4A (Expenses $ 17860404 including grants of $ 0) (Revenue $ 13082866)
INPATIENT, ACUTE AND LONG TERM SKILLED NURSING SERVICES- CHENANGO MEMORIAL HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS AND OTHER HEALTH CARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES AND THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM INPATIENT ACUTE SERVICES AND LONG-TERM SKILLED NURSING CARE. CHENANGO MEMORIAL HOSPITAL PROVIDES A WIDE RANGE OF MEDICAL-SURGICAL SERVICES, INCLUDING: OPHTHALMOLOGY, EMERGENCY MEDICINE, MATERNITY CARE, PULMONARY MEDICINE, AND PEDIATRICS. TOTAL INPATIENT DAYS FOR THE YEAR ENDED DECEMBER 31, 2021 WAS 4,199. DISCHARGES WERE 1,396, AND AVERAGE LENGTH OF STAY WAS 3.01 DAYS. LONG TERM SKILLED NURSING DAYS WERE 12,085. THERE WERE 224 BIRTHS AND 279 INPATIENT SURGERIES PERFORMED AT CHENANGO MEMORIAL HOSPITAL IN 2021. IN 2021, CHENANGO MEMORIAL HOSPITAL GAVE FINANCIAL ASSISTANCE TO 91 INDIVIDUALS FOR WHICH $684,303 OF INPATIENT CARE (AT CHARGES) WAS PROVIDED.

4B (Expenses $ 35195829 including grants of $ 0) (Revenue $ 57509478)
OUTPATIENT AND AMBULATORY SERVICES- CHENANGO MEMORIAL HOSPITAL ALSO PROVIDES A WIDE RANGE OF OUTPATIENT DIAGNOSTIC AND TREATMENT SERVICES, INCLUDING EMERGENCY DEPARTMENT, AMBULATORY SURGERY, FULL-SERVICE LABORATORY, COMPREHENSIVE IMAGING AND OTHER PROCEDURAL OUTPATIENT SERVICES. TOTAL PATIENT VISITS FOR OUTPATIENT SERVICES FOR YEAR-ENDED 2021 WAS 176,004. INCLUDED IN THE 176,004 VISITS WERE 14,323 EMERGENCY ROOM VISITS, 819 EMERGENCY ROOM TREATED AND ADMITTED AS ACUTE CARE PATIENTS, 3,404 VARIOUS OUTPATIENT SURGICAL CASES, AND 157,458 OTHER OUTPATIENT DEPARTMENT VISITS. IN 2021, CHENANGO MEMORIAL HOSPITAL GAVE FINANCIAL ASSISTANCE TO 1,997 INDIVIDUALS FOR WHICH $1,435,052 OF OUTPATIENT CARE (AT CHARGES) WAS PROVIDED.

4C (Expenses $ 13986908 including grants of $ 0) (Revenue $ 7774704)
CLINICS- CHENANGO MEMORIAL HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY CARE AND SPECIALTY CARE CLINICS. PRIMARY CARE SERVICES ARE THE FOUNDATION FOR SERVING THE COMMUNITY WITH A COORDINATED SYSTEM OF CARE, WITH SPECIAL ATTENTION TO UNDER-SERVED AREAS. CMH OFFERS FIVE FAMILY HEALTH CENTERS LOCATED THROUGHOUT A MULTI-COUNTY SERVICE AREA: 1) NORWICH FAMILY HEALTH CENTER 2) INTERNAL MEDICINE 3) OXFORD FAMILY HEALTH CENTER 4) SHERBURNE FAMILY HEALTH CENTER AND 5) SIDNEY FAMILY HEALTH CENTER. OTHER OUTPATIENT SERVICES INCLUDE: GERIATRICS, WOMEN'S HEALTH CENTER, GENERAL SURGERY, HEART CENTER, GI, ORTHOPEDICS, PODIATRY, ONCOLOGY AND PAIN MANAGEMENT CLINIC. TOTAL PATIENT VISITS FOR THE CMH CLINICS AT YEAR-ENDED 2021 WAS 70,806.

4D (Expenses $ 0 including grants of $ 0) (Revenue $ 2128707)

CHENANGO MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 13H: FEDERAL POVERTY GUIDELINES (FPG) IS USED TO DETERMINE THE FAMILY INCOME LIMIT FOR FREE CARE ELIGIBILITY OF 200%. THE FPG IS NOT USED TO DETERMINE DISCOUNTED CARE ELIGIBILITY. HOWEVER THE FPG IS USED TO DETERMINE THE PERCENTAGE OF DISCOUNTED CARE A PATIENT WILL RECEIVE.

PART V, SECTION B, LINE 5: NEEDS ASSESSMENT
IN DECEMBER 2018, CHENANGO MEMORIAL HOSPITAL (CMH), CHENANGO COUNTY PUBLIC HEALTH (CCPH) AND THE CHENANGO HEALTH NETWORK (CHN) CAME TOGETHER TO START A COLLABORATION AROUND THE DEVELOPMENT OF THE 2019-2021 COMMUNITY HEALTH ASSESSMENT (CHA) AND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE NEWLY FORMED NEEDS ASSESSMENT COMMITTEE SUBSEQUENTLY CONTRACTED WITH HORN RESEARCH LLC TO CONDUCT THE ASSESSMENT TO ENSURE AN OBJECTIVE, UNBIASED, AND EXPERIENCED APPROACH. THE COMMITTEE PROVIDED OVERSIGHT AND GUIDANCE TO THE ASSESSMENT PROCESS AND ORGANIZED THE MEETINGS OF STAKEHOLDERS DESCRIBED IN MORE DETAIL LATER IN THIS SECTION. QUALITATIVE DATA WAS GATHERED FIRST FROM 51 CHENANGO COUNTY RESIDENTS THROUGH FOCUS GROUPS AND TELEPHONE INTERVIEWS. PARTICIPANTS WERE ASKED TO SHARE THEIR PERSPECTIVES ON THE MOST PRESSING HEALTH ISSUES FACING THE COUNTY, AS WELL AS THE BARRIERS AND CHALLENGES THEY FACE IN THEIR EFFORT TO LEAD HEALTHY LIVES. IN ADDITION, 23 KEY STAKEHOLDERS REPRESENTING A RANGE OF NON-PROFIT ORGANIZATIONS, GOVERNMENT AGENCIES AND PROVIDERS, WERE INTERVIEWED TO GAIN FURTHER INSIGHT INTO THE COUNTY'S HEALTH CARE STRENGTHS AND BARRIERS. CHENANGO COUNTY THEN ENGAGED IN AN ITERATIVE PROCESS TO SELECT PRIORITIES AND ACTIVITIES FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP)/COMMUNITY SERVICE PLAN (CSP). THE PROCESS ALLOWED SIGNIFICANT INPUT FROM STAKEHOLDERS AND INTEGRATED FEEDBACK FROM THE COMMUNITY. HEALTHCARE AND SOCIAL DETERMINANTS OF HEALTH DATA WERE COLLECTED FROM A VARIETY OF SOURCES INCLUDING, BUT NOT LIMITED TO, THE NYS DEPARTMENT OF HEALTH (NYSDOH), THE US CENSUS, THE NYS DEPARTMENT OF EDUCATION (NYSED), THE NYS OFFICE OF FAMILY AND CHILDREN (NYSOCFS), AND THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (BRFSS). ADDITIONAL DATA RESOURCES UTILIZED INCLUDED THE COUNTY HEALTH RANKINGS AND OTHER LOCAL NEEDS ASSESSMENT REPORTS. THE THREE ORGANIZATIONS THEN SCHEDULED THE FIRST OF TWO STAKEHOLDER MEETINGS INVITING SEVERAL COMMUNITY STAKEHOLDERS.AGENCIES REPRESENTED AT THE STAKEHOLDER MEETINGS WERE:-CARE COMPASS NETWORK-CHENANGO COUNTY AREA AGENCY ON AGING-CHENANGO COUNTY CATHOLIC CHARITIES-CHENANGO COUNTY DEPARTMENT OF PUBLIC HEALTH-CHENANGO COUNTY DEPARTMENT OF SOCIAL SERVICES-CHENANGO COUNTY MENTAL HYGIENE & BEHAVIORAL HEALTH SERVICES-CHENANGO HEALTH NETWORK-CHENANGO UNITED WAY-CHOBANI-COMMUNITY FOUNDATION OF SOUTH CENTRAL NEW YORK-CORNELL COOPERATIVE EXTENSION-CROUSE HOSPITAL-DCMO BOCES-DELAWARE COUNTY DEPARTMENT OF HEALTH-FRIENDS OF ROGERS-HOSPICE & PALLIATIVE CARE OF CHENANGO COUNTY-LIBERTY PARTNERSHIP-LOCAL BUSINESSES-LOCAL SCHOOL DISTRICTS-MOTHERS & BABIES PERINATAL NETWORK-NEW YORK CONNECTS-NORWICH FAMILY YMCA-OPPORTUNITIES FOR CHENANGO AND HEADSTART-POPULATION HEALTH IMPROVEMENT PROGRAM-PUBLIC LIBRARIES-THE PLACE-UHS CHENANGO MEMORIAL HOSPITAL-UNITED HEALTH SERVICES (UHS)-VARIOUS COMMUNITY FOUNDATIONS-WOMEN, INFANTS & CHILDREN (WIC)NEXT, THE FIRST DRAFT OF THE CHA/CHNA WAS DEVELOPED BASED ON A COMPREHENSIVE REVIEW OF INDICATOR DATA AND QUALITATIVE DATA COLLECTED FROM COMMUNITY MEMBERS AND KEY STAKEHOLDERS. THE DRAFT REPORT WAS COMPLETED BY HORN RESEARCH ON DECEMBER 31, 2018. THIS WAS FOLLOWED BY THE FIRST OF TWO STAKEHOLDER MEETINGS ON JANUARY 28, 2019 WHEN KEY COMMUNITY PARTNERS CONVENED TO HEAR FEEDBACK COLLECTED FROM THE COMMUNITY AND OTHER STAKEHOLDERS, AND SUBSEQUENTLY VOTE ON THE PRIORITY AREAS. A PRESENTATION WAS PROVIDED WHICH INCLUDED AREAS WHERE THERE WAS CONVERGENCE IN INDICATOR INFORMATION AND QUALITATIVE DATA. AFTER THE PRESENTATION, PARTICIPANTS WERE ASKED TO PARTICIPATE IN A RANKING ACTIVITY TO PROVIDE A FIRST CUT OF THE PRIORITY SELECTION. EACH STAKEHOLDER WAS GIVEN FIVE STICKERS AND ASKED TO PLACE THEM ON THE PREVENTION AGENDA FOCUS AREAS THEY BELIEVED SHOULD BE SELECTED FOR THE CHIP/CSP. PARTICIPANTS WERE ALLOWED TO DISBURSE THEIR STICKERS IN WHATEVER WAY THEY PREFERRED WHICH ALLOWED THEM TO WEIGHT THEIR PREFERENCES. THE RANKING ACTIVITY RESULTED IN THE IDENTIFICATION OF FOUR MAIN FOCUS AREAS: -MENTAL HEALTH AND SUBSTANCE USE PREVENTION-HEALTHY EATING AND FOOD SECURITY-CHILD AND ADOLESCENT HEALTH-PREVENTIVE CARE AND MANAGEMENT. THE NEEDS ASSESSMENT COMMITTEE THEN REVIEWED THE DATA, GOALS AND OBJECTIVES RELATED TO THESE FOUR FOCUS AREAS. THEY IDENTIFIED CURRENT AND POTENTIAL PROGRAMMING, AND ASSESSED THE FEASIBILITY OF ADDRESSING THEM. THIS PROCESS RESULTED IN THE SELECTION OF EIGHT GOALS RELATED TO THESE FOUR FOCUS AREAS. THEN THE SECOND STAKEHOLDER MEETING WAS CONVENED ON APRIL 8, 2019 TO MAP OUT CURRENT RESOURCES TO THE ABOVE-MENTIONED FOCUS AREAS AND RELATED GOAL AREAS. THE MAPPING PROCESS IDENTIFIED OPPORTUNITIES FOR COLLABORATION AND ENHANCEMENT OF PROGRAMMING TO ADDRESS POTENTIAL GAPS IN SERVICE AND IMPROVE COMMUNITY HEALTH OUTCOMES. DURING THE FINAL STEP, THE NEEDS ASSESSMENT COMMITTEE SELECTED INTERVENTIONS BASED ON THE FOLLOWING CRITERIA:A.THE RESULTS OF THE MAPPING PROCESSB.OPTIMIZATION OF CURRENT RESOURCES C.GREATEST IMPACT ON THE FOCUS AREAS RELATED TO THE COUNTY'S MOST SIGNIFICANT HEALTH ISSUES.ALL OF THESE ORGANIZATIONS ASSIST THE MEDICALLY UNDERSERVED, LOW INCOME, AND AGED POPULATIONS THAT ARE DETAILED IN LINE 4 OF PART VI SUPPLEMENTAL INFORMATION.

PART V, SECTION B, LINE 6A:
UHS CHENANGO MEMORIAL HOSPITAL IS THE ONLY HOSPITAL IN CHENANGO COUNTY.

