENTAL HEALTH - AT THE COMMUNITY HEALTH CENTERS, A SBIRT (SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT) IS CONDUCTED FOR EVERY PATIENT. THROUGH A HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) GRANT IN THE AMOUNT OF $350,000, MHSM HIRED BEHAVIORAL HEALTH COUNSELORS. ADDITIONALLY, DEPRESSION SCREENINGS ARE CONDUCTED AT EACH PRIMARY CARE AND SPECIALTY OFFICE VISIT USING THE PHQ-2/9 TOOL FOR ALL PATIENTS 12 YEARS OF AGE AND OLDER. ELIGIBLE PATIENTS ARE THEN ENROLLED IN MHSM'S PHARMACEUTICAL ACCESS PROGRAM TO ENSURE POVERTY IS NOT A BARRIER FOR PATIENTS TO SEEK MENTAL HEALTH MEDICATIONS. LASTLY, THE COMPLEX CARE PROGRAM HAS EXPANDED TO INCLUDE PATIENTS WITH COMPLEX MEDICAL AND PSYCHO/SOCIAL BEHAVIOR CHALLENGES, THOSE UNENGAGED WITH CARE MANAGEMENT OR A MEDICAL HOME, WHO HAVE FREQUENT EMERGENCY DEPARTMENT UTILIZATION, AND WHO HAVE SIGNIFICANT SAFETY ISSUES, INCLUDING THOSE AT RISK FOR SUICIDE OR WHO PORTRAY VIOLENT, THREATENING BEHAVIOR.NUTRITION AND OBESITY - AT EACH PRIMARY CARE VISIT, BMI MEASUREMENTS ARE TAKEN AND EDUCATION AND/OR APPROPRIATE REFERRAL TO TREATMENT ARE PROVIDED TO PATIENTS WITH A BMI OUTSIDE OF NORMAL PARAMETERS (SEE BELOW). CHILDREN WHO STRUGGLE WITH OBESITY ARE REFERRED TO FITKIDS, A COMMUNITY PROGRAM THAT SPECIALIZES IN FIGHTING CHILDHOOD OBESITY AT THE HELEN DEVOS CHILDREN'S HOSPITAL, AND ANY CHILD UNDER THE AGE OF 5 IS REFERRED TO WIC FOR NUTRITION COUNSELING. ADDITIONALLY, MHSM IS A KEY COMMUNITY PARTNER AT THE KENT COUNTY HEALTH DEPARTMENT OBESITY AND POOR NUTRITION COALITION, WHOSE PRIMARY GOAL IS TO INCREASE THE NUMBER OF KENT COUNTY RESIDENTS WHO ARE AT A HEALTHY WEIGHT (DEFINED BY A BMI BETWEEN 18.5 AND 24.9) BY 2018. AS PART OF THE COMMUNITY HEALTH PROGRAMS, SEVERAL COMMUNITY HEALTH WORKERS (CHWS) HAVE BECOME FACILITATORS FOR DIABETES PATH, A SIX-WEEK WORKSHOP TO IMPROVE DIABETES MANAGEMENT THROUGH EXERCISE AND EDUCATION ABOUT HEALTH AND NUTRITION.IN ADDITION, MHSM OFFERED WELLNESS OPPORTUNITIES TO THE COMMUNITY INCLUDING FIT FIRST FRIDAY WHICH PROVIDES INBODY 520 TESTING AND A BRIEF CONSULTATION REGARDING PERSONALIZED FITNESS GOALS AND INDIVIDUAL BODY COMPOSITION; HOLD IT THROUGH THE HOLIDAYS, WHICH IS A WEIGHT MAINTENANCE CHALLENGE DURING THE HOLIDAY SEASON; MICHIGAN FIRE FIGHTERS CAMPAIGN, WHICH PROVIDES EDUCATION AND SUPPORT TO FIRE FIGHTERS TO ENHANCE EATING AND WELLNESS PRACTICES AT FIRE STATIONS; AND ONSITE EXERCISE CLASSES INCLUDING YOGA, ZUMBA, AND TAI-CHI THAT ARE OPEN TO THE PUBLIC FOR FREE OR FOR A NOMINAL FEE. MHSM ALSO SPONSORS AND PARTICIPATES IN SEVERAL COMMUNITY HEALTH AND WELLNESS EVENTS SUCH AS THE FIFTH THIRD BANK RUN, GRAND RAPIDS TRIATHLON, NANA'S RUN, BRIDGE RUN, GRAND RAPIDS HEART WALK, AND GRAND RAPIDS TOUR DE RAPIDS, AMONG OTHERS. THE HOSPITAL CAFETERIA PARTICIPATED IN ""FRESH FROM THE FARM TUESDAY"", WHICH PARTNERED WITH LOCAL FARMERS TO OBTAIN FRESH, SEASONAL FOOD TO PURCHASE. UTILIZING THE MATTER OF BALANCE CURRICULUM AS A MODEL FOR EXERCISE TO INCREASE STRENGTH AND BALANCE FOR OLDER ADULTS, MHSM CONDUCTED THREE EIGHT-WEEK, TWO-HOUR SESSIONS AT SPARTA HEALTH CENTER. TEN PARTICIPANTS ATTENDED THESE CLASSES ON A REGULAR BASIS TO IMPROVE THEIR FALL RISK AND TO SET GOALS TO INCREASE THEIR ACTIVITY LEVELS, STRENGTH AND BALANCE.SUBSTANCE USE - IN ADDITION TO THE SBIRT TREATMENT AND THE BEHAVIORAL HEALTH COUNSELORS AT EACH COMMUNITY HEALTH CENTER, ONE OF THE COMMUNITY HEALTH CENTERS (HEARTSIDE HEALTH CENTER) HAS IMPLEMENTED A NON-NARCOTIC PAIN PROGRAM, WHICH FOCUSES ON PHYSICAL THERAPY, OCCUPATIONAL THERAPY, PAIN PSYCHOLOGY AND CASE MANAGEMENT. THIS PROGRAM IS AN ALTERNATIVE PROGRAM FOR PATIENTS WITH CHRONIC PAIN AND WHO ARE ADDICTED OR AT RISK FOR ADDICTION TO NARCOTIC PAIN MEDICATION. MHSM IS ALSO A KEY COMMUNITY PARTNER AT THE KENT COUNTY HEALTH DEPARTMENT SUBSTANCE USE COALITION WHOSE PRIMARY GOALS ARE TO INCREASE EDUCATION OF SUBSTANCE USE, EXPAND MEDICATION DROP-OFF SITES AND EVENTS, PROVIDE MEDICATION TREATMENT FOR OPIOID ADDICTION, REDUCE ADULT AND YOUTH TOBACCO/ELECTRONIC CIGARETTE USE, REDUCE ADULT BINGE DRINKING, INCREASE PERCEPTION OF HARM WITH MARIJUANA USE, AND REDUCE THE NONMEDICAL USE OF PAIN RELIEVERS FOR 18-25 YEAR OLDS. MHSM HAS ALSO BEGUN PURSUIT OF AN ADDICTION SPECIALIST TO JOIN THE HEALTH SYSTEM TO ADDRESS BOTH THE SUBSTANCE ABUSE AND THE MENTAL HEALTH CHNA NEEDS. PLANS TO INCORPORATE THEIR SERVICES TO PATIENTS IN THE NEAR FUTURE ARE IN DEVELOPMENT.SAFETY AND VIOLENCE - IN ADDITION TO THE SBIRT TREATMENT AND THE BEHAVIORAL HEALTH COUNSELORS AT EACH COMMUNITY HEALTH CENTER, SCREENING AND TREATMENT FOR DEPRESSION, BULLYING, AND DOMESTIC VIOLENCE, AMONG OTHER ISSUES, IS PROVIDED. MHSM HAS BUILT A STRONG RELATIONSHIP WITH THE KENT COUNTY HEALTH DEPARTMENT, WHO WILL RECEIVE AND RESETTLE 700 REFUGEE FAMILIES THIS YEAR, FOR 400 OF WHICH MHSM WILL PROVIDE MEDICAL TREATMENT AND BECOME THEIR PRIMARY CARE PROVIDERS AS THEY SEEK SAFETY FROM DRUGS AND VIOLENCE IN THEIR HOME COUNTRY. CLINICA SANTA MARIA PROVIDES PRIMARY CARE FOR CHILDREN WHO ARE ABANDONED OR SEPARATED FROM THEIR PARENTS WHILE IMMIGRATING TO THE U.S. FROM MEXICO. LASTLY, THE INJURY PREVENTION COORDINATOR AT MHSM PROVIDES A PROGRAM TITLED ""DRIVEN TO DISTRACTION"", A TWO-HOUR, MULTI-DISCIPLINARY, STUDENT DRIVEN PROGRAM TO IDENTIFY RISK FACTORS AND BEHAVIORS THAT CONTRIBUTE TO DISTRACTED DRIVING AND POTENTIAL CONSEQUENCES. THE GOAL OF THIS PROGRAM IS INJURY PREVENTION THROUGH EDUCATION AND HIGH IMPACT DEMONSTRATIONS, INCLUDING A SIMULATED ACCIDENT, AN INVESTIGATION, A FUNERAL, A COURT HEARING, AND AN EDUCATIONAL DISCUSSION REGARDING BEHAVIOR MODIFICATION. IN FISCAL YEAR 16, THE INJURY PREVENTION COORDINATOR CONDUCTED ONE EVENT AT NORTHVIEW HIGH SCHOOL FOR 300 HIGH SCHOOL STUDENTS."