PART V, SECTION B, LINE 11:
HOW THE HOSPITAL ADDRESSED NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.THE MAJORITY OF 2019 WAS SPENT RESEARCHING THE NEEDS OF THE COMMUNITY, IDENTIFYING THE INITIATIVES THAT WOULD HAVE THE GREATEST IMPACT WITH AVAILABLE RESOURCES, AUTHORING THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2019-2021, AND BEGINNING WORK ON THE IDENTIFIED INITIATIVES IN COLLABORATION WITH THE LHD. THE COMPLETED CHNA WAS FIRST PRESENTED TO THE PLANNING COMMITTEE OF THE HOSPITAL'S BOARD OF DIRECTORS FOR APPROVAL IN NOVEMBER 2019. IT WAS THEN PRESENTED TO THE HOSPITAL'S BOARD OF DIRECTORS IN DECEMBER 2019 FOR FINAL APPROVAL BY RESOLUTION. SELECTED PRIORITY AREAS AND INTERVENTIONSPREVENT CHRONIC DISEASE: PREVENTIVE CARE AND MANAGEMENTWITH HIGH MORTALITY RATES FOR SEVERAL CHRONIC DISEASES, CHENANGO COUNTY FACES A SIGNIFICANT CHALLENGE IN ASSISTING COUNTY RESIDENTS IN EFFECTIVELY MANAGING THEIR CONDITIONS. HORN RESEARCH CONDUCTED AN ANALYSIS OF THE POTENTIAL HEALTH CARE COSTS AS WELL AS THE YEARS OF LIFE LOST AND POTENTIAL EARNINGS LOSS ASSOCIATED WITH THESE DISEASES IN THE COUNTY. THE RESULTS SHOW A NEED FOR INCREASED HEALTHY BEHAVIORS AND BETTER DISEASE MANAGEMENT AMONG CHENANGO COUNTY RESIDENTS. LOW-INCOME INDIVIDUALS AND FAMILIES ARE AT PARTICULAR RISK FOR CHRONIC DISEASE AND OFTEN LACK THE RESOURCES AND KNOWLEDGE TO MANAGE THEIR ILLNESSES.CHN HAS RECENTLY INCORPORATED THE EVIDENCE-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM INTO THE SERVICES THEY OFFER. THE PROGRAM SUCCESSFULLY TAUGHT SELF-MANAGEMENT SKILLS TO 59 CHENANGO COUNTY RESIDENTS IN 2018 AND CONTINUED CLASSES IN 2019. PROGRAM RESULTS SHOW A CLINICAL REDUCTION IN A1C LEVELS IN PARTICIPANTS AS WELL AS INCREASED KNOWLEDGE OF DISEASE SELF-MANAGEMENT AND A BETTER UNDERSTANDING OF THEIR HEALTH AND PHYSICAL ACTIVITY. THE PROGRAM'S EARLY SUCCESS COUPLED WITH THE HIGH NEED FOR INDIVIDUAL SELF-MANAGEMENT IMPROVEMENT CLEARLY SHOW THE SUITABILITY OF INVESTING IN THE PROGRAM MORE BROADLY.CHENANGO COUNTY PROPOSES TO EXPAND THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM BY ESTABLISHING A REFERRAL PROCESS OF NEWLY DIAGNOSED PATIENTS THROUGH THE HOSPITAL, INCORPORATING THE HOSPITAL'S HEAD DIETICIAN AND CHEF INTO THE PROGRAM'S CURRICULUM, CREATING A REFERRAL PROCESS THROUGH THE HEALTH DEPARTMENT'S PROGRAMS, AND EXPLORING HAVING HEALTH DEPARTMENT STAFF BECOME TRAINED AS PEER LEADERS. A SPECIAL EMPHASIS WILL BE PLACED ON PARTNERING WITH AND RECRUITING FROM COMMUNITY-BASED ORGANIZATIONS WHO WORK WITH LOW-INCOME INDIVIDUALS AND FAMILIES TO ADDRESS THE HEALTH DISPARITIES ASSOCIATED WITH INCOME AND HEALTH.PROMOTE WELL-BEINGCHENANGO COUNTY HAS HIGH RATES OF POOR SELF-REPORTED MENTAL HEALTH IN ADULTS, HAS HIGH RATES OF YOUTH DISCONNECTION, AND IS DESIGNATED AS A HEALTH PROVIDER SHORTAGE AREA FOR MENTAL HEALTH. WHILE INCREASING THE NUMBER OF MENTAL HEALTH CARE PROVIDERS WOULD BE OF BENEFIT TO THE COUNTY, A MORE IMMEDIATE AND EFFECTIVE COMMUNITY-BASED INTERVENTION WOULD BE TO EXPAND THE NUMBER OF PEOPLE TRAINED TO IDENTIFY MENTAL HEALTH ISSUES IN THEIR PROFESSIONAL SPHERE AND PROVIDE APPROPRIATE SUPPORT. IN PARTICULAR, NEGATIVE YOUTH MENTAL HEALTH OUTCOMES IN THE COUNTY HAVE BEEN INCREASING. EARLY INTERVENTION COULD HAVE A SIGNIFICANT IMPACT ON THE TRAJECTORY OF THE YOUNG PEOPLE IN THE COUNTY AND IMPROVE THOSE OUTCOMES.CHN HAS ADDED THE EVIDENCE-BASED TRAINING PROGRAM MENTAL HEALTH FIRST AID TO THEIR PROGRAMMING. SINCE THE BEGINNING OF 2019, CHN HAS TRAINED 35 CHENANGO COUNTY RESIDENTS IN ADULT MENTAL HEALTH FIRST AID AND HAS PLANS FOR TRAINING MORE THROUGH THE YOUTH MENTAL HEALTH FIRST AID MODULE. UNFORTUNATELY, 2020 IMPOSED COVID RESTRICTIONS WHICH PREVENTED ADDITIONAL TRAINING, BUT THE INTENT TO RESTART TRAINING EXISTS. THIS TRAINING CREATES MORE OPPORTUNITIES FOR EARLY DETECTION AND INTERVENTION, AND WITH THE INCREASING NEGATIVE YOUTH MENTAL HEALTH OUTCOMES IN THE COUNTY, EARLY INTERVENTION COULD HAVE A SIGNIFICANT IMPACT ON THE TRAJECTORY OF YOUNG PEOPLE IN THE COUNTY.CHENANGO COUNTY PROPOSES TO EXPAND THE MENTAL HEALTH FIRST AID PROGRAM BY MAKING HOSPITAL STAFF, HEALTH DEPARTMENT STAFF, AND PROVIDERS AVAILABLE FOR TRAINING. IN ADDITION, EFFORTS WILL BE MADE TO PROMOTE THE PROGRAM AND ORGANIZE TRAININGS FOR OTHER STAKEHOLDERS AND PROFESSIONALS FROM COMMUNITY BASED ORGANIZATIONS. A PARTICULAR EMPHASIS WILL BE PLACED ON TRAINING INDIVIDUALS WHO WORK WITH YOUNG PEOPLE SUCH AS SCHOOL STAFF, EDUCATORS, AND ORGANIZATIONS SERVING YOUTH.

PART V, SECTION B, LINE 11 CONTINUED:
INITIATIVE 1PRIORITY: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERSFOCUS AREA: PROMOTE WELL BEINGGOAL: FACILITATE SUPPORTIVE ENHANCEMENTS THAT PROMOTE RESPECT AND DIGNITY FOR PEOPLE OF ALL AGES.OBJECTIVE: INCREASE CHENANGO COUNTY COMMUNITY SCORES BY 7% TO 44.8%.DISPARITIES: LACK OF EDUCATION OF MENTAL HEALTH ISSUES IN COUNTY, LOW-INCOME, LOW PROVIDER AREA, LACK OF TRANSPORTATION AND SERVICES ACCESS.INTERVENTIONS-MENTAL HEALTH FIRST AID COURSES MADE AVAILABLE/DELIVERED TO COMMUNITY AND PROFESSIONALS -EDUCATE PROVIDERS VIA DETAILING VISITS TO PROMOTE POSTPARTUM DEPRESSION (PPD) SCREENING AT INFANT'S WELL CHILD VISITS (1WK, 2WK, 2, 4 AND 6 MONTHS) IN PEDIATRIC OFFICE WITH REFERRAL TO MOTHER'S PRIMARY HEALTH CARE PROVIDER (PCP)-EDUCATE PEDIATRIC PROVIDERS IN THE COUNTY ON THE PROJECT TEACH REFERRAL AND MATERNAL HEALTH MENTAL HEALTH PROJECT THROUGH PROJECT TEACH INITIATIVE VIA DETAILING VISITS TO PROVIDERS-MULTI-AGENCY LOBBYING EFFORTS TO NYS MEDICAID TRANSPORTATION PROGRAM TO IMPROVE ACCESS AND TIMELINESS OF TRANSPORTATION TO MEDICAL APPOINTMENTS FOR COUNTY RESIDENTS -IMPROVE AWARENESS OF LOCAL AND REGIONAL SERVICES IN AN EFFORT TO IMPROVE OUTREACH EFFORTS-EVALUATE AND IMPROVE OUTREACH EFFORTSFAMILY OF MEASURESMENTAL HEALTH FIRST AID-NUMBER OF COURSES HELD-NUMBER OF INDIVIDUALS TRAINEDPROVIDER DETAILING POSTPARTUM DEPRESSION-NUMBER OF PROVIDERS EDUCATED ON PROJECT-NUMBER OF PEDIATRIC PRACTICES WILLING TO SCREEN MOMSPROJECT TEACH DETAILING -100% OF HEALTH CARE PROVIDERS IN COUNTY EDUCATED ON BOTH PROJECTS-100% OF HEALTH CARE PROVIDERS IN COUNTY RECEIVE ANNUAL UPDATES AND EDUCATION-NUMBER OF PROVIDERS PARTICIPATING IN KICK OFF DINNER/WEBINAR-NUMBER OF PROVIDERS COMPLETING CORE TRAINING BY PROJECT TEACHMEDICAID TRANSPORTATION LOBBYING-NUMBER OF AGENCIES JOINING LETTER WRITING CAMPAIGN -AGENCY SELF-REPORTS IMPROVEMENT IN MEDICAID TRANSPORTATION FOR CLIENTSSERVICES AWARENESS AND IMPROVED OUTREACH -NUMBER OF CHENANGO COUNTY CALLS TO 211-AGENCY SELF-REPORTS IMPROVEMENT FOR CLIENTSPROJECTED (OR COMPLETED) YEAR 1 INTERVENTIONSMENTAL HEALTH FIRST AID1.ORGANIZE RESOURCES 2.COALESCE PARTNERS 3.PRIORITIZE AND SCHEDULE FIRST TRAININGSPROVIDER DETAILING - POSTPARTUM DEPRESSION 1.BY END OF 2019, REACH OUT AND MEET WITH 100% OF HEALTH CARE PROVIDERS IN COUNTY WHO SEE NEWBORNS AND INFANTS TO PROVIDE EDUCATION REGARDING POSTPARTUM DEPRESSION SCREENING OF MOMS IN PEDIATRIC OFFICES 2.EDUCATE HEALTH CARE PROVIDERS ON THE EVIDENCE BASED PROGRAM PROJECT TEACH DETAILING PROJECT 1.BY END OF 2019, REACH OUT TO PROJECT TEACH FACILITATOR TO DISCUSS PLAN2.FORM SUBCOMMITTEE TO PLAN KICK OFF INFORMATIONAL DINNER3.SECURE FUNDING FOR DINNER PRESENTATIONTRANSPORTATION1.FORM WORKGROUP2.EXPLORE ISSUE IN DEPTH 3.INTERVIEW PARTNERS 4.DRAFT ADVOCACY LETTERACCESS TO SERVICES 1.FORM WORKGROUP 2.EXPLORE ISSUE IN DEPTH3.COLLECT 211 USER DATA 4.IDENTIFY AND TARGET SHORT COMINGS AND GAPSPROJECTED YEAR 2 INTERVENTIONSMENTAL HEALTH FIRST AID 1.EXECUTE FULL SLATE OF TRAINING COURSES PROVIDER DETAILING - POSTPARTUM DEPRESSION1.BEGIN DETAILING VISITS AT 2ND QUARTER WITH PLANNED REVISIT BY END OF THE YEAR 2020 TO REMIND AND RE-INFORCE THE PROJECT DETAILS2.HAVE AT LEAST ONE HEALTH CARE PROVIDER SUCCESSFULLY IMPLEMENT POSTPARTUM DEPRESSION SCREENING IN THEIR PEDIATRIC PRACTICEPROJECT TEACH DETAILING PROJECT 1.PLAN AND IMPLEMENT INFORMATIONAL DINNER FOR HEALTH CARE PROVIDERS TO EDUCATE THEM ON PROJECT TEACH IN FIRST QUARTER OF THE YEAR 2020

PART V, SECTION B, LINE 11 CONTINUED:
2.ENCOURAGE PARTICIPANTS TO SIGN UP FOR CORE TRAININGS FOR THEIR STAFF BY PROJECT TEACH FACILITATORS 3.BEGIN DETAILING VISITS IN 2ND QUARTER, WITH PLANNED REVISIT BY END OF THE YEAR 2020 TO REMIND AND RE-INFORCE TRANSPORTATION 1.INTRODUCE PARTNERS TO ADVOCACY LETTER2.EDIT DRAFT AS NEEDED3.COLLECT SIGNATURES 4.SEND LETTERSACCESS TO SERVICE 1.GATHER REFERRALS, CONTACTS AND PROGRAM INFORMATION TO FILL GAPS IN 211 SERVICESPROJECTED YEAR 3 INTERVENTIONSMENTAL HEALTH FIRST AID1.EXECUTE ADDITIONAL TRAININGS 2.EVALUATE PROGRESS AND FUTURE NEEDSPROVIDER DETAILING - POSTPARTUM DEPRESSION1.ANNUAL DETAILING TO HEALTH CARE PROVIDERS TO ENCOURAGE THOSE WHO ARE NOT SCREENING TO START DOING SO2.HAVE ONE ADDITIONAL HEALTH CARE PROVIDER AGREE TO AND IMPLEMENT POSTPARTUM DEPRESSION SCREENING IN THEIR PEDIATRIC PRACTICEPROJECT TEACH DETAILING PROJECT 1.VISIT EACH HEALTH CARE PROVIDER ANNUALLY TO REVIEW PROJECT TEACH AND ENCOURAGE ITS USETRANSPORTATION 1.CONTINUE CONVERSATION WITH PARTNERS AND TARGET PROGRAM STAFF 2.EVALUATE CHANGE AND ADDITIONAL NEEDS ACCESS TO SERVICES 1.CONTINUE TO IMPROVE PROGRAM DETAIL IN 211 SYSTEM 2.ENCOURAGE AGENCY UPDATES TO THE SYSTEM3.PROMOTE SYSTEM USEIMPLEMENTATION PARTNER, ROLE(S) AND RESOURCESLOCAL HEALTH DEPARTMENTMENTAL HEALTH FIRST AID1.HOST TRAINING FOR STAFF2.PROMOTE AND REFER PROVIDER DETAILING - POSTPARTUM DEPRESSION1.CARRY OUT DETAILING PROJECT WITH PROVIDERSPROJECT TEACH DETAILING1.FACILITATE TRAININGS & EVENTS2.FUNDINGMEDICAID TRANSPORTATION LOBBYING1.LEAD AGENCY LOBBYING EFFORTSSERVICES AWARENESS AND IMPROVED OUTREACH WORKGROUP PARTICIPANT1.ID RESOURCES2.ID GAPS IN RESOURCE AWARENESS3.CULMINATE CORRECTIVE RESOURCES AND RECOMMENDATIONSHOSPITALMENTAL HEALTH FIRST AID1.HOST TRAINING FOR STAFF2.FACILITATE3.PROVIDE SPACE4.PROMOTE PROGRAM5.OBTAIN FUNDINGPROVIDER DETAILING - POSTPARTUM DEPRESSION UHS CHENANGO MEMORIAL HOSPITAL COMMUNITY HEALTH ADVOCATE - PROMOTE TO PROVIDERSMEDICAID TRANSPORTATION LOBBYINGASSIST IN FINALIZING LETTERSERVICES AWARENESS AND IMPROVED OUTREACH UHS CHENANGO MEMORIAL COMMUNITY HEALTH ADVOCATE - WORKGROUP PARTICIPANT1.ID RESOURCES 2.ID GAPS IN RESOURCE AWARENESS 3.CULMINATE CORRECTIVE RESOURCES AND RECOMMENDATIONS PROVIDERSMENTAL HEALTH FIRST AIDBASSETT - STAFF TRAINING, PROMOTEPROVIDER DETAILING - POSTPARTUM DEPRESSION UHS CHENANGO MEMORIAL HOSPITAL - ADOPT PRACTICE CHANGEBASSETT - ADOPT PRACTICE CHANGE PROJECT TEACH DETAILINGUHS CHENANGO MEMORIAL HOSPITAL - PROMOTE & UTILIZE.BASSETT - PROMOTE & UTILIZE.PRIVATE - PROMOTE & UTILIZE.

PART V, SECTION B, LINE 11 CONTINUED:
MEDICAID TRANSPORTATION LOBBYING 1.ASSIST IN FINALIZING LETTER2.CONSIDER SUPPORT COMMUNITY BASED ORGANIZATIONSMENTAL HEALTH FIRST AIDCHENANGO HEALTH NETWORK (CHN) 1.FACILITATE2.PROVIDE SPACE3.PROMOTE PROGRAM4.OBTAIN FUNDINGCHENANGO COUNTY BEHAVIORAL HEALTH1.STAFF TRAINED AS PROGRAM FACILITATORSPROJECT TEACH DETAILING CHENANGO HEALTH NETWORK 1.VOLUNTEER2.OBTAIN FUNDING3.FACILITATE KICKOFF EVENTCHENANGO COUNTY BEHAVIORAL HEALTH1.SUPPORT2.KICKOFF EVENT PARTICIPANTMEDICAID TRANSPORTATION LOBBYINGCATHOLIC CHARITIES - LOBBYING EFFORTS CHENANGO COUNTY BEHAVIORAL HEALTH - LOBBYING EFFORTSSERVICES AWARENESS AND IMPROVED OUTREACH CATHOLIC CHARITIES - WORKGROUP PARTICIPANT1.ID RESOURCES2.ID GAPS IN RESOURCE AWARENESS 3.CULMINATE CORRECTIVE RESOURCES AND RECOMMENDATIONSCHENANGO COUNTY BEHAVIORAL HEALTH - WORKGROUP PARTICIPANT 1.ID RESOURCES2.ID GAPS IN RESOURCE AWARENESS 3.CULMINATE CORRECTIVE RESOURCES AND RECOMMENDATIONS OTHERMENTAL HEALTH FIRST AIDFIRST RESPONDERS - HOST TRAININGS FOR STAFFLAW ENFORCEMENTMENTAL HEALTH FIRST AID HOST TRAININGS FOR STAFFK-12 SCHOOLMENTAL HEALTH FIRST AIDHOST TRAININGS FOR STAFF AND PROMOTEPROJECT TEACH DETAILINGUNADILLA VALLEY SCHOOL BASED CLINIC - PROMOTE AND UTILIZESHERBURNE SCHOOL BASED CLINIC - PROMOTE AND UTILIZE2019 UPDATEMENTAL HEALTH FIRST AIDIN 2019 WITH COLLABORATION BETWEEN CHENANGO HEALTH NETWORK AND CHENANGO MEMORIAL HOSPITAL THERE WERE 13 ADULT AND YOUTH MENTAL HEALTH FIRST AID CLASSES HELD AROUND THE COUNTY TRAINING OVER 200 COMMUNITY MEMBERS, BUSINESS PROFESSIONALS AND EDUCATION STAFF. MULTIPLE PRESENTATIONS HAVE BEEN GIVEN THROUGH CHENANGO AND DELAWARE COUNTIES SCHOOLS, PROVIDING A CURRICULUM OVERVIEW AND BENEFIT OF HOSTING A TRAINING FOR THEIR STAFF. ALL OF THE CHENANGO COUNTY SHERIFF'S OFFICE PERSONNEL WENT THROUGH THE FIRE/EMS MENTAL HEALTH TRAINING IN 2019. POSTPARTUM DEPRESSION DEPARTMENT OF HEALTH HAS REACHED OUT AND MET WITH 100% OF HEALTH CARE PROVIDERS IN COUNTY WHO SEE NEWBORNS AND INFANTS TO PROVIDE EDUCATION REGARDING POSTPARTUM DEPRESSION SCREENING OF MOMS IN PEDIATRIC OFFICES. UHS CHENANGO MEMORIAL HOSPITAL STARTED SCREENING IN THEIR PEDIATRIC OFFICES. PROJECT TEACH THE PLANNING FOR A PROVIDER EDUCATION EVENT IS BEING PLANNED FOR SPRING OF 2020. PROJECT TEACH FACILITATOR IS SCHEDULED TO DISCUSS PROGRAM BENEFITS, PLAN AND HOW TO IMPLEMENT. FUNDING HAS BEEN SECURED FOR DINNER EVENT AND WILL BE ORGANIZED BY CHENANGO HEALTH NETWORK AND CHENANGO COUNTY DEPARTMENT OF HEALTH. ALL PROVIDERS WITHIN CHENANGO COUNTY WILL BE INVITED TO ATTEND.TRANSPORTATIONWORKGROUP HAS BEEN FORMED, THE GROUP HAS EXPLORED THE ISSUE IN DEPTH, PARTNERS WERE INTERVIEWED AND THE DRAFT OF THE ADVOCACY LETTER HAS BEEN STARTED AND CONTINUING TO BE FINALIZED.ACCESS TO SERVICES THE WORKGROUP WAS FORMALIZED AND A RESOURCE GUIDE IS BEING DEVELOPED FOR CHENANGO COUNTY ALONG WITH A COLLABORATION WITH CHENANGO UNITED WAY TO IMPROVE OUR COMMUNITY RELATIONSHIP AND RESOURCES WITH OUR LOCAL 211.

PART V, SECTION B, LINE 11 CONTINUED:
"2020 UPDATEMENTAL HEALTH FIRST AIDIN 2020 WITH COLLABORATION BETWEEN CHENANGO HEALTH NETWORK AND CHENANGO MEMORIAL HOSPITAL, THERE WERE 4 ADULT AND YOUTH MENTAL HEALTH FIRST AID CLASSES HELD AROUND THE COUNTY TRAINING OVER 68 COMMUNITY MEMBERS, BUSINESS PROFESSIONALS AND EDUCATION STAFF. TRAININGS WERE SUSPENDED IN FEBRUARY IN RESPONSE TO THE COVID PANDEMIC. DURING THE PANDEMIC, THE COURSES WERE MOVED TO A DIGITAL PLATFORM WITH 3 TRAININGS SCHEDULED BY THE END OF THE YEAR. CLASSES ARE PLANNED TO CONTINUE IN 2021.POSTPARTUM DEPRESSION PROVIDER DETAILING IN THE SPRING OF 2020 WAS DELAYED DUE TO COVID RESPONSE. WE ARE LOOKING FORWARD TO RESUMING THIS INITIATIVE IN THE SUMMER OF 2021. PROJECT TEACH PROVIDER EDUCATION PLANNED FOR SPRING OF 2020 WAS POSTPONED IN RESPONSE TO THE PANDEMIC. PROJECT TEACH MAY BE CONVERTED TO A DIGITAL PLATFORM FOR VIRTUAL TRAINING IN 2021. PROJECT TEACH FACILITATOR IS SCHEDULED TO DISCUSS PROGRAM BENEFITS, PLAN AND HOW TO IMPLEMENT. FUNDING HAS BEEN SECURED FOR A DINNER EVENT AND WILL BE ORGANIZED BY CHENANGO HEALTH NETWORK AND CHENANGO COUNTY DEPARTMENT OF HEALTH. ALL PROVIDERS WITHIN CHENANGO COUNTY WILL BE INVITED TO ATTEND.TRANSPORTATIONA DRAFT OF THE ADVOCACY LETTER WAS COMPLETED BUT BEFORE PARTNER SIGNATORIES COULD BE COLLECTED THE PROJECT WAS SUSPENDED BY THE PANDEMIC. IT HAS BEEN NOTED THAT INCREASED VIRTUAL OPTIONS FOR CARE HAVE BEEN CREATED AS A RESULT OF THE PANDEMIC AND THIS MAY SERVE TO CHANGE THE NEED FOR THIS INTERVENTION. IT WILL BE RE-EVALUATED IN 2021. ACCESS TO SERVICES THE WORKGROUP WAS FORMALIZED AND A RESOURCE GUIDE IS BEING DEVELOPED FOR CHENANGO COUNTY ALONG WITH A COLLABORATION WITH CHENANGO UNITED WAY TO IMPROVE OUR COMMUNITY RELATIONSHIP AND RESOURCES WITH OUR LOCAL 211. THIS ENTIRE INITIATIVE WAS SUSPENDED DUE TO THE PANDEMIC DUE TO COMPONENT AGENCY RESOURCES BEING REASSIGNED TO COVID RELIEF EFFORTS. INTERVENTION WILL BE RESUMED AFTER THE PANDEMIC CONCLUDES.2021 UPDATEMENTAL HEALTH FIRST AID2021 OFFERED THE FEWEST COLLABORATION OPPORTUNITIES IN SEVERAL YEARS. THE AFTERMATH AND STILL LINGERING EFFECTS OF COVID HAVE REALLY AFFECTED THE MENTAL HEALTH EFFORTS IN CHENANGO COUNTY.TRAININGS ARE SLOWLY BEGINNING TO RESURFACE BUT WITH LITTLE INTEREST. DURING THE PANDEMIC, THE COURSES WERE MOVED TO A DIGITAL PLATFORM WITH 3 TRAININGS SCHEDULED BY THE END OF THE YEAR. CLASSES ARE PLANNED TO CONTINUE IN 2022.POSTPARTUM DEPRESSION ALL SERVICES STILL REMAIN POSTPONED DUE TO COVID, AND LOW STAFFING NUMBERS.PROJECT TEACH PROVIDER EDUCATION PLANNED FOR SPRING OF 2021 WAS POSTPONED IN RESPONSE TO THE PANDEMIC. TALKS HAVE BEEN MOVING FORWARD TO WORK TOWARD RESTARTING THIS PROGRAM. MORE TO FOLLOW IN 2022.ACCESS TO SERVICES THE WORKGROUP WAS FORMALIZED AND A RESOURCE GUIDE IS BEING DEVELOPED FOR CHENANGO COUNTY ALONG WITH A COLLABORATION WITH CHENANGO UNITED WAY TO IMPROVE OUR COMMUNITY RELATIONSHIP AND RESOURCES WITH OUR LOCAL 211. THIS ENTIRE INITIATIVE WAS SUSPENDED DUE TO THE PANDEMIC DUE TO COMPONENT AGENCY RESOURCES BEING REASSIGNED TO COVID RELIEF EFFORTS. INTERVENTION WILL BE RESUMED AFTER THE PANDEMIC CONCLUDES.INITIATIVE 2PRIORITY: PREVENT CHRONIC DISEASESFOCUS AREA: HEALTHY EATING AND FOOD SECURITYGOAL: INCREASE SKILLS AND KNOWLEDGE TO SUPPORT HEALTHY FOOD AND BEVERAGE CHOICES.OBJECTIVE: DECREASE THE PERCENTAGE OF ADULTS WHO CONSUME ONE OR MORE SUGARY DRINKS PER DAY BY 5%. DECREASE THE PERCENT OF CHILDREN WITH OBESITY BY 5%. DECREASE THE PERCENT OF ADULTS, AGES 18 YEARS AND OLDER WITH OBESITY BY 5%. REDUCE DENTAL CARIES. DISPARITIES: LOW INCOME, GEOGRAPHYINTERVENTIONSPROJECT YEAR 1"" ""RETHINK YOUR DRINK: DRINK WATER"" - CAMPAIGN "" ADOPT BEVERAGE STANDARDS AND PROMOTE MESSAGE THROUGH LITERATURE AND PROGRAMMING TO REDUCE OVER CONSUMPTION OF SUGARY SWEETENED BEVERAGES"" PROVIDE DENTAL SUPPLIES TO PRE K - 5TH GRADES IN ALL 9 COMMUNITY SCHOOLS"" ENCOURAGE CLASSROOM DENTAL CARE PRACTICE CHANGE IN THE SCHOOLSPROJECT YEAR 2"" EXPAND ""RETHINK YOUR DRINK: DRINK WATER"" CAMPAIGN "" FOCUS ON: SUGARY SWEETENED BEVERAGE PRACTICE CHANGE AMONG 1. SCHOOLS 2. COMMUNITY - BASED PARTNERS3. BUSINESS"" PROVIDE DENTAL SUPPLIES TO PRE K - 5TH GRADES IN ALL 9 COMMUNITY SCHOOLS ALONG WITH A DENTAL PRESENTATION"" ENCOURAGE CLASSROOM DENTAL CARE PRACTICE CHANGE IN THE SCHOOLSPROJECT YEAR 3"" EXPAND ""RETHINK YOUR DRINK: DRINK WATER"" CAMPAIGN "" FOCUS ON: SUGARY SWEETENED BEVERAGE PRACTICE CHANGE FOR PROVIDERS 1. CHENANGO MEMORIAL HOSPITAL PROVIDERS 2. BASSETT AND PRIVATE PROVIDERS3. DENTAL PROVIDERS"" PROVIDE DENTAL SUPPLIES TO PRE K - 5TH GRADES IN ALL 9 COMMUNITY SCHOOLS"" ENCOURAGE CLASSROOM DENTAL CARE PRACTICE CHANGE IN THE SCHOOLSFAMILY OF MEASURESPROJECT YEAR 1-NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF EDUCATED-NUMBER OF PROVIDERS' OFFICES AND THEIR STAFF EDUCATED-NUMBER OF HOUSEHOLDS REACHED WITH DOOR TO DOOR MESSAGING-NUMBER OF NEW FAMILIES OF NEWBORNS REACHED THROUGH MAILINGS-NUMBER OF COMMUNITY EVENTS-NUMBER OF PEOPLE REACHED DURING COMMUNITY EVENTS-PHONE SURVEY (100 RANDOM CALLS THROUGHOUT THE TOWNSHIPS) TO ASSESS NUMBER OF PEOPLE REACHED VIA CAMPAIGN-NUMBER OF PRE K - 5TH GRADE CLASSES PROVIDED WITH DENTAL SUPPLIES AND EDUCATIONAL PRESENTATIONS IN THE SPRING AND FALL-NUMBER OF STUDENTS REACHED"