ST. JOSEPH MERCY OAKLAND
"PART V, SECTION B, LINE 11: THE FOUR COMMUNITY HEALTH NEEDS PRIORITIZED BY SJMO ARE OBESITY, FINANCIAL ACCESS TO CARE, DENTAL CARE, AND BEHAVIORAL HEALTH. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS:OBESITY - SJMO IS WORKING TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES TO ADDRESS RISING OBESITY RATES IN OUR COMMUNITY. SJMO SUPPORTS AREA SCHOOLS WITH EDUCATION & PREVENTION STRATEGIES, SUCH AS A ""BOOT CAMP"" FOR MIDDLE SCHOOL GIRLS AND SUMMER CAMP CAMPERSHIPS FOR HIGH RISK CHILDREN IDENTIFIED BY THE SCHOOL DISTRICT. ALL PONTIAC PUBLIC SCHOOL TEACHERS WERE PROVIDED A FREE MEMBERSHIP TO THE HOSPITAL'S WELLNESS CENTER AND OVER 500 AREA SENIORS PARTICIPATED IN ""SENIOR FIT"" FREE EXERCISE CLASSES AT TEN LOCATIONS AROUND THE COMMUNITY. WE SEEK TO INCREASE COMMUNITY ACCESS TO NUTRITIOUS FOODS, OPPORTUNITIES FOR PHYSICAL ACTIVITY, AND EDUCATION ON HEALTHY LIVING IN VARIOUS COMMUNITY VENUES. AS A CERTIFIED ""BABY FRIENDLY"" HOSPITAL, SJMO PROVIDES EDUCATION, SUPPORT AND ENCOURAGEMENT TO MOTHERS WHO CHOOSE TO BREASTFEED THEIR BABIES. ACCESS TO CARE - SJMO CONTINUES TO PROVIDE ENROLLMENT SERVICES TO ASSIST THOSE ELIGIBLE FOR INSURANCE PLANS AND ALTERNATIVE PAYMENT SOURCES, WHILE STILL PROVIDING NEEDED CARE TO THOSE WITHOUT ACCESS TO INSURANCE. ADDITIONALLY, A KEY PARTNERSHIP WITH ""FREEDOM ROAD"" WILL ASSIST PATIENTS AND COMMUNITY MEMBERS IN GETTING TO MEDICAL APPOINTMENTS AND OTHER NEEDED SERVICES IN A COMMUNITY WITH A SEVERELY INADEQUATE MASS TRANSIT SYSTEM. DENTAL CARE - SJMO HAS RAISED THE NEEDED CAPITAL FUNDING TO EXPAND ITS IN-HOSPITAL DENTAL CLINIC FOR LOW-INCOME AND MEDICALLY COMPLEX INDIVIDUALS AND ANTICIPATES CONSTRUCTION TO BEGIN SOON. FURTHER, SJMO IS WORKING TO IMPROVE COORDINATION AND ACCESS TO NECESSARY FOLLOW UP CARE AFTER DENTAL TREATMENT. SJMO CONTINUES TO SUPPORT DENTAL HYGIENE EDUCATION IN THE COMMUNITY.BEHAVIORAL HEALTH - SJMO IS WORKING TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY AND TO MEET THE NEEDS OF THESE INDIVIDUALS. THE HOSPITAL PUT TOGETHER A WELL-ATTENDED COMMUNITY SUICIDE PREVENTION EDUCATION SESSION AND FORUM AND HAVE CREATED A MONTHLY SUPPORT GROUP FOR FAMILIES OF THOSE DIAGNOSED WITH A MENTAL ILLNESS. SJMO IS A FOUNDING PARTNER IN THE HOPE RECUPERATIVE CENTER WHICH PROVIDES A SAFE PLACE FOR HEALING AND RECOVERY FOR HOMELESS PERSONS RECENTLY DISCHARGED FROM THE HOSPITAL. SJMO CONTINUES TO CONTRIBUTE TOWARD IMPROVING ACCESS TO SUBSTANCE ABUSE TREATMENT AND SUPPORT FOR PATIENT COMPLIANCE. A NEWLY LAUNCHED PARTNERSHIP WITH THE LOCAL TIMEBANK IS AN INITIATIVE WHICH THE HOSPITAL ANTICIPATES MAY HELP TO ADDRESS ISSUES OF ISOLATION AND LONELINESS IN OUR COMMUNITY, ESPECIALLY AMONG THE ELDERLY. SJMO WILL ADDRESS ACCESS TO CARE BARRIERS AND WILL PROVIDE EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS."

ST. MARY MERCY LIVONIA
"PART V, SECTION B, LINE 11: LISTED IN ORDER OF PRIORITY, SMML FOCUSED ON DEVELOPING AND/OR SUPPORTING INITIATIVES AND MEASURING THEIR EFFECTIVENESS, TO IMPROVE THE FOLLOWING HEALTH NEEDS: OBESITY - IN PARTNERSHIP WITH MEIJER (LOCAL RETAILER), MADONNA UNIVERSITY DIETETICS PROGRAM AND SOUTH REDFORD SCHOOLS, ACTIVITIES ENCOURAGING INCREASED FRUIT AND VEGETABLE INTAKE WERE CARRIED OUT DURING THE SCHOOL YEAR AT A TARGETED SCHOOL WITH THE GOAL OF REDUCING OBESITY THROUGH IMPROVED EATING HABITS. TWO ""ALL SCHOOL TASTING DAYS"", GROCERY STORE TOUR AND STUDENT ASSEMBLIES WERE HELD WITH POSITIVE IMPACT. WITH THE GOAL OF INCREASED PHYSICAL ACTIVITY AND IMPROVED NUTRITION, ESPECIALLY IN CHILDREN AGES K-12, EDUCATIONAL PROGRAMS AND ACTIVITIES FOR CHILDREN AND FAMILIES IN THE LIVONIA PUBLIC SCHOOLS WERE THE FOCUS OF A ""HEALTHY FAMILIES"" NIGHT.ACCESS TO CARE AND TRANSPORTATION - ACCESS TO PRIMARY CARE PROVIDERS AND HEALTHCARE SERVICES WAS IMPROVED BY EXPANDING TRANSPORTATION SERVICES FOR HEALTHCARE APPOINTMENTS AND THROUGH EDUCATION/PROMOTION OF RIGHT CARE/RIGHT TIME TO INCREASE THE NUMBER OF ADULTS RECEIVING PRIMARY CARE AND WELLNESS CHECKS. IN PARTNERSHIP WITH A FAITH-BASED CHARITABLE NON-PROFIT COMMUNITY HEALTH CENTER, EFFORTS ARE BEING DIRECTED TO OPENING A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) THAT WILL OFFER INTEGRATED MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE TO WESTLAND RESIDENTS.MENTAL HEALTH/SUBSTANCE ABUSE - THROUGH A PARTNERSHIP WITH LIVONIA SAVE OUR YOUTH (LSOY) AND GROWTH WORKS, AN ONGOING (10 MONTHS/YEAR) PROGRAM FOR TEENS, FAMILIES AND THE COMMUNITY-AT-LARGE WAS IMPLEMENTED TO ADDRESS DRUG/ALCOHOL EDUCATION IN A NEUTRAL LOCATION. THE INTENT WAS TO INCREASE INFORMATION AND REDUCE THE STIGMA OF TALKING ABOUT SUBSTANCE USE/ABUSE LEADING TO INTERVENTIONS AND DECREASING AT-RISK BEHAVIORS. ADDRESSING THE IDENTIFIED NEED TO REDUCE TEEN SUICIDE, SMML PARTNERED WITH SOUTH REDFORD SCHOOLS, OAKLAND SCHOOLS, WAYNE RESA, REDFORD COMMISSION ON YOUTH AND FAMILIES, GROWTH WORKS, AND DETROIT WAYNE MENTAL HEALTH AUTHORITY TO PROVIDE A FORUM TO BRING TOGETHER SCHOOL COUNSELORS AND SOCIAL WORKERS TO START THE CONVERSATION ON SUICIDE PREVENTION AND MENTAL HEALTH AWARENESS. FOR THE FIRST TIME EVER, SEVEN SCHOOL DISTRICTS MET TO START THE CONVERSATION TO ADDRESS PREVENTION AND AWARENESS AND TO IDENTIFY GAPS IN THE COMMUNITY AND OUR SCHOOLS TO ASSIST IN SUICIDE PREVENTION. SMML ACKNOWLEDGED THE WIDE-RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. SMML WILL NOT TAKE ANY NEW OR ADDITIONAL ACTIONS ON THE FOLLOWING HEALTH NEEDS: PHYSICAL ACTIVITY AND NUTRITION FOR ADULTS - ALTHOUGH ADULT PHYSICAL ACTIVITY AND NUTRITION WILL NOT BE ADDRESSED IN THIS PLAN, THE HOSPITAL WILL CONTINUE TO SPONSOR COMMUNITY FUN RUNS, COOKING DEMONSTRATIONS, AND OTHER COMMUNITY EVENTS THAT PROMOTE PHYSICAL ACTIVITY AND HEALTHY EATING. CANCER- CANCER WILL BE ADDRESSED INDIRECTLY THROUGH THE STRATEGY FOR ACCESS TO CARE AND IN THE HOSPITAL'S COMMUNITY BENEFIT PROGRAMS FOR EDUCATIONAL SEMINARS, PREVENTION SCREENINGS AND SUPPORT GROUPS. HEART DISEASE- HEART DISEASE WILL BE ADDRESSED INDIRECTLY THROUGH THE STRATEGIES FOR ACCESS TO CARE AND OBESITY.DIABETES- DIABETES DID NOT RANK AMONG THE TOP PRIORITIZED HEALTH NEEDS, DESPITE STUDIES SHOWING ONE-THIRD OF THE PEOPLE IN THE UNITED STATES UNKNOWINGLY HAVE DIABETES. SMML WILL CONTINUE TO OFFER DIABETES PREVENTION SEMINARS AND PROGRAMS, OUTPATIENT DIABETES EDUCATION AND A SUPPORT GROUP. MANY OF THE STRATEGIES TO INCREASE PHYSICAL ACTIVITY AND IMPROVE NUTRITION WILL ALSO IMPROVE THE QUALITY OF LIFE FOR DIABETIC PATIENTS."

ST. JOSEPH MERCY LIVINGSTON
PART V, SECTION B, LINE 11: THE TWO SIGNIFICANT COMMUNITY HEALTH NEEDS PRIORITIZED BY SJML ARE OBESITY & BEHAVIORAL HEALTH. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR BOTH SIGNIFICANT HEALTH NEEDS:OBESITY- SJML:- WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY, AND- SUPPORTS EFFORTS SEEKING TO INCREASE ACCESS TO NUTRITIOUS FOODS THROUGH THE AVAILABILITY OF AFFORDABLE, LOCALLY SOURCED OPTIONS COUPLED WITH NUTRITION EDUCATION TO ENCOURAGE LONG-TERM BEHAVIOR CHANGE.BEHAVIORAL HEALTH - SJML:- CONTRIBUTES TOWARD IMPROVING ACCESS TO AND INTEGRATION OF BEHAVIORAL HEALTH SERVICES ACROSS THE LIFESPAN, SUBSTANCE USE DISORDER TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE,- ADDRESSES ACCESS TO CARE BARRIERS FOR THOSE MOST VULNERABLE IN THE COMMUNITY WE SERVE, INCLUDING THE DONATION OF FUNDS SUPPORTING THE DEVELOPMENT OF AN ENGAGEMENT CENTER TO SUPPORT THOSE EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE DISORDER CRISES, AND- PROVIDES EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS UTILIZING BEST PRACTICE FRAMEWORKS.

ST. JOSEPH MERCY CHELSEA
PART V, SECTION B, LINE 11: AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH SJMAA AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, COMMUNITY HEALTH NEEDS PRIORITIZED ARE OBESITY, BEHAVIORAL HEALTH, AND PRECONCEPTUAL/PERINATAL HEALTH. OUR IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR EACH SIGNIFICANT HEALTH NEED:OBESITY - SJMC WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY. SJMC SUPPORTS THE COMMUNITY THROUGH:- EFFORTS SEEKING TO INCREASE ACCESS TO NUTRITIOUS FOODS THROUGH THE AVAILABILITY OF AFFORDABLE, LOCALLY SOURCED OPTIONS COUPLED WITH NUTRITION EDUCATION TO ENCOURAGE LONG-TERM BEHAVIOR CHANGE, - OPPORTUNITIES FOR PHYSICAL ACTIVITY THROUGH SUPPORTING POLICY AND ENVIRONMENTAL CHANGE BUILT AROUND ENVIRONMENT STRATEGIES, AND- ENGAGEMENT OF SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND FOOD INSECURITY THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND NUTRITION AND HUNGER RELIEF.BEHAVIORAL HEALTH - SJMC WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY BY:- CONTRIBUTING TOWARD IMPROVING ACCESS TO AND INTEGRATION OF BEHAVIORAL HEALTH SERVICES ACROSS THE LIFESPAN, SUBSTANCE USE DISORDER TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE,- ADDRESSING ACCESS TO CARE BARRIERS FOR THOSE MOST VULNERABLE IN THE COMMUNITY WE SERVE,- PROVIDING EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS UTILIZING BEST PRACTICE FRAMEWORKS, AND- ENGAGING SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND MENTAL HEALTH AND SUBSTANCE USE DISORDER THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND BEHAVIORAL HEALTH SERVICES.PRECONCEPTUAL/PERINATAL HEALTH - THIS HEALTH NEED IS NEWLY PRIORITIZED IN THE 2016 CHNA. STRATEGIES TO ADDRESS THIS COMMUNITY HEALTH NEED ARE IN DEVELOPMENT.