PART V, SECTION B, LINE 11 CONTINUED:
-NUMBER OF SCHOOLS THAT AGREE TO ADOPT CLASSROOM DENTAL CARE PRACTICE CHANGE FOR PRE K- 5TH GRADEPROJECT YEAR 2-NUMBER POTENTIALLY REACHED IN 2020 WITH BILL BOARD MESSAGING CREATED ON 2019-NUMBER OF SCHOOLS THAT AGREE TO CLASS ROOM SUGARY SWEETENED BEVERAGES PRACTICE CHANGE (PLEDGE) -NUMBER OF COMMUNITY PARTNERS AGREED TO SUGARY SWEETENED BEVERAGES PRACTICE CHANGE FOR MEETINGS AND EVENTS (PLEDGE)-NUMBER OF BUSINESSES THAT AGREE TO SUGARY SWEETENED BEVERAGES PRACTICE CHANGE FOR MEETINGS AND EVENTS (PLEDGE)-NUMBER OF PRE K - 5TH GRADE CLASSES PROVIDED WITH DENTAL SUPPLIES AND SUGARY SWEETENED BEVERAGES EDUCATIONAL PRESENTATIONS -NUMBER OF STUDENTS REACHED-INCREASE THE NUMBER OF SCHOOLS ADOPTING CLASSROOM DENTAL PRACTICE CHANGE BY 1-SUGARY SWEETENED BEVERAGES CONSUMPTION AMONG NYS ADULTS BY COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM -PREVALENCE OF OBESITY AMONG NYS ADULTS BY COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEMPROJECT YEAR 3-PROVIDERS TO SCREEN AND COUNSEL PATIENTS REGARDING SUGARY SWEETENED BEVERAGES CONSUMPTION AS PART OF ROUTINE MEDICAL CARE-NUMBER OF CHENANGO MEMORIAL HOSPITAL PROVIDERS CURRENTLY SCREENING AND COUNSELLING -NUMBER OF CHENANGO MEMORIAL HOSPITAL PROVIDERS THAT AGREE TO PRACTICE CHANGE-NUMBER OF BASSETT AND PRIVATE PROVIDERS CURRENTLY SCREENING AND COUNSELLING -NUMBER OF BASSETT AND PRIVATE PROVIDERS THAT AGREE TO PRACTICE CHANGE-NUMBER OF DENTISTS CURRENTLY SCREENING AND COUNSELLING -NUMBER OF DENTISTS THAT AGREE TO PRACTICE CHANGE-INCREASE THE NUMBER OF SCHOOLS ADOPTING CLASSROOM DENTAL PRACTICE CHANGE BY 1-SUGARY SWEETENED BEVERAGES CONSUMPTION AMONG NYS ADULTS BY COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM-PREVALENCE OF OBESITY AMONG NYS ADULTS BY COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEMPROJECTED (OR COMPLETED) YEAR 1 INTERVENTIONS1.CAMPAIGN CREATION (3 PRONGED APPROACH - PARTNERS, PROVIDERS AND COMMUNITY)2.CAMPAIGN PRESENTATIONS TO PARTNERS AND THEIR STAFF, PROVIDERS AND OFFICE STAFF, AND COMMUNITY AT LARGE3.CUPS WITH CAMPAIGN MESSAGING DEVELOPED AND DISTRIBUTED DURING EDUCATIONAL OPPORTUNITIES (5,000+)4.WORK WITH THE DENTAL TASK FORCE TO COMBINE MESSAGING PROJECTED YEAR 2 INTERVENTIONS1.WORK WITH COMMUNITY SCHOOLS TO PROVIDE PRESENTATIONS TO STUDENTS, MESSAGING IN SCHOOLS AND SUGARY SWEETENED BEVERAGES PRACTICE CHANGE2.WORK WITH COMMUNITY PARTNERS AROUND SUGARY SWEETENED BEVERAGES PRACTICE CHANGE3.WORK WITH BUSINESSES AROUND SUGARY SWEETENED BEVERAGES PRACTICE CHANGE4.INCREASE THE NUMBER OF SCHOOLS ADOPTING CLASSROOM DENTAL PRACTICE CHANGE PROJECTED YEAR 3 INTERVENTIONS1.WORK WITH PROVIDERS (PHYSICIANS AND DENTISTS) TO SCREEN AND COUNSEL ABOUT SUGARY SWEETENED BEVERAGES CONSUMPTION AS PART OF ROUTINE MEDICAL CARE 2.INCREASE THE NUMBER OF SCHOOLS ADOPTING CLASSROOM DENTAL PRACTICE CHANGE (BRUSHING IN THE CLASSROOM)IMPLEMENTATION PARTNERS, ROLES(S) AND RESOURCESLOCAL HEALTH DEPARTMENTSUGARY SWEETENED BEVERAGESCREATE AND FACILITATE SUGARY SWEETENED BEVERAGE CAMPAIGNDENTALFUNDING, VOLUNTEERS, PRESENTATIONS IN SCHOOLSBUSINESSESSUGARY SWEETENED BEVERAGESADVOCATE FOR WORKSITE PRACTICE CHANGEDENTALFRONTIER - VOLUNTEERNBT BANK - VOLUNTEERBLUEOX - VOLUNTEERCOMMUNITY-BASED ORGANIZATIONSSUGARY SWEETENED BEVERAGESADVOCATE FOR WORKSITE PRACTICE CHANGEDENTAL CHENANGO UNITED WAY - FORMATION OF DENTAL TASKFORCE, FUNDING, VOLUNTEER CHENANGO HEALTH NETWORK - FUNDING, VOLUNTEERNORWICH ROTARY - FUNDING, VOLUNTEERROGERS CENTER - HOST EVENTS/SPACE, VOLUNTEERHEALTH INSURANCE PLANSDENTALFIDELIS - FUNDINGHOSPITALSUGARY SWEETENED BEVERAGESUHS CHENANGO MEMORIAL HOSPITAL COMMUNITY HEALTH ADVOCATE - FACILITATE SUGARY SWEETENED BEVERAGES PRACTICE CHANGE AMONG THEIR PROVIDERS

PART V, SECTION B, LINE 11 CONTINUED:
K-12 SCHOOLSUGARY SWEETENED BEVERAGESPLEDGE TO ADOPT CLASSROOM PRACTICE CHANGEPROMOTE MESSAGING IN SCHOOLSDENTALADOPT CLASSROOM PRACTICE CHANGEPROJECT YEAR 1-11 SCHOOLS PROVIDED WITH DENTAL SUPPLIES (ZIP BAGS, TOOTHBRUSHES, TOOTHBRUSH COVERS AND TOOTHPASTE) TWICE DURING THE SCHOOL YEAR (4000 CHILDREN IMPACTED)-11 SCHOOLS ACCEPTED THE INITIAL DENTAL PRESENTATION (4000 CHILDREN IMPACTED)-UNADILLA VALLEY CENTRAL SCHOOL - ROLE MODEL FOR CLASSROOM PRACTICE CHANGE-PERRY BROWN - ADOPTED CLASSROOM PRACTICE CHANGE -STANFORD GIBSON - ADOPTED CLASSROOM PRACTICE CHANGE-HOLY FAMILY - ADOPTED CLASSROOM PRACTICE CHANGEMEDIASUGARY SWEETENED BEVERAGESEVENING SUN - RUN PRESS RELEASESPARK OUTDOORS - ASSIST WITH BILLBOARD ADSLOCAL RADIO - ASSIST WITH ADSPROVIDERSSUGARY SWEETENED BEVERAGESADVOCATE FOR STAFF TRAINING, PRACTICE CHANGE AROUND SUGARY SWEETENED BEVERAGESPROVIDERS - SCREEN AND EDUCATE DURING MEDICAL VISITSOTHERDENTALCARE COMPASS NETWORK, DSRIP - DONATION COLLECTIONOFFICE FOR THE AGINGSUGARY SWEETENED BEVERAGESADVOCATE FOR MESSAGING CAMPAIGN2019 UPDATE DENTAL INITIATIVE AND RETHINK YOUR DRINK INITIATIVE 2019 UPDATE FOUR CHENANGO COUNTY SCHOOLS HAVE STUDENTS BRUSHING THEIR TEETH IN SCHOOL TO DEVELOP HEALTHY HABITS. ALONG WITH IN-SCHOOL TEETH BRUSHING THE CHENANGO DENTAL TASKFORCE HAS 2 DROP-OFFS A YEAR FOR DENTAL HYGIENE BAGS FOR ALL STUDENTS PRE-K THROUGH 5TH GRADE. CHENANGO COUNTY PUBLIC HEALTH HAS PARTNERS ON THIS INITIATIVE AND IS PLANNING THEIR NEXT DROP-OFF AND EDUCATION TO BE FOCUSED AROUND DRINKING WATER AND DENTAL HEALTH. BELOW ARE THE STATISTICS FROM OUTREACH FROM THE CHENANGO DENTAL TASKFORCE AND RETHINK YOUR DRINK INITIATIVE. THE RETHINK YOUR DRINK HAS ALSO BEEN OUTREACHING TO COMMUNITY BUSINESSES FOR PLEDGES TO ONLY SERVE WATER, COFFEE OR TEA AT STAFF MEETINGS AND GATHERINGS. ANY BUSINESS THAT PLEDGES WILL BE HIGHLIGHTED ON A BILLBOARD IN THE SPRING OF 2020.NUMBER OF COMMUNITY PARTNERS 23 AND THEIR STAFF EDUCATED 224NUMBER OF PROVIDERS' OFFICES 12 AND THEIR STAFF EDUCATED 114NUMBER OF HOUSEHOLDS REACHED WITH DOOR TO DOOR MESSAGING 5,085NUMBER OF NEW FAMILIES OF NEWBORNS REACHED THROUGH MAILINGS 402NUMBER OF COMMUNITY EVENTS 5,125NUMBER OF PEOPLE REACHED DURING COMMUNITY EVENTS WERE 97PHONE SURVEY (100 RANDOM CALLS THROUGHOUT THE TOWNSHIPS) TO ASSESS NUMBER OF PEOPLE REACHED VIA CAMPAIGN, 28 HEARD OF IT, 72 NOT NUMBER OF PRE K - 5TH GRADE CLASSES PROVIDED WITH DENTAL SUPPLIES AND EDUCATIONAL PRESENTATIONS IN THE SPRING AND FALL 98NUMBER OF STUDENTS REACHED WERE 3,740NUMBER OF SCHOOLS AGREED TO ADOPT CLASSROOM DENTAL CARE PRACTICE CHANGE FOR PRE K- 5TH GRADE WERE 3 SCHOOLS. 2020 UPDATE DENTAL INITIATIVE AND RETHINK YOUR DRINK INITIATIVETHIS INITIATIVE WAS STALLED DURING 2020 BECAUSE OF THE INABILITY TO GET INTO THE SCHOOLS DURING THE PANDEMIC. PRIOR TO THE PANDEMIC, 3,740 STUDENTS PRE K-5TH GRADE RECEIVED DENTAL SUPPLIES AND EDUCATIONAL PRESENTATIONS. IN TOTAL, 10,366 DENTAL KITS CONSISTING OF A TOOTHBRUSH, TOOTHPASTE AND DENTAL FLOSS WERE DISTRIBUTED TO 12 ELEMENTARY SCHOOLS THROUGHOUT CHENANGO COUNTY. DENTAL SUPPLIES WERE ALSO DISTRIBUTED TO THE EMMANUEL SOUL KITCHEN THAT PROVIDES A FREE MEAL ONCE A MONTH; HELPING HANDS THAT DISTRIBUTES FOOD AND SUPPLIES TO THE NEEDY; AND NOURISHING NY THAT HELPS PEOPLE WHO ARE FOOD INSECURE TO ACCESS THE NOURISHMENT THEY NEED. ALL OF THE SUPPLIES WERE DONATED, PRIMARILY FROM EXCELLUS BLUE CROSS/BLUE SHIELD. THIS INITIATIVE WILL RESUME WHEN SCHOOLS RETURN TO NORMAL ACTIVITIES.DESPITE THE PANDEMIC, THE LHD CONTINUED TO PROMOTE THE RETHINK YOUR DRINK PROGRAM USING A MULTI-FACETED APPROACH TO REACH THE MOST PEOPLE POSSIBLE IN A SOCIALLY DISTANT MANNER.-A BILLBOARD APPEARED IN A DIFFERENT LOCATION EACH MONTH REACHING AN ESTIMATED 20,500 DRIVERS PER MONTH FOR A TOTAL OF 205,000. -2 SCHOOLS (MIDDLE AND HIGH SCHOOL) AGREED TO HAVE WATER ONLY IN CLASS.-12 SCHOOLS (MIDDLE AND HIGH SCHOOL) PLEDGED TO CHANGE TO WATER ONLY IN CLASS. THESE SCHOOLS ALSO RECEIVED A 6'X4' BANNER ACKNOWLEDGING THEIR COMMITMENT.-THE LHD PRESENTED INFORMATION AND EDUCATION ABOUT THE PROGRAM TO 12 ELEMENTARY SCHOOLS.-THE LHD SURVEYED HEALTH PARTNERS IN THE AREA. SIX (6) REPORTED THEY CURRENTLY SERVE WATER ONLY. THE LHD MET WITH ANOTHER 17 INCLUDING CHENANGO COUNTY HOSPICE, UNITED WAY,

PART V, SECTION B, LINE 11 CONTINUED:
CHENANGO COUNTY BEHAVIORAL HEALTH, WIC, HEADSTART, AND THE YMCA. ALL PLEDGED TO CHANGE TO WATER ONLY.-THE LHD MET WITH 5 LARGE EMPLOYERS IN THE AREA AND THEY TOO PLEDGED TO CHANGE TO SERVING ONLY WATER.-A RETHINK YOUR DRINK INSERT WAS INCLUDED IN THE LOCAL PENNYSAVER THAT HAS A CIRCULATION OF 16,000 READERS.-A RETHINK YOUR DRINK DOOR-TO-DOOR MESSAGING CAMPAIGN REACHED 5,085 HOUSEHOLDS.-RETHINK YOUR DRINK INFORMATION WAS INCLUDED IN 422 BIRTH PACKETS MAILED TO PARENTS OF NEWBORNS.LOOKING AHEAD, THE GROUP IS RECONSIDERING THEIR OPTIONS DUE TO THE INABILITY TO GET INTO SCHOOLS AND OTHER PUBLIC FACILITIES TO INCREASE THE AWARENESS OF CONSUMING SUGARY BEVERAGES.2021 UPDATE DENTAL INITIATIVE AND RETHINK YOUR DRINK INITIATIVETHESE TWO INITIATIVES HAVE BOTH SLOWED DOWN OVER THE LAST FEW YEARS. SCHOOLS HAVE BEEN WILLING TO PROMOTE WATER IN SCHOOL AND SHOW INTEREST WHEN ASKED TO HELP SUPPORT. PROMOTIONAL MATERIALS HAVE NOT BEEN PRODUCED WITH THE SAME FREQUENCY AS YEARS PAST. THE DENTAL PUSH HAS ALSO BEEN SLOWED DOWN THROUGH SERVICES IN THE COUNTY DUE TO LOWER STAFFING LEVELS AND OTHER PRIORITIES.THESE PROGRAMS WILL BE LOOKED AT CAREFULLY AS WE MOVE FORWARD AND MAYBE A NEW STRATEGY WILL BE DEVELOPED IN ORDER TO HELP INTEGRATE INTO THE LOCAL SCHOOLS MORE EFFECTIVELY.OTHER INITIATIVESPRIORITY: PREVENT CHRONIC DISEASES FOCUS AREA: PHYSICAL ACTIVITYGOAL: INCREASE ACCESS, FOR PEOPLE OF ALL AGES AND ABILITIES, TO INDOOR AND/OR OUTDOOR PLACES FOR PHYSICAL ACTIVITIES.OBJECTIVE: BY DECEMBER 31, 2021: DECREASE THE PERCENTAGE OF ADULTS AGES 18 YEARS AND OLDER WITH OBESITY (AMONG ALL ADULTS). OBJECTIVE 1.7 - INCREASE THE PERCENTAGE OF ADULTS AGE 18 YEARS AND OLDER WHO PARTICIPATE IN LEISURE-TIME PHYSICAL ACTIVITY (AMONG ALL ADULTS).DISPARITIES: LOW-INCOME, GEOGRAPHYINTERVENTIONSCHENANGO HEALTHY CHALLENGE: A FREE RESOURCE FOR ALL COMMUNITY MEMBERS TO BECOME ENGAGED IN PHYSICAL ACTIVITY, HEALTHY EATING AND WHOLE HEALTH WELLNESS.FAMILY OF MEASURESPROJECT YEAR 1NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF INVOLVEDNUMBER OF FAMILIES INVOLVEDNUMBER OF PARTICIPANTSNUMBER OF ORGANIZATIONAL TEAMS NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ACTIVITYNUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR OVERALL HEALTHPROJECT YEAR 2INCREASE NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF INVOLVEDINCREASE NUMBER OF FAMILIES INVOLVEDINCREASE NUMBER OF PARTICIPANTSINCREASE NUMBER OF ORGANIZATIONAL TEAMSNUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ACTIVITYNUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR OVERALL HEALTHPROJECT YEAR 3NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF INVOLVEDNUMBER OF FAMILIES INVOLVEDNUMBER OF PARTICIPANTSNUMBER OF ORGANIZATIONAL TEAMS NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ACTIVITYNUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR OVERALL HEALTHPROJECTED (OR COMPLETED) YEAR 1 INTERVENTIONSLAUNCH THE CHENANGO HEALTHY CHALLENGEPROJECTED YEAR 2 INTERVENTIONSINCREASE THE NUMBER OF PARTICIPANTS WHO PARTICIPATE IN THE CHALLENGE AND COMPLETE ITPROJECTED YEAR 3 INTERVENTIONSTO HAVE THE SUPPORT OF COMMUNITY PARTNERS, BUSINESSES AND THE COMMUNITY AT LARGE TO EXTEND THE HEALTHY CHALLENGE BEYOND 2021IMPLEMENTATION PARTNERS, PARTNER ROLE(S) AND RESOURCESLOCAL HEALTH DEPARTMENTCHENANGO HEALTHY CHALLENGEVOLUNTEER, PROMOTE AND EDUCATE PARTICIPANTS AROUND SUGARY SWEETENED BEVERAGES MESSAGINGBUSINESSCHENANGO HEALTHY CHALLENGECHOBANI - DONATIONSWILLOW PRIMITIVE & BOUTIQUE - FACILITATE CLASSES AROUND CREATIVE THERAPY FOR EMOTIONAL AND SOCIAL HEALTHOTHER - PROMOTE TO STAFFHEADSTARTCHENANGO HEALTHY CHALLENGEVOLUNTEERHOSPITALCHENANGO HEALTHY CHALLENGEUHS CHENANGO MEMORIAL HOSPITAL, COMMUNITY HEALTH ADVOCATE - VOLUNTEER, PROMOTE TO HOSPITAL STAFF K-12 SCHOOLCHENANGO HEALTHY CHALLENGE

PART V, SECTION B, LINE 11 CONTINUED:
PROMOTE TO FAMILIES AND STAFFOFFICE OF THE AGINGCHENANGO HEALTHY CHALLENGEPROMOTE TO STAFF AND SENIORSHEALTHY CHENANGO 2019 UPDATEIN 2019 THE HEALTHY CHENANGO CHALLENGE FORMERLY KNOWN AS THE CHOBANI HEALTHY CHALLENGE WAS REFORMED TO A FUN AND FREE CHALLENGE FOR OUR COMMUNITY. OUR GOAL FOR 2019 WAS TO REESTABLISH THE CHALLENGE AND BRING ATTENTION BACK TO IT AND HELP TO PROMOTE OVERALL WELLBEING INCLUDING HEALTHY EATING AS WELL AS MENTAL, PHYSICAL, AND EMOTIONAL HEALTH. WE RAN THE CHALLENGE FROM LATE SUMMER INTO FALL SO WE COULD BUILD INTEREST BACKUP FOR OUR 2020 CHALLENGES. WE DEVELOPED AND HELD A SUCCESSFUL CHALLENGE AND BEGAN PLANNING FOR A MORE ROBUST CHALLENGE IN 2020. NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF INVOLVED 6-8NUMBER OF FAMILIES INVOLVED 6NUMBER OF PARTICIPANTS 107NUMBER OF ORGANIZATIONAL TEAMS 14 NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ACTIVITY 20NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR OVERALL HEALTH 45HEALTHY CHENANGO 2020 UPDATEDUE TO COVID-19, THE IN-PERSON EVENT WAS CANCELLED. INSTEAD, CHALLENGE ORGANIZERS ENGAGED PARTICIPANTS THROUGH SOCIAL MEDIA BY PROVIDING TIPS AND STRATEGIES TO HELP DURING THE QUARANTINE. POSTS INCLUDED TIPS ON HEALTHY LIVING, EATING, EXERCISE AND MENTAL HEALTH. THE FACEBOOK SITE HAS 100 ACTIVE PARTICIPANTS. IT IS HOPED A VIRTUAL CHALLENGE CAN BE HELD IN 2021. THE WALK/RUN IS NOW PART OF THE SUICIDE PREVENTION COALITION.HEALTHY CHENANGO 2021 UPDATETHIS INITIATIVE WILL CONTINUE TO STAY ON THE AGENDA AND LOOKED AT TO EXPAND ONCE THE PANDEMIC SUBSIDES.PRIORITY: PREVENT CHRONIC DISEASESFOCUS AREA: PREVENTIVE CARE AND MANAGEMENTGOAL: IN THE COMMUNITY SETTING, IMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH CHRONIC DISEASES, INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES AND PREDIABETES AND OBESITY.OBJECTIVE: BY DECEMBER 31, 2021 INCREASE THE PERCENTAGE OF ADULTS WITH CHRONIC CONDITIONS (ARTHRITIS, ASTHMA, CVD, DIABETES, CKD,) WHO HAVE TAKEN A COURSE OR CLASS TO LEARN HOW TO MANAGE THEIR CONDITION BY 5%. INCREASE HEALTH SYSTEM REFERRALS BY 5%. OVERALL, DECREASE A1CS BY 5% OF PARTICIPANTS THAT COMPLETED THE PROGRAM.DISPARITIES: LOW-INCOME, GEOGRAPHY, AGEINTERVENTIONS: CHN, UHS CHENANGO MEMORIAL HOSPITAL AND BASSETT HEALTH CARE: CHRONIC DISEASE SELF-MANAGEMENT PROGRAMEXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONEBASSET HEALTH CARE: NATIONAL DIABETES PREVENTION PROGRAMEXPAND ACCESS TO THE NATIONAL DIABETES PREVENTION PROGRAM (NATIONAL DPP), A LIFESTYLE CHANGE FOR PREVENTING TYPE 2 DIABETESFAMILY OF MEASURES:NUMBER OF HEALTH SYSTEMS THAT HAVE POLICIES & PRACTICES FOR IDENTIFYING AND REFERRING PATIENTS TO EVIDENCE-BASED SELF- MANAGEMENT EDUCATION (EBSMP) (PROGRAMS OFFERED: CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP), DIABETES SELF-MANAGEMENT PROGRAM (DSMP), PAIN SELF-MANAGEMENT PROGRAM (PSMP)NUMBER AND TYPE OF EVIDENCE-BASED SELF-MANAGEMENT EDUCATION PROGRAMS IN COMMUNITY SETTINGSNUMBER OF PATIENTS WHO PARTICIPATE IN EVIDENCE-BASED SELF-MANAGEMENT EDUCATION PROGRAMSPERCENTAGE OF PATIENTS WHO COMPLETE EVIDENCE-BASED SELF-MANAGEMENT EDUCATION PROGRAMSA1C PRE/POST FOR DIABETES MANAGEMENT PROGRAMOTHER PRE/POST FOR PAIN MANAGEMENT PROGRAMNUMBER OF HEALTH SYSTEMS THAT HAVE POLICIES & PRACTICES FOR IDENTIFYING AND REFERRING PATIENTS TO NATIONAL DIABETES PREVENTION PROGRAMS (NDPP) NUMBER OF NATIONAL DIABETES PREVENTION PROGRAMS IN COMMUNITY SETTINGSNUMBER OF PATIENTS REFERRED TO NATIONAL DIABETES PREVENTION PROGRAMSNUMBER OF PATIENTS WHO PARTICIPATE IN NATIONAL DIABETES PREVENTION PROGRAMSPERCENTAGE OF PATIENTS WHO COMPLETE NATIONAL DIABETES PREVENTION PROGRAMSPROJECTED (OR COMPLETED) YEAR 1 INTERVENTIONSOFFER:OCHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP)ODIABETES SELF-MANAGEMENT PROGRAM (DSMP)95% OF PARTICIPANTS REGISTERED COMPLETE THE PROGRAMPROJECTED YEAR 2 INTERVENTIONSOFFER: OCHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP)ODIABETES SELF-MANAGEMENT PROGRAM (DSMP)OPAIN SELF-MANAGEMENT PROGRAM (PSMP)UHS CHENANGO MEMORIAL HOSPITAL TO GENERATE REFERRALS VIA THEIR ELECTRONIC MEDICAL RECORDPROJECTED YEAR 3 INTERVENTIONS