ST. JOSEPH MERCY ANN ARBOR
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

MERCY HEALTH SAINT MARY'S
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

ST. JOSEPH MERCY OAKLAND
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

ST. MARY MERCY LIVONIA
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

ST. JOSEPH MERCY LIVINGSTON
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

ST. JOSEPH MERCY CHELSEA
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

ST. JOSEPH MERCY PORT HURON
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

ST. JOSEPH MERCY ANN ARBOR
PART V, SECTION B, LINE 20E: OFFERED INFORMATION FOR OTHER VARIETIES OF PAYMENT PLAN OPTIONS; USED AUTOMATED PRESUMPTIVE CHARITY FOR SELF PAY ACCOUNTS

ST. JOSEPH MERCY LIVINGSTON
PART V, SECTION B, LINE 20E: OFFERED INFORMATION FOR OTHER VARIETIES OF PAYMENT PLAN OPTIONS; USED AUTOMATED PRESUMPTIVE CHARITY FOR SELF PAY ACCOUNTS

ST. JOSEPH MERCY CHELSEA
PART V, SECTION B, LINE 20E: OFFERED INFORMATION FOR OTHER VARIETIES OF PAYMENT PLAN OPTIONS; USED AUTOMATED PRESUMPTIVE CHARITY FOR SELF PAY ACCOUNTS

ST. JOSEPH MERCY ANN ARBOR
PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.

MERCY HEALTH SAINT MARY'S
PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.

ST. JOSEPH MERCY OAKLAND
PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.

ST. MARY MERCY LIVONIA
PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.

ST. JOSEPH MERCY LIVINGSTON
PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.

ST. JOSEPH MERCY CHELSEA
PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.

ST. JOSEPH MERCY PORT HURON
PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.

ST. JOSEPH MERCY ANN ARBOR - PART V, SECTION B, LINE 9
AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.

ST. JOSEPH MERCY CHELSEA - PART V, SECTION B, LINE 9
AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.

PART I, LINE 3C:
IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS.

PART I, LINE 6A:
TRINITY HEALTH - MICHIGAN (TH-MI) REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG. IN ADDITION, THE HOSPITAL DIVISIONS OF TH-MI INCLUDE A COPY OF THEIR MOST RECENT SCHEDULE H ON THEIR RESPECTIVE WEBSITES. TRINITY HEALTH ALSO INCLUDES TH-MI'S MOST RECENTLY FILED SCHEDULE H ON ITS WEBSITE.

PART I, LINE 7:
THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITALS' COST ACCOUNTING SYSTEMS.

PART I, LN 7 COL(F):
THE FOLLOWING NUMBER, $54,044,933, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).

PART II, COMMUNITY BUILDING ACTIVITIES:
THE HOSPITALS IN TH-MI SERVE ON COMMUNITY TASK FORCES AND COALITIONS TO HELP ADDRESS THE NEEDS OF THE SERVICE AREA. THE HOSPITALS PARTICIPATE IN DIVERSITY COUNCILS, MINISTRY ASSOCIATIONS, HEALTH COALITIONS, AND HEALTH IMPROVEMENT COUNCILS.ST. MARY MERCY LIVONIATO ASSIST IN ADDRESSING THE EDUCATIONAL DISPARITIES IN DETROIT, SMML HAS BEEN ONE OF THE CORPORATE SPONSORS OF THE DETROIT CHRISTO REY SCHOOL SINCE IT OPENED. CHRISTO REY IS A COLLEGE PREP CATHOLIC HIGH SCHOOL, ONE OF OVER 30 AROUND THE COUNTRY, FOR LOW-INCOME KIDS WHO OTHERWISE WOULD NOT BE ABLE TO AFFORD PRIVATE SCHOOL. THE VAST MAJORITY OF STUDENTS ARE EITHER HISPANIC OR BLACK, AND MOST OF THEM WILL BE THE FIRST IN THEIR FAMILY TO GO TO COLLEGE. THIS UNIQUE EDUCATIONAL MODEL PREPARES STUDENTS FOR COLLEGE AND FOR WORK. ONE DAY A WEEK, BEGINNING FRESHMAN YEAR, THE STUDENTS GO TO WORK FOR A PROFESSIONAL COMPANY. THE COMPANY, IN TURN, AGREES TO PAY 60% OF THE STUDENT'S SCHOOL TUITION. THERE HAVE BEEN THREE GRADUATING CLASSES SINCE CRISTO REY OPENED IN DETROIT. STUDENTS INTERESTED IN HEALTH CARE ALSO TRADE THEIR SCHOOL UNIFORMS FOR HOSPITAL SCRUBS AS THEY TRAVEL ONCE PER WEEK TO SMML FOR THEIR WORK-EXPERIENCE IN THE MIRACLE OF LIFE BIRTHING CENTER. BESIDES THE WORK EXPERIENCE, THEY ARE MENTORED AND GUIDED BY THE SIXTY EMPLOYEES WORKING IN THIS DEPARTMENT. IN ADDITION TO THE BEHAVIORAL HEALTH SERVICES PROVIDED BY SMML, THE HOSPITAL IS INVOLVED IN THE LIVONIA SAVE OUR YOUTH (LSOY) WHICH IS A COALITION WITH A MISSION TO EDUCATE AND EMPOWER THE COMMUNITY REGARDING THE HEALTH AND SAFETY OF OUR YOUNG PEOPLE WITH A FOCUS ON ALCOHOL AND OTHER DRUGS. THE COALITION INCLUDES PARENTS, TEENS, EDUCATORS, HEALTH CARE WORKERS, LAW ENFORCEMENT, THE FAITH COMMUNITY, AND SUBSTANCE ABUSE PROFESSIONALS. THE GROUP PARTNERS BROADLY WITH COMMUNITY MEMBERS AND GROUPS TO PREVENT SUBSTANCE ABUSE AND BRING AWARENESS OF DRUG ISSUES TO THE COMMUNITY AND PROVIDES RESOURCE GUIDES, EDUCATION, AND AN ANNUAL RUN 2 SAVE OUR YOUTH WHICH IS A FAMILY EXPO EVENT TO RAISE AWARENESS AND FUNDS. SMML SUPPORTED THIS EVENT AND THE COALITION ACTIVITIES.

PART III, LINE 2:
METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.

PART III, LINE 3:
TH-MI USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, TH-MI IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, TH-MI IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.

PART III, LINE 4:
"TH-MI IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 15 OF THOSE STATEMENTS: ""THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE.""PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION."

PART III, LINE 8:
TH-MI DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.

PART III, LINE 9B:
THE HOSPITALS' COLLECTION POLICIES CONTAIN PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN EACH ORGANIZATION'S COLLECTION POLICY. THE HOSPITALS HAVE IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS.

PART VI, LINE 2:
NEEDS ASSESSMENT - THE HOSPITALS IN TH-MI ASSESS THE HEALTH STATUS OF THEIR COMMUNITIES, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THEIR OVERALL COMMUNITIES. IN THE ASSESSMENT OF THEIR COMMUNITIES, THE HOSPITALS MAY USE PATIENT DATA, PUBLIC HEALTH DATA, COMMITTEE MEETINGS WITH MEDICAL STAFF (PHYSICIANS) AND DEPARTMENT STAFF, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - TH-MI IS COMMITTED TO:-PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES-CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES-ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE -BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, TH-MI HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: -PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS-MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS-OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS-IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER-IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSTH-MI COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. TH-MI OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH AND SEVERAL OTHER LANGUAGES, REFLECTING OTHER LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITALS. TH-MI HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. TH-MI MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER.

PART VI, LINE 4:
COMMUNITY INFORMATION - ST. JOSEPH MERCY HEALTH SYSTEM (ANN ARBOR):SAINT JOSEPH MERCY HEALTH SYSTEM (SJMHS) IS A SUBURBAN HEALTH CARE NETWORK SERVING WASHTENAW, LIVINGSTON, EASTERN JACKSON, LENAWEE, MONROE, WESTERN WAYNE AND SOUTHWESTERN OAKLAND COUNTIES. THE SJMHS HEALTH CARE NETWORK INCLUDES FIVE HOSPITALS: ST. JOSEPH MERCY ANN ARBOR, ST. MARY MERCY HOSPITAL IN LIVONIA, ST. JOSEPH MERCY CHELSEA, ST. JOSEPH MERCY OAKLAND IN PONTIAC AND SAINT JOSEPH MERCY LIVINGSTON IN HOWELL. COMBINED, THESE HOSPITALS ARE LICENSED FOR 1,726 INPATIENT BEDS. THE SJMAA SERVICE AREA IS DEFINED AS THE POPULATION OF WASHTENAW COUNTY. WASHTENAW COUNTY IS ESTIMATED TO HAVE A POPULATION OF 358,081 AS OF DECEMBER 2014 (SEMCOG). THE POPULATION UNDER AGE 18 HAS CONSISTENTLY DECLINED OVER THE PAST FOUR YEARS WHILE THE OVER-65 POPULATION HAS GROWN. IN 2014, 12% OF THE POPULATION WAS 65 AND OLDER. WASHTENAW COUNTY'S POPULATION IS RACIALLY DIVERSE WITH 76.2% WHITE, 13.9% BLACK, 9.4% ASIAN, AND 0.6% NATIVE AMERICAN IN JULY 2014. INCOME AND POVERTY ARE SIGNIFICANT INDICATORS OF HEALTH AND LIFE EXPECTANCY. EDUCATION LEVEL IS ALSO SIGNIFICANTLY CONNECTED WITH INCOME LEVEL AND POVERTY. IN WASHTENAW COUNTY, THE MEDIAN HOUSEHOLD INCOME IS $60,805. THIS IS SIGNIFICANTLY HIGHER THAN THE MEDIAN INCOME OF MICHIGAN IN GENERAL, WHICH IS $49,087. IT IS ALSO HIGHER THAN THE U.S. MEDIAN INCOME OF $52,482. HOWEVER, OBSERVING THE PERCENTAGE OF THOSE LIVING IN POVERTY BASED ON GEOGRAPHICAL LOCATION DEMONSTRATES THAT THERE ARE SPECIFIC AREAS OF WASHTENAW COUNTY THAT ARE EXPERIENCING HIGHER RATES OF POVERTY COMPARED TO THE REST OF THE COUNTY AND THE STATE.MERCY HEALTH SAINT MARY'S GRAND RAPIDS:KENT COUNTY IS CONSIDERED THE PRIMARY MARKET AREA OF MHSM. KENT COUNTY IS LOCATED IN WESTERN MICHIGAN AND IS THE FOURTH LARGEST POPULOUS COUNTY IN THE STATE. THE COUNTY IS COMPOSED OF 21 TOWNSHIPS, FIVE VILLAGES, AND NINE CITIES COVERING 864 SQUARE MILES. GRAND RAPIDS IS THE COUNTY SEAT AND IS 30 MILES FROM LAKE MICHIGAN. THE HEALTHCARE RESOURCES IN KENT COUNTY INCLUDE MHSM, METROPOLITAN HEALTH, SPECTRUM HEALTH-BUTTERWORTH CAMPUS, SPECTRUM HEALTH-BLODGETT CAMPUS, PINE REST, AND MARY FREE BED REHABILITATION HOSPITAL. IN ADDITION, THE HEALTH DEPARTMENT OPERATES SIX PUBLIC HEALTH CLINICS THROUGHOUT THE COUNTY THAT OFFER PERSONAL HEALTH SERVICES. THERE ARE AN ESTIMATED 636,369 PEOPLE RESIDING IN KENT COUNTY AS OF JULY 1, 2015. THE MEDIAN HOUSEHOLD INCOME FOR KENT COUNTY IS $52,716. TWENTY-FIVE PERCENT (25%) OF THE POPULATION IS BELOW THE AGE OF 18 AND 13% IS 65 YEARS OF AGE AND OLDER. EIGHTY-THREE PERCENT (83%) OF THE POPULATION IS WHITE, 10.5% BLACK, AND 10.3% LATINO. EIGHTY-NINE PERCENT (89%) ARE HIGH SCHOOL GRADUATES AND 33% HAVE A BACHELOR'S DEGREE. THE CURRENT UNEMPLOYMENT RATE IS 3.3%.ST. JOSEPH MERCY OAKLAND (PONTIAC):SJMO IS A PART OF SJMHS, A SUBURBAN HEALTH CARE NETWORK SERVING WASHTENAW, LIVINGSTON, EASTERN JACKSON, LENAWEE, MONROE, WESTERN WAYNE AND SOUTHWESTERN OAKLAND COUNTIES. SJMO IS LICENSED FOR 443 INPATIENT BEDS. THE SJMO SERVICE AREA IS DEFINED AS THE ENTIRE POPULATION OF OAKLAND COUNTY. OAKLAND COUNTY IS ESTIMATED TO HAVE A POPULATION OF 1,231,640 AS OF 2013 (MICHIGAN DEPARTMENT OF COMMUNITY HEALTH). THE POPULATION OF OAKLAND COUNTY IS GROWING AT A STEADY RATE. THIS ESTIMATE INDICATES POPULATION GROWTH OF NEARLY 2.4% BETWEEN 2010 AND 2013 AND 4.4% BETWEEN 2000 AND 2013.THE POPULATION OF OAKLAND COUNTY IS GRADUALLY AGING. THE POPULATION UNDER AGE 18 HAS CONSISTENTLY DECLINED OVER THE PAST FOUR YEARS WHILE THE OVER-65 POPULATION HAS GROWN AS A PERCENTAGE OF THE WHOLE. WHILE OAKLAND COUNTY'S POPULATION OVERALL IS RACIALLY DIVERSE WITH A 77.9% WHITE, 15.0% BLACK, 6.6% ASIAN, AND 0.4% NATIVE AMERICAN IN 2013, THE RACIAL MAKEUP OF THE CITY OF PONTIAC IS 34% WHITE, 51% BLACK AND 15% LATINO. OAKLAND COUNTY'S POVERTY RATE HAS CONSISTENTLY BEEN LOWER THAN THAT OF ALL MICHIGAN; HOWEVER, THE COMMUNITY OF PONTIAC, IN WHICH THE HOSPITAL RESIDES, HAS ONE OF THE HIGHEST POVERTY LEVELS IN THE STATE WITH APPROXIMATELY 38% OF PONTIAC RESIDENTS AND OVER 50% OF PONTIAC CHILDREN LIVING IN POVERTY. IN 2013, APPROXIMATELY 7.3% OF ALL OAKLAND COUNTY HOUSEHOLDS LIVED IN POVERTY. THIS PERCENTAGE HAS DECLINED SINCE 2011 BUT IS NOT AS LOW AS IT WAS IN 2010.OAKLAND COUNTY HAS A HIGH PROPORTION OF PEOPLE WITH A 4-YEAR DEGREE OR HIGHER. HOWEVER, IT ALSO HAS