PART V, SECTION B, LINE 11 CONTINUED:
OFFER:OCHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP)ODIABETES SELF-MANAGEMENT PROGRAM (DSMP)OPAIN SELF-MANAGEMENT PROGRAM (PSMP)INSTITUTE THE NATIONAL DIABETES PREVENTION PROGRAM (NDPP)IMPLEMENTATION PARTNERS, PARTNER ROLE(S) AND RESOURCESLOCAL HEALTH DEPARTMENTCHRONIC DISEASE SELF-MANAGEMENTREFERRALS, OUTREACH, AND CLASS PROMOTIONCOMMUNITY-BASED ORGANIZATIONCHRONIC DISEASE SELF-MANAGEMENTCHENANGO HEALTH NETWORK - FUNDING, PROGRAM FACILITATORS, SPACE, REFERRALS, OUTREACH AND EDUCATION ABOUT CLASSES, ADVERTISE THE CLASSES, COLLECTING AND TRACKING DATA IN GSINORWICH FAMILY YMCA - SPACE, OUTREACH AND EDUCATION ABOUT CLASSES, AND ADVERTISE THE CLASSESHOSPITALCHRONIC DISEASE SELF-MANAGEMENT UHS CHENANGO MEMORIAL HOSPITAL - FUNDING, PROGRAM FACILITATORS, SPACE, REFERRALS VIA PROVIDERS AND EMR, OUTREACH AND PROMOTIONBASSETT - FACILITATE NATIONAL DIABETES PREVENTION PROGRAM, FUNDING, REFERRALS, OUTREACH AND PROMOTION.PROVIDERSCHRONIC DISEASE SELF-MANAGEMENTPROMOTE AND REFERRAL SOURCEOTHERCHRONIC DISEASE SELF-MANAGEMENT CARE COMPASS NETWORK, DSRIP - OUTREACH AND PROMOTIONOFFICE OF THE AGINGCHRONIC DISEASE SELF-MANAGEMENTSPACE, REFERRAL, OUTREACH AND PROMOTION 2019 UPDATE - CHRONIC DISEASE SELF MANAGEMENT AND DIABETES SELF MANAGEMENTTHERE WAS 1 CDSMP CLASS HELD AND 2 DSMP CLASSES IN 2019, ABOUT 30 COMMUNITY MEMBERS BENEFITED FROM THE WORKSHOPS. WITH COMMUNITY COLLABORATION AND PARTNERSHIPS WE ARE PLANNING TO HOLD MORE WORKSHOPS IN 2020.2020 UPDATE - CHRONIC DISEASE SELF MANAGEMENT AND DIABETES SELF MANAGEMENTBASSETT HEALTHCARE OFFERED VIRTUAL SESSIONS BUT THEY WERE POORLY ATTENDED. IT IS UNKNOWN IF THEY CONTINUED THE SESSIONS DURING THE PANDEMIC BUT THEY DO PLAN TO CONTINUE TO OFFER THEM IN 2021.THE LHD AND CHENANGO HEALTH NETWORK ARE LOOKING FOR PEOPLE TO BECOME TRAINERS FOR THESE PROGRAMS. DURING THE PANDEMIC, TRAINING TRANSITIONED TO A VIRTUAL FORMAT MAKING IT EASIER FOR PEOPLE TO COMPLETE THE TRAINING. ADDITIONALLY, THE SELF-MANAGEMENT CLASSES ALSO TRANSITIONED TO A VIRTUAL FORMAT MAKING IT EASIER FOR PEOPLE TO ATTEND IN THIS RURAL ENVIRONMENT.2021 UPDATE - CHRONIC DISEASE SELF-MANAGEMENT AND DIABETES SELF-MANAGEMENTTHE LHD AND CHENANGO HEALTH NETWORK CONTINUE TO WORK TOWARD COMMUNITY EDUCATION THROUGH CLASS PARTICIPATION AND COMMUNITY COLLABORATION. THIS INITIATIVE HAS STARTED TO REGAIN STRENGTH OVER THE LAST SEVERAL MONTHS AND HAS A STRONG FUTURE IN 2022 AFTER THE PANDEMIC IS UNDER CONTROL.

PART I, LINE 7:
A COMBINATION OF IRS PROVIDED WORKSHEETS AND THE RATIO OF PATIENT CARE COST TO CHARGES WAS USED.

PART I, LN 7 COL(F):
100% OF THE ANNUAL BAD DEBT EXPENSE OF $2,614,755 WAS NOT INCLUDED IN THE CALCULATION OF NET BENEFIT EXPENSE.

PART III, LINE 2:
THE COST OF BAD DEBTS IS TAKEN FROM THE 2021 AUDITED FINANCIAL STATEMENTS.

PART III, LINE 3:
THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON A PERCENTAGE ALLOCATION APPLIED TO THE TOTAL BAD DEBT EXPENSE REPORTED ON THE AUDITED FINANCIAL STATEMENTS. THE PERCENTAGE CALCULATION COMPARED THE 2021 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2021 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2021, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 19.91% OF THE TOTAL BAD DEBT WRITE-OFFS.

PART III, LINE 4:
THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON A PERCENTAGE ALLOCATION APPLIED TO THE TOTAL BAD DEBT EXPENSE REPORTED ON THE AUDITED FINANCIAL STATEMENTS. THE PERCENTAGE CALCULATION COMPARED THE 2021 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2021 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2021, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 19.91% OF THE TOTAL BAD DEBT WRITE-OFFS.

PART III, LINE 8:
CMH FEELS THAT ANY SERVICES PROVIDED TO MEDICARE BENIFICIARIES THAT RESULTS IN A SHORTFALL TO THE ORGANIZATION BASED ON A LESS THAN ADEQUATE MEDICARE REIMBURSEMENT SHOULD BE TREATED AS A COMMUNITY BENEFIT. CMH TREATS ANY AND ALL COMMUNITY MEMBERS REGARDLESS OF ABILITY TO PAY. CMH'S SERVICE REGION HAS A HIGHER PROPORTION OF ELDERLY THAN THE U.S. AVERAGE. THEREFORE, CMH IS SERVICING AT RISK MEDICARE BENEFICIARIES WITH ALL ITS PROGRAMS AND SERVICES.

PART III, LINE 9B:
THE ORGANIZATION'S COLLECTION POLICY PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE AS FOLLOWS:CHARITY CARE IS GIVEN FIRST, THE REMAINING BALANCE, IS THEN SUBJECT TO AN INTEREST FREE PAY PLAN. IF THE PATIENT GUARANTOR CHOOSES TO IGNORE ALL FURTHER ATTEMPTS TO MAKE ARRANGEMENTS FOR PAYMENTS, AFTER 180 DAYS THE ACCOUNT IS SENT TO A COLLECTION AGENCY AT THE DISCOUNTED LEVEL.CMH'S POLICY CLEARLY STATES THAT THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE, LIQUIDATION OF RETIREMENT ASSETS OR COLLEGE SAVINGS, AND THE SALE OF A CAR USED REGULARLY ARE NOT PERMITTED. THE POLICY ALSO PROHIBITS COLLECTION FROM PATIENTS WHO ARE DETERMINED TO BE ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE.CMH REFRAINS FROM SENDING AN ACCOUNT TO COLLECTION AGENCIES IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION AND THE REQUIRED DOCUMENTATION ARE PROVIDED. CMH PROVIDES WRITTEN NOTICE NO LESS THAN 30 DAYS PRIOR TO REFERRING DEBTS TO COLLECTION AGENCIES AND WILL REFRAIN FROM INITIATING ANY EXTRAORDINARY COLLECTION ACTS FOR AT LEAST 120 DAYS FROM THE DATE OF THE FIRST DISCHARGE BILLING STATEMENT. CMH ALSO REQUIRES THAT COLLECTION AGENCIES FOLLOW THE FINANCIAL ASSISTANCE POLICY GUIDELINES AND MUST RECEIVE WRITTEN CONSENT FROM UHSH BEFORE COMMENCING LEGAL ACTION.

PART VI, LINE 2:
"IN BETWEEN CHNA SUBMITTALS, UHS CHENANGO MEMORIAL HOSPITAL (CMH) USES IN-PATIENT AND OUT-PATIENT SURVEYS ADMINISTERED THROUGH PRESS GANEY TO COLLECT PATIENT INPUT. ALL CMH PATIENTS, BOTH IN-PATIENT AND OUT-PATIENT, RECEIVE EASY-TO-COMPLETE FORMS ASKING THEM QUESTIONS ABOUT THE CARE ISSUES THEY FEEL NEED TO BE ADDRESSED, AND SERVICES THAT NEED TO BE IMPROVED OR ADDED. PATIENTS PROVIDE VALUABLE INFORMATION IN THE ""COMMENTS"" SECTION OF THESE SURVEYS. EACH MONTH, THE SURVEY SCORES ARE COMPARED TO A ROLLING 12-MONTH AVERAGE AND TARGETS. THE TARGETS ARE BASED ON NATIONAL AVERAGES TO DETERMINE IF CMH IS AT OR ABOVE TARGET, WITHIN 10% OF APPROACHING TARGET, OR IS MORE THAN 10% BELOW TARGET. THE PROCESS FOR COMPILING AND REPORTING THIS DATA HAS BEEN CUMBERSOME AND TIME CONSUMING. IN 2019, CMH IDENTIFIED THREE OPPORTUNITIES TO IMPROVE THE PROCESS: 1) DEVELOP MORE PURPOSEFUL, CONSISTENT VISUALS (CHARTS) ACROSS SURVEY TYPES, 2) CREATE MORE USEFUL PATIENT COMMENT SHARING - FOR BOTH SUCCESSES AND REMINDERS OF AREAS FOR IMPROVEMENT, AND 3) INCREASE STAFF INVOLVEMENT WITH MORE TRANSPARENCY ON PERFORMANCE AND CREATE A PLATFORM FOR EDUCATION.DEPARTMENTAL SURVEY SCORES ARE NOW SHOWN IN A ""SCORECARD"" FORMAT THAT IS A CLEANER VISUAL AND IS EASY TO USE AND MODIFY. IT IS ALSO A BETTER REPRESENTATION OF ACTUAL PERFORMANCE ILLUSTRATING CAHPS AND HCAHPS SCORES AS WELL AS PATIENT COMMENTS. CMH'S PATIENT EXPERIENCE TEAM REVIEWS THE CHARTS MONTHLY AND DEPARTMENT LEADERS SHARE THE CHARTS WITH THEIR STAFF SO THEY CAN SEE PROGRESS AGAINST TARGETS AND READ PATIENT COMMENTS. PATIENT COMMENTS THAT REQUIRE MANAGEMENT CONSIDERATION ARE FORWARDED TO THE APPROPRIATE LEADERS FOR REVIEW AND DISCUSSION TO IMPROVE SERVICES.LIVING IN A SMALL COMMUNITY, WE ALSO GET SUGGESTIONS DIRECTLY FROM RESIDENTS ABOUT SERVICES THAT ARE NEEDED OR NEED IMPROVEMENT. HOSPITAL BOARD MEMBERS, AUXILIARY BOARD MEMBERS, AND FOUNDATION BOARD MEMBERS ARE VERY VOCAL ABOUT WHAT THEY ARE HEARING IN THE COMMUNITY OR EXPERIENCING THEMSELVES. EMPLOYEES ARE QUITE CRITICAL ABOUT THEIR OR THEIR FAMILY'S EXPERIENCES IN ALL FACETS OF PATIENT CARE PROVIDING VALUABLE FEEDBACK WITH A TRAINED EYE. BASED ON THIS FEEDBACK AND THOSE OF PATIENTS CALLING IN OR VISITING PROVIDERS, THE HOSPITAL HAS DEVELOPED THE FOLLOWING INITIATIVES.THE HOSPITAL HAS USED OTHER MEANS FOR COLLECTING COMMUNITY INPUT BETWEEN NEEDS ASSESSMENTS. FOCUS GROUPS HAVE BEEN USED TO DISCUSS A SPECIFIC NEED THAT HAS BEEN IDENTIFIED AND REQUIRES FURTHER RESEARCH. FOCUS GROUPS WERE HELD DURING OUR MOST RECENT NEEDS ASSESSMENT PROCESS AND MORE INFORMATION ABOUT THAT IS AVAILABLE IN PART V, SECTION C - SUPPLEMENTAL INFORMATION FOR PART V, SECTION B.CMH ALSO LOOKS AT DIAGNOSIS CODES AND MARKET DATA PERIODICALLY TO DETECT DEVELOPING TRENDS AND ADDRESS THEM AS NEEDED.LASTLY, THE HOSPITAL'S VP OF SERVICE COORDINATION & DEVELOPMENT IS CHAIRMAN OF THE CHENANGO HEALTH NETWORK (CHN). THE CHN IS CHENANGO COUNTY'S RURAL HEALTH NETWORK. THE BOARD CONSISTS OF 13 COMMUNITY LEADERS REPRESENTING A CROSS SECTION OF HEALTH CARE SERVICES IN THE AREA. THIS GROUP MEETS MONTHLY AND DISCUSSES HEALTH CARE CONCERNS AND OPPORTUNITIES IN THE COMMUNITY AND INITIATES SUBCOMMITTEES TO ADDRESS SPECIFIC ISSUES AS NEEDED."

PART VI, LINE 4:
"CHENANGO COUNTY IS A RURAL COUNTY WITH TWO PRIMARY DISPARITIES: SOCIO-ECONOMIC AND AGE. THE COUNTY IS LOCATED IN SOUTH-CENTRAL NEW YORK STATE IN THE AREA REFERRED TO AS THE SOUTHERN TIER. THE COUNTY IS ALSO LOCATED IN THE APPALACHIAN REGION OF THE UNITED STATES. PER GOOGLE MAPS, CHENANGO COUNTY IS 126.5 MILES WEST OF ALBANY, NEW YORK STATE'S CAPITAL, AND 211 MILES NORTHWEST OF NEW YORK CITY. PER THE US CENSUS BUREAU, ITS LAND AREA ENCOMPASSES 899 SQUARE MILES WITH 56.5 PERSONS PER SQUARE MILE. CONTIGUOUS COUNTIES ARE MADISON, OTSEGO, DELAWARE, BROOME, AND CORTLAND. THERE ARE 21 TOWNS, 8 VILLAGES AND 1 CITY IN CHENANGO COUNTY. THE CITY OF NORWICH IS THE COUNTY SEAT WHERE THE LARGEST SEGMENT OF THE POPULATION RESIDES. UHS CHENANGO MEMORIAL HOSPITAL, LOCATED IN NORWICH, IS A NYS DESIGNATED RURAL HOSPITAL AND IS THE ONLY HOSPITAL IN THE COUNTY. THE MAJORITY OF RESIDENTS (60%) LIVE WITHIN 10 MILES OF NORWICH, MAKING NORWICH A GOOD LOCATION FOR TIMELY CARE. THE REMAINING 40% LIVE IN MORE REMOTE AREAS OF THE COUNTY, DETERRED BY GEOGRAPHY AS A PHYSICAL BARRIER TO ACCESS. THE COUNTY'S LARGER POPULATION CENTERS ARE LOCATED ALONG NYS ROUTE 12 AND THE CHENANGO AND UNADILLA RIVERS WHICH RUN NORTH TO SOUTH THROUGH THE CENTER OF THE COUNTY. GREENE, NORWICH, AND SHERBURNE ARE THE MOST POPULOUS TOWNS SITUATED ALONG THE ROUTE 12 CORRIDOR. THERE ARE 2 INTERSTATE HIGHWAYS ACCESSIBLE TO CHENANGO COUNTY RESIDENTS: I-88 AND I-81. INTERSTATE 88 INTERSECTS WITH CHENANGO COUNTY AT BAINBRIDGE AND IS ACCESSIBLE FROM DELAWARE AND BROOME COUNTIES. INTERSTATE 81 IS ACCESSIBLE FROM BROOME AND CORTLAND COUNTIES; NYS ROUTE 12 BISECTS THE COUNTY AND IS THE MAJOR NORTH-SOUTH ROUTE.TRAVEL DISTANCES TO THE NEAREST HOSPITALS ARE AS FOLLOWS:A.O. FOX HOSPITAL, ONEONTA, NY, IS 32 MILES OR 45 MINUTESM.I. BASSETT HEALTHCARE, COOPERSTOWN, NY, IS 44 MILES OR 1 HOURUHS BINGHAMTON GENERAL HOSPITAL, NY, IS 43 MILES OR 1 HOURCOMMUNITY MEMORIAL HOSPITAL (CRITICAL ACCESS), HAMILTON, NY, IS 22 MILES OR 30 MINUTESCORTLAND REGIONAL MEDICAL CENTER, NY, IS 43 MILES OR 1 HOURCROUSE HOSPITAL, SYRACUSE, NY, IS 58 MILES OR 1 HOUR, 15 MINUTESMOHAWK VALLEY MEDICAL HEALTH SYSTEM, UTICA, NY, IS 47 MILES OR 1 HOUROUR LADY OF LOURDES HOSPITAL, JOHNSON CITY, NY, IS 42 MILES OR 1 HOURST. JOSEPH'S HOSPITAL, SYRACUSE, NY, IS 58 MILES OR 1 HOUR, 15 MINUTESSYRACUSE VA MEDICAL CENTER, NY, IS 58 MILES OR 1 HOUR, 15 MINUTESTRI TOWN REGIONAL HOSPITAL (ED ONLY), NY, 22 MILES OR 30 MINUTESUHS WILSON MEDICAL CENTER, BINGHAMTON, NY, IS 43 MILES OR 1 HOURUPSTATE UNIVERSITY HOSPITAL, SYRACUSE, NY IS 58 MILES OR 1 HOUR, 15 MINUTES.THE ONLY EMERGENCY ROOM (ER) IN CHENANGO COUNTY IS LOCATED AT CHENANGO MEMORIAL. THE ER IS PHYSICIAN STAFFED 24/7 AND THERE ARE OVER 18,000 VISITS PER YEAR. ACCORDING TO THE DSRIP COMMUNITY HEALTH ASSESSMENT, THE ER IS VIEWED BY SOME RESIDENTS AS AN ""ALWAYS AVAILABLE"" OPTION FOR HEALTH AND DENTAL SERVICES AND IS OFTEN VISITED BECAUSE OF CONVENIENCE AND ACCESSIBILITY. SOME RESIDENTS CONSIDER THE ER AS AN ACCEPTABLE LOCATION TO RECEIVE ""ANY TYPE"" OF MEDICAL CARE, NOT JUST WHEN LIFE-THREATENING HEALTHCARE IS NEEDED. SIGNIFICANT DRIVERS FOR USING THE ER INCLUDE READY TRANSPORTATION, ONE-STOP SHOPPING (X-RAY, LAB, SPECIALISTS, MEDICATIONS) ALL UNDER ONE ROOF, ABILITY TO ALWAYS ""BE SEEN BY A DOCTOR"", SHORTAGE OF OTHER HEALTHCARE RESOURCES (PROVIDERS), AND NO OUT OF POCKET, UP-FRONT COSTS.DEMOGRAPHICALLY, 95% OF THE COUNTY'S POPULATION (49,286) IS PREDOMINANTLY WHITE NON-HISPANIC. THE REMAINING POPULATION INCLUDES HISPANIC, LATINO, OR PERSONS WHO IDENTIFY AS BEING OF TWO OR MORE RACES. 85.8% OF THE COUNTY'S POPULATION IS CATEGORIZED AS LIVING IN RURAL AREAS. CHENANGO COUNTY IS 49TH IN TOTAL POPULATION AMONG THE 62 COUNTIES IN NEW YORK STATE AND HAS BEEN EXPERIENCING A STEADY DECLINE IN ITS OVERALL POPULATION. THE AGE OF THE COUNTY'S RESIDENTS HAS BEEN CHANGING AS WELL. THE MEDIAN AGE HAS INCREASED TO 44.9 YEARS FROM 43 YEARS IN 2010. THE GROUP THAT HAS SEEN THE LARGEST INCREASE DURING THIS TIME IS ADULTS AGED 65 TO 79, WITH A POPULATION INCREASE FROM 11.6% IN 2010 TO 14.5% IN 2017. IT IS ANTICIPATED THAT THE POPULATION OF RESIDENTS BETWEEN 45 AND 64 WILL DECREASE FROM 29.8% TO 28.1% IN 2020 AND THEN TO 23.6% IN 2030. HOWEVER, THE POPULATION OF RESIDENTS OVER 65 YEARS WILL INCREASE FROM 18.9% TO 21.85% IN 2020 AND TO 27.5% BY 2030 DUE TO RESIDENTS AGING IN PLACE. ALL TOTALED, IT IS PROJECTED THE PERCENTAGE OF RESIDENTS IN CHENANGO COUNTY OVER 45 WILL INCREASE TO 49.9% IN 2020 AND TO 51.1% BY 2030.THE MEDIAN FAMILY INCOME FOR CHENANGO COUNTY IS $58,675 IN COMPARISON TO THE REST OF NEW YORK STATE WITH AN AVERAGE FAMILY INCOME OF $74,036. THE MAJORITY OF JOBS ARE IN EDUCATION, HEALTH AND HUMAN SERVICE SECTORS. MANUFACTURING AND RETAIL TRADE ARE THE NEXT LARGEST SECTORS FOR EMPLOYMENT. THE PERCENTAGE OF UNEMPLOYED RESIDENTS OF CHENANGO COUNTY FROM DATA OF DECEMBER 2019 WAS 4.9% COMPARED TO NEW YORK STATE'S UNEMPLOYMENT RATE OF 4.0% DURING THE SAME TIME FRAME.CHENANGO COUNTY IS A POOR COUNTY WITH 15.4% OF ITS POPULATION AND 18.9% OF ITS CHILDREN LIVING BELOW THE FEDERAL POVERTY LEVEL. THE NUMBER OF CHILDREN AGED 0-17 LIVING IN POVERTY INCREASED FROM 18.7% IN 2010 TO 18.9% IN 2016. THE NUMBER OF CHILDREN IN GRADES K-6 WHO ARE ELIGIBLE FOR FREE OR REDUCED LUNCHES INCREASED FROM 50.5% IN 2009/2010 TO 58% IN 2017/2018. THIS INCREASE IS ALSO ABOVE THE NYS LEVEL OF 52.4%. OF THOSE FAMILIES WITH FEMALE HEADS OF HOUSEHOLD AND CHILDREN PRESENT, 44.2% LIVE IN POVERTY. OF THE 30,870 PEOPLE AGED 16-64 IN THE COUNTY, 72.3% (22,322) WORKED AT LEAST A PART-TIME FOR PART OF THE YEAR. IN 2016, 16.4% OF THE PEOPLE IN CHENANGO COUNTY AGED 18-64 IDENTIFIED AS HAVING A DISABILITY, AN INCREASE FROM 13.6% IN 2012.POOR ECONOMIC STATUS IS OFTEN ASSOCIATED WITH POOR HEALTH OUTCOMES AS THOSE WITHOUT MEANS ARE NOT IN A POSITION TO MAKE LIFESTYLE CHANGES TO PROMOTE GOOD HEALTH. IN CHENANGO COUNTY MANAGING EXPENSES RELATED TO FOOD, HOUSING, CLOTHING, TRANSPORTATION, CHILD CARE AND HEALTH CARE IS A MAJOR STRESSOR FOR INDIVIDUALS PARTICULARLY WITH FAMILIES AND SENIOR ADULTS. CHENANGO COUNTY'S POVERTY LEVELS BRING TO FOCUS FOOD INSECURITIES FOR THAT POPULATION. ONE OF THE ISSUES OF GENERATIONAL POVERTY (FAMILIES AND INDIVIDUALS LIVING IN POVERTY GENERATION TO GENERATION) THAT IS EVIDENT IN THE COUNTY IS THE UTILIZATION OF FOOD PANTRIES AND FREE MEAL PROGRAMS OFFERED BY AREA CHURCHES. RESIDENTS WITH FOOD INSECURITY LIVE DAY-TO-DAY TO PROVIDE FOR THEMSELVES AND THEIR FAMILIES; THEY FOCUS ON DAY-TO-DAY SURVIVAL VERSUS DEVELOPING STRATEGIES TO PREVENT FOOD INSECURITY AND OTHER HEALTH CONCERNS.ACCORDING TO THE 2019-2024 NYS PREVENTION AGENDA, 94.7% OF ADULTS IN THE COUNTY HAVE HEALTH INSURANCE WHICH IS ABOVE THE NEW YORK STATE RATE OF 92.4%. THIS IS AN IMPROVEMENT OF 1.5% SINCE 2013. DATA FROM DSRIP INDICATES THAT AS OF DECEMBER OF 2017, 29% OF THE CHENANGO COUNTY POPULATION (13,912 UNIQUE MEMBERS) WAS ENROLLED IN MEDICAID. THIS IS SLIGHTLY BELOW THE NYS RATIO OF 31.3% FOR THE SAME TIME PERIOD. THE NUMBER OF PEOPLE ENROLLED IN MEDICAID IN CHENANGO COUNTY HAS INCREASED BY 15.8% SINCE 2013 (12,003 UNIQUE MEMBERS), A RATE SLIGHTLY LOWER THAN NYS'S INCREASE OF 17.3%. THE INCREASE IN THE NUMBER OF MEDICAID ENROLLEES IS REFLECTED IN THE TREND TOWARD LOWER UNINSURED RATES. ACCORDING TO CENSUS DATA, THE PERCENTAGE OF THE COUNTY POPULATION WITHOUT INSURANCE DECLINED FROM 14% IN 2010 TO THE CURRENT LOW OF 5.3% IN 2017. THESE DATA ALSO SHOW THAT AS THE PERCENTAGE OF PEOPLE WHO ARE INSURED HAS INCREASED, THE DISTRIBUTION OF PEOPLE COVERED BY DIFFERENT INSURANCE ENTITIES HAS ALSO CHANGED. IN 2017, A HIGHER PERCENTAGE OF CHENANGO COUNTY RESIDENTS WERE COVERED BY INSURANCE THAT THEY PURCHASED DIRECTLY (SUCH AS THROUGH THE STATE EXCHANGE) AND THROUGH MEDICAID ONLY, THAN WERE IN 2013. A GREATER NUMBER OF CHENANGO COUNTY RESIDENTS WERE ALSO ENROLLED IN MORE THAN ONE INSURANCE PLAN IN 2017. IN CONTRAST, IN 2017 FEWER CHENANGO COUNTY RESIDENTS WERE COVERED BY EMPLOYER-BASED INSURANCE PLANS THAN IN 2013. AS OF YEAR END 2021, UHS CHENANGO MEMORIAL HOSPITAL SHOWED A PAYER MIX OF 43% MEDICARE, 26% MEDICAID, 26% COMMERCIAL, 2% SELF-PAY AND 3% OTHER. ** CONTINUED ON SCHEDULE H SUPPLEMENTAL INFORMATION"

990 PART VI, LINE 5 CONTINUED:
-THE RADIOLOGY DEPARTMENT CONTINUES TO BUILD OUT AND WILL SOON TAKE OVER THE ENTIRE OLD ER LOCATION. AND THE REAR HALLWAYS. THIS BUILDOUT WILL INCLUDE ALL MAJOR RADIOLOGY SERVICES INCLUDING MRI, CT, X-RAY, ULTRASOUND, NUCLEAR MEDICINE, FLUOROSCOPY AND OTHER IMAGING SERVICES. THIS RENOVATION IS THE LAST LARGE PART OF THE CHENANGO MEDICAL NEIGHBORHOOD PROJECT AND SHOULD BE COMPLETED IN EARLY 2022.

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"OUR ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER OUR CHARITY CARE POLICY AS FOLLOWS:* EVERY CLINIC AND AREA OF PATIENT REGISTRATION HAS A NOTICE POSTED INFORMING THE PATIENT/S/PUBLIC OF THE AVAILABILITY OF FINANCIAL ASSISTANCE* BROCHURES DESCRIBING THE POLICY ARE AVAILABLE AT CLINICS, POINTS OF REGISTRATION, AND ARE MAILED TO SELF PAY PATIENTS ALONG WITH APPLICATIONS* INPATIENTS ARE VISITED BY THE PATIENT FINANCIAL ADVOCATE. THEY ARE MADE AWARE OF GOVERNMENT PROGRAMS AND IF NECESSARY, ARRANGEMENTS ARE MADE WITH THE DEPARTMENT OF SOCIAL SERVICES TO HAVE A WORKER COME IN AND TAKE THE APPLICATION FROM THE PATIENT. THE PATIENT IS GIVEN INFORMATION AND AN APPLICATION FOR FINANCIAL ASSISTANCE, WHICH CAN BE COMPLETED AT THE PATIENT'S BEDSIDE.* THE WOMAN'S HEALTH CENTER INFORMS ALL SELF PAY PREGNANT WOMEN OF THE ""PRESUMPTIVE ELIGIBILITY"" PROCESS AND PATIENTS ARE DIRECTED TO PATIENT FINANCIAL SERVICES FOR COMPLETION OF THE APPLICATION AND COMPLETION OF A WIC APPLICATION IF PATIENT SO DESIRES* EVERY CMH EMPLOYEE IS MADE AWARE OF THE CHARITY CARE PROGRAM AT ORIENTATION AND ENCOURAGED TO INFORM PATIENTS AND THE PUBLIC ABOUT THE PROGRAM. PERSONNEL WHO HAVE PATIENT CONTACT ARE ANNUALLY IN-SERVICED ON CHARITY CARE PROGRAM* EVERY BILL THAT IS SENT OUT IS MARKED ""FOR INFORMATION REGARDING OUR ""PATIENT FINANCIAL ASSISTANCE"" PROGRAM"" PLEASE CONTACT 607-337-4295"

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CMH IS AN IMPORTANT PART OF THE UNITED HEALTH SERVICES SYSTEM OF INTEGRATED DELIVERY OF CARE, WHICH PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY. AS A RESULT OF THE FORMATION OF CMH IN 1910 AND THE SUBSEQUENT TRANSFORMATION OF THE COMBINED ORGANIZATION INTO A HEALTH CARE SYSTEM, OUR REGION TODAY OFFERS MORE COMPLETE AND ADVANCED CARE THAN MANY COMMUNITIES FIVE TIMES OUR SIZE. IN 2013, THE UNITED HEALTH SERVICES SYSTEM ENGAGED IN A STRATEGIC PLANNING PROCESS FOR THE YEARS 2014-2016. CONSISTENT WITH THE MISSION AND VISION, THE PLAN IS FOCUSED ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO COMMUNITY. THE STRATEGIC PLAN IS ORGANIZED AROUND FOUR GOALS: CLINICAL EXCELLENCE,SERVICE EXCELLENCE, MARKET GROWTH AND FINANCIAL STRENGTH. SPECIFIC DESTINATION METRICS OR MEASURES OF SUCCESS WERE DEVELOPED FOR EACH STRATEGIC GOAL. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE GOALS ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES LOCALLY AND REGIONALLY. THE CMH COMMUNITY SERVICE REPORT CAPTURES THE BENEFITS SPECIFIC TO CMH. THE OTHER HOSPITAL MEMBERS OF THE UHS SYSTEM, UHS WILSON MEDICAL CENTER, UHS BINGHAMTON GENERAL HOSPITAL, AND DELAWARE VALLEY HOSPITAL SUBMIT SEPARATE REPORTS.- CLINICAL EXCELLENCE: CMH HAS FOCUSED ITS RESOURCES AND ENERGY AROUND ACHIEVING DISTINCTION AS A HEALTH SYSTEM IN CLINICAL QUALITY, PATIENT SAFETY AND SERVICE. CMH IS FOCUSED ON VIGOROUS ASSESSMENT AND IMPROVEMENT OF THE ORGANIZATION'S PERFORMANCE USING KEY PATIENT QUALITY, SAFETY AND SATISFACTION INDICATORS. THE PLAN PLACES A FOCUS IN PARTICULAR ON EMERGENCY ROOM PERFORMANCE, CLOSER INTEGRATION OF NON-ACUTE SERVICES WITH THE HOSPITALS, DEVELOPMENT AND IMPLEMENTATION OF STATE-OF-THE-ART INFORMATION TECHNOLOGY TO SUPPORT INITIATIVES IN PATIENT QUALITY AND SAFETY AND NEW INITIATIVES IN THE RECRUITMENT AND RETENTION OF A QUALITY PHYSICIAN AND ALLIED HEALTH WORKFORCE.- SERVICE EXCELLENCE: ADDRESS DELIVERING ON THE CMH BRAND PROMISE OF A MEANINGFULLY BETTER PATIENT EXPERIENCE. THE PLAN FOCUSES ON PATIENT-CENTERED CARE AND THE BRAND PROMISE OF RESPECT AND ACCOUNTABILITY. THIS GOAL ALIGNS TECHNOLOGY WITH PERFORMANCE STANDARDS TO IMPROVE ACCESS TO BETTER MEET PATIENT NEEDS.- MARKET GROWTH: THIS GOAL AREA ADDRESSES THE KEY ASPECTS OF ALIGNING TECHNOLOGY, PHYSICIAN RESOURCES AND PROGRAMS AROUND THE CLINICAL NEEDS OF THE SERVICE AREA. THE PLAN FOCUSES ATTENTION ON KEY TERTIARY SERVICES AND THE ASSURANCE OF AN ADEQUATE SUPPLY OF PRIMARY CARE AND SPECIALIST PHYSICIANS FOR THE AREA. AT THE SAME TIME, CMH REMAINS COMMITTED TO MEETING THE COMMUNITY'S BEHAVIORAL HEALTH SERVICES NEEDS.- FINANCIAL STRENGTH: TO ENSURE CMH HAS THE FINANCIAL CAPACITY TO SUPPORT ITS CLINICAL SERVICE AND GROWTH GOALS, THE STRATEGIC PLAN CALLS THE ORGANIZATION TO DEMONSTRATE CONSISTENT PERFORMANCE WITH RESPECT TO BENCHMARKED OPERATING EFFICIENCIES. THIS INCLUDES PARTICIPATING IN 340B INDIGENT CARE PHARMACY PRICING IN ORDER TO SERVE MORE ELIGIBLE PATIENTS AND PROVIDE MORE COMPREHENSIVE SERVICE.PART VI, LINE 7CHENANGO MEMORIAL HOSPITAL FILES THE COMMUNITY BENEFIT REPORT WITH NEW YORK STATE.

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COMMUNITY BOARDUHS CHENANGO MEMORIAL'S BOARD OF DIRECTORS TOTALS 16 MEMBERS, 11 OF WHOM ARE LOCAL RESIDENTS AND COMMUNITY LEADERS IN BANKING, LAW, PHARMACEUTICALS, MANUFACTURING, INSURANCE, INVESTMENTS, AND INDEPENDENT BUSINESS. THE BOARD MEETS BI-MONTHLY. THE BOARD ALSO HAS COMMITTEES THAT FOCUS ON FINANCES, STAFF CREDENTIALING, AND GOVERNANCE ALL OF WHICH HAVE REPRESENTATION FROM THE COMMUNITY.THE CMH AUXILIARY, WHO ALSO REPORT UNDER THE HOSPITAL'S TAX ID NUMBER, HAS ITS OWN BOARD THAT MEETS MONTHLY AND CONSISTS OF 16 MEMBERS ALL OF WHOM LIVE LOCALLY. THEY, TOO, REPRESENT A CROSS SECTION OF BUSINESSES SIMILAR TO THE HOSPITAL'S BOARD OF DIRECTORS. IN ADDITION, THEY INCLUDE RETIRED INDIVIDUALS AND FAMILY MEMBERS OF PROMINENT COMMUNITY LEADERS IN THE AREA.ALTHOUGH THE CHENANGO MEMORIAL HOSPITAL FOUNDATION, INC., HAS ITS OWN TAX ID NUMBER, ITS SOLE PURPOSE IS TO SUPPORT THE HOSPITAL THROUGH FUNDRAISING. THE FOUNDATION BOARD ALSO HAS 14 MEMBERS WHO REPRESENT BUSINESSES FROM THROUGHOUT THE COUNTY AND MEET APPROXIMATELY 3 TIMES PER YEAR.OPEN MEDICAL STAFF THE HOSPITAL REVIEWS MEDICAL STAFF PRIVILEGES OF ANY QUALIFIED PHYSICIANS AND ALLIED PROFESSIONALS IN THE COMMUNITY THAT APPLY. THE RIGOROUS CREDENTIALING PROCESS INCLUDES REVIEW BY AN INTERNAL CREDENTIALS COMMITTEE AND MEDICAL EXECUTIVE COMMITTEE. AFTER APPROVAL FROM THESE TWO COMMITTEES, THE APPLICATION PROCEEDS TO THE PROFESSIONAL ADVISORY COMMITTEE (PAC), A SUBCOMMITTEE OF THE HOSPITAL'S BOARD OF TRUSTEES, FOR APPROVAL. AFTER APPROVAL BY PAC, THE APPLICATION PROCEEDS TO THE HOSPITAL'S BOARD OF DIRECTORS FOR FINAL APPROVAL AND CREDENTIALING. USE OF SURPLUS FUNDS SURPLUS FUNDS ARE MADE AVAILABLE PRIMARILY FOR PURCHASES OF EQUIPMENT, FACILITY IMPROVEMENTS, OR TECHNOLOGY TO IMPROVE PATIENT CARE. IN SOME INSTANCES, FUNDS ARE USED TO SUPPORT NEW SERVICES. CHENANGO MEMORIAL HOSPITAL CONTINUED TO DRAW FROM THE $9M TRANSFORMATION GRANT AWARDED BY THE NYS DEPARTMENT OF HEALTH IN 2017. THE FIRST PHASE OF THE 2-PHASE TRANSFORMATION PROJECT WAS COMPLETED IN 2019. THE LAST PHASE BEGAN IN EARNEST IN MARCH 2020 AND THE MECHANICAL AND ELECTRICAL INFRASTRUCTURE WILL BE COMPLETED IN EARLY 2022. EXTENSIVE EXCAVATION AND SITE PREP WAS COMPLETED INCLUDING COMPLEX RELOCATION OF BURIED ELECTRICAL, GAS, AND COMMUNICATION LINES TO MAKE WAY FOR THE NEW AMBULANCE DRIVEWAY. STEEL, BRICK AND MORTAR APPEARED DURING THE SUMMER. THE NEW MAIN ENTRANCE, AS WELL AS THE NEW ER AND WALK-IN CANOPIES, WERE COMPLETED IN THE FALL OF 2021. THEN, THE NEW ER AND WALK-IN CENTERS WERE THE FOCUS FOR THE REMAINDER OF 2021 WITH A SCHEDULED COMPLETION DATE OF EARLY 2022. THE NEW SPACE IF TAKING SHAPE QUICKLY AND WILL BE AN IMPRESSIVE AND VERY FUNCTIONAL SPACE.-THE HOSPITAL RELOCATED MRI SERVICE THAT HAD BEEN PREVIOUSLY LOCATED ACROSS THE PARKING LOT AT 6 NEWTON AVENUE. THE OLD MRI WAS IN NEED OF REPLACEMENT, SO THE RELOCATION WAS AN OPPORTUNITY TO REPLACE WITH MORE MODERN EQUIPMENT. THE NEW LOCATION IS NEAR THE NEW EMERGENCY ROOM AND WILL BE AN ADVANTAGE FOR BOTH STAFF AND PATIENTS. THE NEW MRI SUITE WAS COMPLETED IN THE FALL 2021 JUST AHEAD OF THE FINAL STAGES OF THE ER. THE NEW ROOM WAS BUILT WITH THE PROPER LEAD SHIELDING AND WIRING OFFERING A LARGE MODERN LOOKING LOCATION. THE NEW ROOMS INCLUDE A CHANGING ROOM, METAL DETECTOR AND SITTING AREA.ONE IMPORTANT PART OF THE RENOVATION OF ALL INTERIOR SERVICES IS THE NEED FOR ADDITIONAL AND UPDATED PARKING SERVICES. THE NEW REAR PARKING LOT WAS FINISHED AND STRIPPED AS WELL AS GATED. THE NEW PARKING SPOTS ADDED 50 PLUS LOCATIONS FOR PATIENTS. THE OLD REAR LOCATIONS WERE ALSO UPDATED WITH NEW PAVEMENT AND HOLE REPAIRS. THESE UPDATED LOCATIONS BENEFIT THE PATIENTS IN MULTIPLE WAYS. SAFETY AND CONVENIENCE ARE OF THE MOST IMPORTANCE WHEN CONSIDERING PATIENT AND EMPLOYEE NEEDS. OTHER SPOTS WILL BE COMPLETED AND FINISHED IN 2022.-THE HOSPITAL PERMANENTLY INSTALLED A COVID TESTING LOCATION IN THE FRONT OF THE BUILDING. PATIENTS THAT ARE IN NEED OF SURGERY MUST BE COVID TESTED PRIOR TO SURGERY AND THIS TESTING LOCATION PROVIDES THOSE TESTING NEEDS. THE LOCATION IS LOCATED IN THE FRONT OF THE BUILDING AND OFFERS A CONVENIENT DRIVE THROUGH PROCESS. THE BUILDING COSTS TOTALED AROUND $8000 AND WILL BE IN PLACE UNTIL NO LONGER NEEDED. -DURING 2021, THE ROOF OVER THE 1958 SECTION OF THE HOSPITAL NEEDED EMERGENCY REPLACEMENT. THIS WORK WAS COMPLETED IN OCTOBER OF 2021. THE REPLACEMENT OF THIS ROOF ALSO INVOLVED REPLACING AN AGING AIR HANDLING UNIT. THE PRICE OF BOTH THE ROOF AND AIR HANDLING UNIT TOTALED $720K. -ONCOLOGY INFUSION WAS EXPANDED TO HELP MORE PATIENTS. THE NEW EXPANSION INCLUDED A MOVE TO A DIFFERENT SPACE AND OFFERING MORE ROOMS AND ADDITIONAL NURSES. THE COMMUNITY IS IN NEED OF THIS SERVICE AND THE EXPANSION WAS A WELCOMED CHANGE FOR LOCAL PATIENTS. THE EXPANSION INTO THE NEW SPACE ON THE 4TH FLOOR REQUIRED AN ADDITIONAL $150,000.-LIKE MANY HEALTHCARE FACILITIES, CMH LAUNCHED VIRTUAL VISITS DURING THE PANDEMIC SO PATIENTS COULD CONTINUE COMMUNICATING WITH THEIR PROVIDERS. THIS NEW FORM OF ACCESS HAS PROVEN TO BE VERY CONVENIENT FOR SOME OF OUR PATIENTS AND WILL REMAIN ANOTHER OPTION FOR OUR PATIENTS TO USE TO ACCESS THE CARE THEY NEED. THESE SERVICES ARE CONTINUING TO EXPAND AND INCLUDE MORE PROVIDERS. 2021 WAS A GOOD YEAR TO DEVELOP A MORE SOLID AND CONSTANT SERVICE.-THE SEWER DRAIN THAT RUNS UNDER THE HOSPITAL NEEDED AN EMERGENCY REPLACEMENT. UNFORTUNATELY THIS DRAIN WAS LOCATED UNDER THE CONCRETE FLOOR IN THE BASEMENT. 100 FEET OF THE BASEMENT FLOOR NEEDED TO BE OPENED, THE DRAIN REPLACED, AND THE FLOOR RESET AND REPAIRED. THE NEW DRAIN WAS ENLARGED AND MAPPED ACCORDING TO NEEDS. THE NEW FLOOR WAS REPLACED WITH NEW CONCRETE AND THE HALLWAY REOPENED AFTER WEEKS OF CLOSURE DUE TO THE REPAIR.** SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION FOR CONTINUATION