GEOGRAPHIC POCKETS WHERE MORE THAN 20% OF THE POPULATION HAS LESS THAN A HIGH SCHOOL DIPLOMA.ST. MARY MERCY LIVONIA:SMML'S SERVICE AREA INCLUDES CANTON, LIVONIA, NORTHVILLE CITY AND TOWNSHIP, PLYMOUTH CITY AND TOWNSHIP, REDFORD, FARMINGTON CITY AND FARMINGTON HILLS, AND WESTLAND WITH ABOUT 500,000 PEOPLE IN THESE COMMUNITIES. THE MEDIAN HOUSEHOLD INCOME RANGES FROM $44,000 IN WESTLAND TO $119,000 IN NORTHVILLE. THE HIGHEST POVERTY LEVEL CAN BE FOUND IN WESTLAND AT 15.7%, FOLLOWED BY REDFORD AT 13.8%. UNEMPLOYMENT IS THE HIGHEST IN REDFORD AT 8% AND THE LOWEST AT 2.4% IN FARMINGTON HILLS. CANTON HAS A SIGNIFICANT NUMBER OF YOUTH (26%) AND LIVONIA HAS THE HIGHEST NUMBER OF PEOPLE 65 OR OLDER (20%). THE HOSPITAL'S COMMUNITY IS PREDOMINANTLY CAUCASIAN WITH SOME AFRICAN AMERICANS, HISPANICS AND ASIANS. ST. JOSEPH MERCY CHELSEA:THE SJMC SERVICE AREA IS DEFINED AS THE GEOGRAPHIC AREA ENCOMPASSING THE ZIP CODES OF CHELSEA, DEXTER, GRASS LAKE, GREGORY, MANCHESTER, MUNITH AND STOCKBRIDGE, MICHIGAN. THIS INCLUDES SECTIONS OF FOUR COUNTIES (WESTERN WASHTENAW, SOUTHEASTERN INGHAM, SOUTHWESTERN LIVINGSTON AND EASTERN JACKSON) AND ALL OR PART OF THE FOLLOWING CITIES, VILLAGES, AND TOWNSHIPS: BRIDGEWATER, CHELSEA, DEXTER, DEXTER TOWNSHIP, FREEDOM, GRASS LAKE, HENRIETTA, LIMA, LYNDON, MANCHESTER, SCIO, SHARON, STOCKBRIDGE, SYLVAN, UNADILLA, WATERLOO, WEBSTER, VILLAGE OF GRASS LAKE, VILLAGE OF MANCHESTER, AND VILLAGE OF STOCKBRIDGE. ACCORDING TO THE HOSPITAL'S PLANNING DEPARTMENT, THE SJMC SERVICE AREA WAS DETERMINED BY THE GEOGRAPHIC PROXIMITY OF THESE COMMUNITIES TO THE HOSPITAL IN CHELSEA, MI. THE TOTAL POPULATION OF THE SIX ZIP CODES INCLUDED IN THE SJMC SERVICE AREA IS 56,023 ACCORDING TO THE 2010 CENSUS. THE AVERAGE RACE DISTRIBUTION FOR THE SERVICE AREA IS 95% CAUCASIAN, 2.1% HISPANIC, AND LESS THAN ONE PERCENT EACH OF OTHER RACES. THE AVERAGE AGE FOR THE SERVICE AREA IS 42.5.BECAUSE GREGORY AND MUNITH DO NOT HAVE THEIR OWN SCHOOL DISTRICTS (YOUTH THERE ATTEND SCHOOL IN A NEIGHBORING COMMUNITY), THE SJMC SERVICE AREA IS COMMONLY REFERRED TO AS THE FIVE COMMUNITIES OF CHELSEA, DEXTER, GRASS LAKE, MANCHESTER AND STOCKBRIDGE. WE USE THE DEMOGRAPHIC DATA OUTLINED ABOVE, BUT OTHERWISE REFER TO THESE FIVE TOWNS AS THE SJMC SERVICE AREA. ST. JOSEPH MERCY LIVINGSTON:THE SJML SERVICE AREA FOR PURPOSES OF THE NEEDS ASSESSMENT IS DEFINED AS THE POPULATION OF LIVINGSTON COUNTY. LIVINGSTON COUNTY IS ESTIMATED TO HAVE A POPULATION OF 186,234 AS OF DECEMBER 2014 (SEMCOG). THE POPULATION OF LIVINGSTON COUNTY IS GROWING; IT WAS SE MICHIGAN'S FASTEST GROWING COUNTY BY PERCENTAGE IN THE FIRST DECADE OF 2000 AT NEARLY 15.3%. HOWEVER, THE POPULATION OF LIVINGSTON COUNTY IS AGING. THE PERCENT OF AND ACTUAL NUMBER OF PEOPLE UNDER AGE 18 HAS CONSISTENTLY DECLINED OVER THE PAST FOUR YEARS WHILE THE OVER-65 POPULATION HAS GROWN. LIVINGSTON COUNTY'S POPULATION IS RACIALLY HOMOGENOUS WITH NEARLY 98% OF ITS RESIDENTS WHITE. THIS COMPARES WITH MICHIGAN'S POPULATION COMPOSITION WHICH IS ABOUT 79% WHITE AND 14.2% BLACK.A JANUARY 2015 REPORT ON 247WALLST.COM FOUND LIVINGSTON COUNTY HAS THE HIGHEST MEDIAN INCOME OF ALL MICHIGAN COUNTIES, AT $72,359 PER HOUSEHOLD BASED ON THE MOST RECENT AMERICAN COMMUNITY SURVEY DATA. APPROXIMATELY 5.9% OF LIVINGSTON INDIVIDUALS LIVED IN POVERTY IN 2013; LIVINGSTON HAS THE LOWEST POVERTY RATE OF ALL MICHIGAN COUNTIES.LIVINGSTON COUNTY HAS A HIGH PROPORTION OF PEOPLE WITH A 4-YEAR DEGREE OR HIGHER. HOWEVER, LIVINGSTON COUNTY DOES HAVE GEOGRAPHIC POCKETS IN WHICH 11-16% OF THE POPULATION HAVE LESS THAN A HIGH SCHOOL DIPLOMA.ST. JOSEPH MERCY PORT HURON:SJMPH IS LOCATED IN ST. CLAIR COUNTY IN SOUTHEASTERN MICHIGAN. SHARING A BORDER WITH CANADA, THE COUNTY IS HOME TO THE BLUE WATER BRIDGE. DUE TO ITS PROXIMITY TO CANADA AND THE HIGH CONCENTRATION OF MANUFACTURING ON BOTH SIDES OF THE BRIDGE, ST. CLAIR COUNTY HAS BEEN IDENTIFIED BY THE FEDERAL GOVERNMENT AS A HIGH-RISK AREA FOR BOTH NATURAL AND MANMADE DISASTERS.BASED ON 2010 U.S. CENSUS BUREAU DATA, ST. CLAIR COUNTY HAS ABOUT 163,000 RESIDENTS AND IS EXPECTED TO SLOWLY DECLINE. OF THAT POPULATION, 94.5% ARE CAUCASIAN, 2.6% BLACK OR AFRICAN AMERICAN AND 2.9% HISPANIC OR LATINO. IN 2011, 15% OF AREA RESIDENTS WERE SENIORS AGE 65 AND OLDER, WHICH IS THE ONLY DEMOGRAPHIC EXPECTED TO GROW IN THE NEXT DECADE. THE COUNTY IS 721 SQUARE MILES, ENCOMPASSING 33 COMMUNITIES.

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"PROMOTION OF COMMUNITY HEALTH: TH-MI HOSPITALS COLLABORATE WITH OTHERS IN THE COMMUNITY TO ACHIEVE IMPROVEMENTS IN HEALTH AND ACCESS TO HEALTHCARE.SAINT JOSEPH MERCY HEALTH SYSTEM (ANN ARBOR AND CHELSEA):THE WASHTENAW HEALTH PLAN (WHP) REPRESENTS A PARTNERSHIP BETWEEN WASHTENAW COUNTY, THE UNIVERSITY OF MICHIGAN AND SJMHS TO PROVIDE PRIMARY MEDICAL CARE SERVICES FOR THE MOST VULNERABLE AND DISENFRANCHISED IN THE COMMUNITY. SJMHS SUPPORTS THIS PROGRAM BY PROVIDING STAFF SUPPORT TO HELP PATIENTS GAIN ACCESS TO A MEDICAL HOME. THE HOSPITALS ALSO PROVIDE THIS POPULATION WITH FREE OR REDUCED-FEE CLINICAL SERVICES.SJMAA WAS THE LEAD AGENCY IN THE ORIGINATION OF THE WASHTENAW HOUSING ALLIANCE (WHA), A COALITION OF NINE SOCIAL SERVICE AGENCIES DEALING WITH HOUSING OF VARIOUS TYPES, WHOSE MISSION IS TO END HOMELESSNESS IN WASHTENAW COUNTY. IN ADDITION, SJMHS AND ITS BOARD MEMBERS WERE KEY IN BUILDING THE DELONIS CENTER IN DOWNTOWN ANN ARBOR. THIS CENTER PROVIDES NEEDED ACCOMMODATIONS FOR THE HOMELESS, AS WELL AS SOCIAL AND HEALTH SUPPORT SERVICES. IN 2015, SJMAA BECAME A PART OF THE WASHTENAW COUNTY COORDINATED FUNDERS, A PUBLIC-PRIVATE COLLABORATIVE FUNDING PARTNERSHIP WORKING TO FUND SOCIAL SERVICES AGENCIES ACROSS COMMUNITY-LEVEL OUTCOMES IN THE AGING, SAFETY NET HEALTH, CRADLE TO CAREER, NUTRITION, AND HOUSING AND HOMELESSNESS SECTOR. SJMAA ALSO SUPPORTS AVALON HOUSING'S FUSE PROGRAM, WHICH PROVIDES CARE AND RESOURCES TO HOMELESS INDIVIDUALS EXPERIENCING MENTAL HEALTH, SUBSTANCE USE DISORDER, AND CHRONIC ILLNESSES, BY SECURING HOUSING AND NECESSARY SOCIAL SERVICE SUPPORTS THROUGH A PERMANENT SUPPORTIVE HOUSING MODEL.SJMHS OPERATES TWO CLINICS THAT SUPPLY FREE OR REDUCED-FEE HEALTH CARE SERVICES TO AT-RISK POPULATIONS. THE NEIGHBORHOOD HEALTH CLINIC IS LOCATED IN DOWNTOWN YPSILANTI, WHILE THE ACADEMIC OB/GYN CLINIC IS LOCATED ON THE ANN ARBOR HOSPITAL CAMPUS.IN FY16, SJMAA BECAME A PARTNER IN THE COLLABORATIVE FUNDING MODEL, WASHTENAW COORDINATED FUNDING. THE MODEL CONSISTS OF SEVEN PARTNERS MEETING THE NEEDS OF OUR COMMUNITY'S MOST VULNERABLE IN FOUR PRIORITY AREAS THROUGH THREE FUNDING COMPONENTS INTENDED TO: SUPPORT HUMAN SERVICES PROGRAMMING; BUILD NONPROFIT CAPACITY; AND FOSTER COMMUNITY COLLABORATION AND SYSTEMS-LEVEL CHANGE. THE THREE DISTINCT COMPONENTS WITHIN THE MODEL (SECTOR LEADERS (FORMERLY PLANNING & COORDINATING ENTITIES), PROGRAM OPERATIONS FUNDING & CAPACITY BUILDING GRANTS) ARE DESIGNED TO PREVENT GAPS AND AVOID REDUNDANCIES IN SERVICES, WHILE STREAMLINING APPLICATION AND REPORTING PROCEDURES FOR GRANTEES. SJMAA IS CONTRIBUTING FUNDING TO THE MODEL AND DEDICATED STAFF TIME AND OTHER RESOURCES DURING FY16. ALL FUNDING DISTRIBUTED THROUGH THIS MODEL IS ALIGNED WITH SJMAA'S PRIORITY HEALTH AREAS OF BEHAVIORAL HEALTH AND OBESITY.MERCY HEALTH SAINT MARY'S GRAND RAPIDS:MHSM IMPLEMENTS AND PARTICIPATES IN DOZENS OF PROGRAMS EACH YEAR, OFTEN PARTNERING WITH OTHER ORGANIZATIONS IN THE COMMUNITY. MHSM IS A ONE-THIRD PARTNER WITH THE MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE AND MARY FREE BED REHABILITATION HOSPITAL, IN THE COMMUNITY'S ONLY CERTIFIED ALS (AMYOTROPHIC LATERAL SCLEROSIS) TREATMENT CENTER FOR LOU GEHRIG'S DISEASE. THE WEGE INSTITUTE FOR HEALTH AND LEARNING IS HOME TO THE WEGE RESIDENCY PROGRAM, THROUGH WHICH PARTICIPANTS WORK WITH THE UNINSURED, REFUGEE POPULATION AND THOSE EXPERIENCING HOMELESSNESS.IN APRIL 2016, MHSM OPENED A CONCIERGE MEDICINE DEPARTMENT WHICH PROVIDES 24/7 ACCESS TO A PRIMARY CARE PHYSICIAN. TO ALIGN WITH MHSM'S MISSION STATEMENT TO PROVIDE CARE FOR THE POOR AND UNDERSERVED, 10% OF THE REVENUE FROM THE CONCIERGE MEDICINE DEPARTMENT WILL BE REALLOCATED TO FUND PROGRAMS THAT SUPPORT THE POOR AND UNDERSERVED MEMBERS OF THE COMMUNITY. IT IS ESTIMATED THIS AMOUNT WILL RANGE FROM $75,000-$125,000 ANNUALLY.MHSM IS A PARTNER WITH KENT COUNTY HEALTH DEPARTMENT SUBSTANCE USE DISORDER COMMUNITY HEALTH IMPROVEMENT PLAN WORK GROUP. IN FY16, THE WORK GROUP ADDED TOBACCO 21, A NATIONAL INITIATIVE THAT ADVOCATES INCREASING THE LEGAL AGE TO PURCHASE TOBACCO FROM 18 TO 21, TO THE STRATEGIC PLAN, WITH THE GOAL TO REDUCE REPORTED TOBACCO USE WITHIN THE PAST 30 DAYS AMONG HIGH SCHOOL AGED YOUTH FROM 12% TO 11% BY FY18. ST. JOSEPH MERCY OAKLAND (PONTIAC):SJMO WORKED IN PARTNERSHIP WITH THE OAKLAND SCHOOLS MICHIGAN WORKS JOBLINKS PROGRAM (A PROGRAM IN WHICH PARTICIPATION IS BASED ON FINANCIAL NEED) TO DEVELOP OUR HEALTH CARE CO-OP PROGRAM FOR PONTIAC AREA HIGH SCHOOL STUDENTS. THE STUDENTS WORKED APPROXIMATELY 15 HOURS/WEEK AFTER SCHOOL DURING THE SCHOOL YEAR AND 40 HOURS/WEEK DURING THEIR SUMMER BREAK. STUDENTS WERE PAID FOR THEIR HOURS WORKED BY THE MICHIGAN WORKS PROGRAM. THE PROGRAM PROVIDED OPPORTUNITIES FOR PERSONAL AND PROFESSIONAL DEVELOPMENT FOR STUDENTS AS WELL AS FINANCIAL STABILITY FOR THEIR FAMILIES. THE HOSPITAL ALSO CONTINUES TO STRENGTHEN OUR SENIOR FIT PROGRAM, EXPANDING TO SERVE MORE THAN 500 SENIORS IN NINE LOCATIONS ACROSS THE COUNTY, PROVIDING BASIC PRE AND POST HEALTH SCREENING, AND A TWICE WEEKLY EXERCISE PROGRAM FOR SENIORS. THIS PROGRAM SUPPORTS BOTH THEIR PHYSICAL AND EMOTIONAL HEALTH. THROUGH THE MERCY SUPPORT PROGRAM, 5,662 LOW-INCOME AND AT-RISK PERSONS WERE SERVED, WHILE AN ADDITIONAL 2,925 WERE SERVED THROUGH THE INDIGENT PROCUREMENTS AND MERCY SUPPORT PRESCRIPTION PROGRAMS. AS A KEY PARTNER WITH THE OAKLAND COUNTY HEALTH DEPARTMENT, OAKLAND UNIVERSITY, AND PONTIAC ELECTED OFFICIALS, SJMO IS PART OF THE FIVE MEMBER ""INVEST HEALTH"" GRANT TEAM, FUNDED THROUGH THE REINVESTMENT FUND AND ROBERT WOOD JOHNSON FOUNDATION TO ADDRESS SOCIAL DETERMINATES OF HEALTH IN 50 MID-SIZED CITIES ACROSS AMERICA. STILL IN ITS FIRST YEAR, THIS TEAM IS FOCUSED ON BUILDING COMMUNITY COLLABORATIONS AND HELPING TO LEVERAGE RESOURCES TO IDENTIFY AND ADDRESS BARRIERS TO THE HEALTH OF PONTIAC RESIDENTS.ST. MARY MERCY LIVONIA:RESPONDING TO THE COMMUNITY NEED FOR MENTAL HEALTH AND SUBSTANCE ABUSE CARE, SMML OFFERS A ROBUST INPATIENT BEHAVIORAL MEDICINE SERVICE. TO IMPROVE THE ER EXPERIENCE FOR THESE PATIENTS AND THEIR FAMILIES AND FRIENDS, A BEHAVIORAL MEDICINE SECTION WAS CREATED IN THE HOSPITAL'S ER. PSYCHIATRIC SOCIAL WORKERS ASSIST PATIENTS AND THEIR FAMILIES IN THE AUTHORIZATION PROCESS FOR INPATIENT ADMISSION OR CONNECTING THEM WITH OUTPATIENT SERVICES AVAILABLE IN THE COMMUNITY.WITH LIMITED ACCESS TO HEALTHCARE FOR THE UNINSURED, SMML HAS PARTNERED WITH WAYNE HOPE CLINICS TO PROVIDE LAB SERVICES. THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE TO THE MAPI CHARITABLE CLINIC IN LATHRUP VILLAGE, MI. ADDITIONAL FINANCIAL ASSISTANCE WAS PROVIDED TO THE WAYNE HOPE CLINICS TO INCREASE DIABETES PREVENTION AND MANAGEMENT PROGRAMMING ON THEIR SITE. FURTHERMORE, ASSISTANCE WAS PROVIDED TO THE CABRINI CLINIC IN SUPPORT OF STAFFING A COMMUNITY HEALTH WORKER. ADDRESSING THE NEED FOR SPECIALIST CARE FOR THE UNINSURED INDIVIDUALS WHO ARE CARED FOR IN THE ER, AN INTERNAL SPECIALIST CARE PROGRAM, THROUGH THE MEDICAL STAFF OFFICE, CONTINUED. THIS PROGRAM HAS REDUCED THE RATE OF RETURN ER VISITS FOR FOLLOW-UP CARE AND HAS IMPROVED THE PATIENT'S QUALITY OF LIFE; AND WITHOUT THIS PROGRAM MANY OF THESE INDIVIDUALS WOULD NOT HAVE RECEIVED THIS NEEDED CARE.ST. JOSEPH MERCY LIVINGSTON:SJML ACTIVELY SUPPORTS COMMUNITY ENTITIES INCLUDING LIVINGSTON COUNTY PUBLIC HEALTH, LIVINGSTON COUNTY CATHOLIC CHARITIES, WHICH HOUSES THE LIVINGSTON COUNTY SUBSTANCE ABUSE PREVENTION COALITION, LIVINGSTON COUNTY COMMUNITY MENTAL HEALTH, AND THE LOCAL HUMAN SERVICES COLLABORATIVE BODY. SUPPORT OF THESE ORGANIZATIONS INCLUDES BUT IS NOT LIMITED TO: SEATS ON VARIOUS BOARDS, SJML STAFF MEMBERS' PRESENCE AT WORKGROUPS WITHIN COLLABORATIONS SUPPORTING THE WORK OF THESE AGENCIES, AND MONETARY OR IN-KIND STAFF TIME AT EVENTS PROMOTING HEALTH TO THE GENERAL PUBLIC. SJML ALSO SUPPORTS THE LOCAL FOOD BANK THROUGH DONATIONS. ADDITIONALLY, THE SJML COMMUNITY SAW AN OPPORTUNITY TO INCREASE ACCESS FOR THOSE WITH DENTAL ISSUES. SJML DONATED A BUILDING AND FUNDS TO RENOVATE THE SPACE TO ACCOMMODATE A DENTAL CLINIC, WHICH PROVIDES DENTAL CARE FOR MEDICAID RECIPIENTS AND THOSE WITHOUT DENTAL INSURANCE.ST. JOSEPH MERCY PORT HURON:SINCE 1990, SJMPH HAS SPONSORED THE PEOPLES' CLINIC FOR BETTER HEALTH. THIS FREE CLINIC, LOCATED WITHIN THE GUADALUPE MISSION IN PORT HURON, HAS BEEN THE CORNERSTONE OF SJMPH'S COMMUNITY INITIATIVES FOR THE POOR AND UNDERSERVED. THE CLINIC IS OPERATED IN COLLABORATION WITH THE UNITED WAY AND THE ST. CLAIR COUNTY MEDICAL SOCIETY, WHICH PROVIDES VOLUNTEER PHYSICIANS. PRIMARY MEDICAL CARE AND PRESCRIPTION MEDICATIONS ARE PROVIDED FREE OF CHARGE EACH YEAR TO OVER 3,500 18 TO 65 YEAR-OLDS WHO LACK INSURANCE OR ARE UNDERINSURED. THE CLINIC INCLUDES A SWEET TOUCH PROGRAM DESIGNED TO MONITOR AND MANAGE THE CHRONIC DISEASE OF DIABETES TO THE POOR AND UNINSURED POPULATION."

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"TH-MI IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2016, GOALS INCLUDED 1) PARTNERING WITH COMMUNITY ORGANIZATIONS IN INSURANCE ENROLLMENT ACTIVITIES TARGETED AT UNINSURED INDIVIDUALS TO IMPROVE ACCESS TO HEALTHCARE, 2) PARTICIPATING IN LOCAL ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, AND 3) DEVELOPING A STRATEGY WITH MULTI-DISCIPLINARY TEAMS TO OPTIMIZE CARE FOR VULNERABLE PERSONS, WITH PARTICULAR FOCUS ON THOSE WHO ARE DUALLY ENROLLED IN MEDICAID AND MEDICARE. TRINITY HEALTH APPRECIATES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED PROGRAMS FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED AREAS OF NEED AND THAT WILL REDUCE OBESITY AND TOBACCO USE.AS A SYSTEM, TRINITY HEALTH SUPPORTED PROGRAMS AND ORGANIZATIONS WHO ADDRESS THESE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE GRANTING SEVEN DACA ""DREAMERS"" LOW INTEREST LOANS, ENABLING RECIPIENTS TO ATTEND MEDICAL SCHOOL AT STRITCH SCHOOL OF MEDICINE, AND PROVIDING A GRANT TO THE U.S. SOCCER FOUNDATION TO FUND ITS SOCCER FOR SUCCESS PROGRAM IN NINE COMMUNITIES, OFFERING STUDENTS IN UNDERSERVED AREAS THE OPPORTUNITY TO SAFELY AND COST-EFFECTIVELY ENGAGE IN A HEALTHY AND ACTIVE LIFESTYLE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS NEARLY $1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG."