4A (Expenses $ 352184630 including grants of $ 0) (Revenue $ 395090517)
SEVERAL OUTPATIENT FACILITIES WHERE SERVICES ARE PROVIDED TO ITS PATIENTS INCLUDING: AMBULATORY SURGERY, PHYSICAL AND OCCUPATIONAL THERAPY, REHABILITATION, RENAL DIALYSIS, AND DIAGNOSTIC IMAGING. CVPH ALSO OPERATES HEALTH CLINICS LOCATED IN OUTLYING GEOGRAPHIC AREAS, TO BETTER SERVE THE HEALTH NEEDS OF CVPH'S RURAL COMMUNITY SERVICE AREA. THROUGH ITS VARIOUS LOCATIONS, OUTREACH ACTIVITIES, AND SUPPORT GROUPS, CVPH IS ACTIVE IN THE COMMUNITY IN PROMOTING HEALTH AND WELLNESS OF THE BODY, MIND, AND SPIRIT. CVPH PROVIDES ONGOING MEDICAL EDUCATION TO ITS MEDICAL STAFF, IN ADDITION TO OFFERING AN X-RAY TECHNOLOGY PROGRAM FOR ENROLLED STUDENTS. CVPH MAINTAINS A COMPREHENSIVE MEDICAL LIBRARY AND HAVE MADE AVAILABLE WEB-BASED LINKS FOR THE COMMUNITY TO EASILY ACCESS HEALTH AND WELLNESS INFORMATION AND EDUCATIONAL MATERIALS. CVPH ACCEPTS NUMEROUS INSURANCE PLANS, AND IS MEDICARE AND MEDICAID APPROVED. ADDITIONALLY, CVPH HAS A CHARITY CARE POLICY TO ACCOMMODATE PATIENTS WHOSE FINANCIAL MEANS ARE WITHIN SPECIFIED GUIDELINES.

CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MED
"PART V, SECTION B, LINE 5: TO REACH THIS CONCLUSION, THE UNIVERSITY OF VERMONT HEALTH NETWORK- CHAMPLAIN VALLEY PHYSICIANS HOSPITAL (UVMHN-CVPH) AND CLINTON COUNTY HEALTH DEPARTMENT (CCHD), LEAD ENTITIES IN THE PROCESS, FACILITATED/ COMPLETED THE FOLLOWING ACTIVITIES WITH THE CLINTON COUNTY COMMUNITY: TWO COMMUNITY BASED, HEALTH FOCUSED SURVEYS; A REVIEW OF OVER 300 HEALTH INDICATORS AND A SECONDARY DATA ANALYSIS; A COMMUNITY HEALTH PRIORITY SETTING SESSION; A PRIORITY AND FOCUS AREA FINALIZATION PROCESS; AND CREATION OF SHARED ACTION PLANS.HEALTH INDICATORS FROM SCORES OF RESOURCES WERE CONSIDERED IN THE PROCESS, INCLUDING DATA FROM THE NYS PREVENTION AGENDA DASHBOARD, COMMUNITY HEALTH INDICATOR REPORTS, NYS OFFICE OF MENTAL HEALTH, DIVISION OF CRIMINAL JUSTICE SERVICES, NYS EXPANDED BEHAVIORAL RISK FACTOR SURVEY, USDA ECONOMIC RESEARCH SERVICE, AMERICAN COMMUNITY SURVEY, HEALTH RESOURCES AND SERVICES ADMINISTRATION, CENTER FOR HEALTH WORKFORCE STUDIES AND OTHERS. LOCALLY GENERATED AND/ OR COLLECTED DATA WERE ALSO CONSIDERED, WHEN AVAILABLE. PRIMARY DATA INCLUDED FEEDBACK FROM RESIDENT SURVEYS RELATED TO HEALTH, SOCIAL AND ENVIRONMENTAL CONCERNS AS WELL AS QUALITATIVE PROGRAM DATA FROM VARIOUS COMMUNITY BASED ORGANIZATIONS AND CCHD. THE SELECTED PRIORITY AREAS REFLECT CONTINUED COMMITMENT TO THE PRIORITIES SELECTED IN THE 2016 AND 2019 COMMUNITY HEALTH ASSESSMENT PROCESSES. WHILE THE LOCAL PROCESS THAT HAS BEEN INSTITUTED BY THE LEAD PARTNERS OVER MANY YEARS OF COLLABORATION WAS MAINTAINED THIS CYCLE, SEVERAL INTENTIONAL ADJUSTMENTS WERE MADE TO INCREASE INCLUSIVITY AND PARTICIPATION OVER THE YEAR AS WELL AS TO BETTER UNDERSTAND RESIDENTS' EXPERIENCE AND EXISTING HEALTH INEQUITIES. DEMONSTRATIVE CHANGES OF PROCESS QUALITY IMPROVEMENT INCLUDE: MODIFYING SURVEY TOOLS TO BETTER IDENTIFY SUBPOPULATIONS WHILE MAINTAINING ANONYMITY OF RESPONDENTS, EXTENDING INVITATIONS TO PARTICIPATE IN THE COMMUNITY HEALTH PRIORITY SETTING SESSION TO 25% MORE STAKEHOLDERS, CREATING VIRTUAL PARTICIPATION OPTIONS FOR ALL PRIORITIZATION ACTIVITIES TO ACCOMMODATE PROCESS AND STAKEHOLDER PREFERENCES DESPITE PANDEMIC RESTRICTIONS, AND EXPANDING THE DISCUSSION AROUND INEQUITIES AND DISPARITIES THROUGHOUT THE ASSESSMENT AND PLANNING PROCESS. PARTICIPATION IN HEALTH PRIORITY SELECTION REPRESENTED AT LEAST 18 DISTINCT COMMUNITY SECTORS INCLUDING HEALTHCARE (CLINICAL, POPULATION AND PUBLIC HEALTH), BUSINESS, COMMUNITY BASED ORGANIZATION/SERVICE, HOUSING, HUMAN SERVICES, AND MENTAL/BEHAVIORAL HEALTH. THESE VERY PARTNERS CONTRIBUTE ACTIVITIES AND RESOURCES TO CREATE LOCAL ACTION PLANS AND ARE NOTED THROUGHOUT THE DOCUMENT AS ""RESOURCES AND ASSETS AND ""RESPONSIBLE PARTIES"". THE RESULTING ACTION PLANS FEATURE IN-PROGRESS AND PLANNED WORK RELATED TO THE SELECTED HEALTH PRIORITIES AND INTENDED TO ALTER HEALTH OUTCOMES FOR THE BETTER OF ALL RESIDENTS. FEATURED INTERVENTIONS REFLECT A RANGE OF ACTIVITIES AND APPROACHES THAT FALL ACROSS THE HEALTH IMPACT PYRAMID AND INCLUDE SERVICE INFRASTRUCTURE, PROGRAM DEVELOPMENT AND EDUCATION; MANY WILL REQUIRE HIGH LEVEL, CROSS-SECTOR COLLABORATIONS. ONGOING OVERSIGHT OF HEALTH IMPROVEMENT PROGRESS WILL CONTINUE TO BE MANAGED BY THE ACTION FOR HEALTH CONSORTIUM, WHICH ORGANIZES BI-MONTHLY MEETINGS UTILIZING THE NYS PREVENTION AGENDA AS ITS FRAMEWORK. A FORMAL PROGRESS UPDATE IS CAPTURED ANNUALLY AND THIS PROGRESS IS SHARED WITH HEALTH STAKEHOLDERS AND THE COMMUNITY BY CCHD AND UVMHN-CVPH. THESE UPDATES SERVE AS AN OPPORTUNITY TO CELEBRATE SUCCESS JUST AS MUCH AS A MEANS TO ADJUST COURSE BASED ON EMERGING NEEDS AND NEW RESOURCES IN CLINTON COUNTY.CCHD AND UVMHN-CVPH HAVE AND WILL CONTINUE TO EVALUATE THE LOCAL COLLABORATIVE APPROACH TO COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLANNING. AT PRESENT, DIRECT STAKEHOLDER FEEDBACK AND PARTICIPATION TRENDS ALONG WITH EMERGING BEST-PRACTICES GREATLY INFORM AND INFLUENCE THE LOCAL PROCESS. THE LEAD ENTITIES MONITOR AWARENESS AND USE OF THE RESULTING ASSESSMENT DOCUMENTS AMONG PARTNERS, STRIVING TO CONTINUALLY INCREASE BOTH PROCESS MEASURES."

CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MED
PART V, SECTION B, LINE 6A: CVPH IS PART OF THE ADIRONDACK RURAL HEALTH NETWORK. ADIRONDACK RURAL HEALTH NETWORK: THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) IS A PROGRAM OF THE ADIRONDACK HEALTH INSTITUTE, INC. (AHI). AHI IS A JOINT VENTURE OF ADIRONDACK HEALTH (ADIRONDACK MEDICAL CENTER), THE UNIVERSITY OF VERMONT HEALTH NETWORK - CHAMPLAIN VALLEY PHYSICIANS HOSPITAL, GLENS FALLS HOSPITAL, HUDSON HEADWATERS HEALTH NETWORK AND ST. LAWRENCE HEALTH SYSTEM. THE MISSION OF AHI IS TO LEAD AND WORK COLLABORATIVELY WITH COMMUNITY PARTNERS ON INNOVATIVE INITIATIVES THAT ADVANCE QUALITY, IMPROVE ACCESS AND AFFORDABILITY, AND TRANSFORM HEALTHCARE DELIVERY IN THE ADIRONDACK REGION.THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) PROVIDES A FORUM FOR LOCAL PUBLIC HEALTH SERVICES, COMMUNITY HEALTH CENTERS, HOSPITALS, COMMUNITY MENTAL HEALTH PROGRAMS, EMERGENCY MEDICAL SERVICES, AND OTHER COMMUNITY-BASED ORGANIZATIONS TO ADDRESS RURAL HEALTHCARE DELIVERY BARRIERS, IDENTIFY REGIONAL HEALTH NEEDS AND SUPPORT THE NYS PREVENTION AGENDA TO IMPROVE HEALTH CARE IN THE REGION. THE ARHN REGION INCLUDES NEW YORK'S CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN, AND WASHINGTON COUNTIES.SINCE 2002, ARHN HAS BEEN RECOGNIZED AS THE LEADING SPONSOR OF FORMAL COMMUNITY HEALTH PLANNING IN THE REGION WORKING WITH SEVERAL LOCAL HEALTH DEPARTMENTS. THE COMMUNITY HEALTH ASSESSMENT (CHA) COMMITTEE, FACILITATED BY ARHN, IS MADE UP OF HOSPITALS AND COUNTY HEALTH DEPARTMENTS WORKING TOGETHER UTILIZING A SYSTEMATIC APPROACH TO COMMUNITY HEALTH PLANNING. THE CHA COMMITTEE IS MADE UP OF MEMBERS FROM ADIRONDACK HEALTH, CLINTON COUNTY HEALTH DEPARTMENT, ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, FULTON COUNTY PUBLIC HEALTH, GLENS FALLS HOSPITAL, HAMILTON COUNTY PUBLIC HEALTH SERVICES, NATHAN LITTAUER HOSPITAL AND NURSING HOME, UVM HEALTH NETWORK - CVPH, WARREN COUNTY HEALTH SERVICES, WASHINGTON COUNTY PUBLIC HEALTH SERVICES, UVM HEALTH NETWORK - ELIZABETHTOWN COMMUNITY HOSPITAL, AND UVM HEALTH NETWORK ALICE HYDE MEDICAL CENTER.

CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MED
PART V, SECTION B, LINE 6B: THE CHNA IS A JOINT EFFORT WITH THE CLINTON COUNTY HEALTH DEPARTMENT. IN ADDITION, CLINTON COUNTY ACTION FOR HEALTH CONSORTIUM IS A KEY PART OF THE PROCESS, AND THEIR PURPOSE IS DESCRIBED BELOW.CLINTON COUNTY ACTION FOR HEALTH CONSORTIUM: THE CLINTON COUNTY ACTION FOR HEALTH (AFH) CONSORTIUM IS A MULTI-SECTOR, MULTI-DISCIPLINARY COLLECTION OF LOCAL HEALTH SYSTEM PARTNERS WORKING TOWARDS COMMUNITY HEALTH IMPROVEMENT AND FACILITATED BY CCHD. THE PRIMARY WORK OF THE GROUP HAS BEEN BUILT AROUND DATA DRIVEN IDENTIFIED NEEDS (NYS PREVENTION AGENDA) AND AVAILABLE COMMUNITY RESOURCES. PARTNERS IN THE EFFORT INCLUDE: MUNICIPALITIES, BUSINESSES, GRASSROOTS COMMUNITY GROUPS, HEALTH CARE PROVIDERS, THE LOCAL HOSPITAL, CHAMBER OF COMMERCE, HUMAN SERVICE AGENCIES, SCHOOLS AND LOCAL NOT-FOR-PROFITS. THE GROUP HAS EXISTED FOR OVER A DECADE AND PRESENTLY HAS APPROXIMATELY FORTY MEMBERS THAT HAVE FORMALLY COMMITTED TO ITS PURPOSE BY SIGNING AFH PARTNERSHIP LETTERS. RECRUITMENT OF NEW MEMBERS IS ONGOING. THE AFH CONSORTIUM HAS INCREASED COMMUNITY OWNERSHIP AND COMMITMENT TO THE SHARED HEALTH IMPROVEMENT GOALS AND TO THE WORK CAPTURED IN THE CHIP. IN FACILITATING THESE EFFORTS, THE CCHD HAS STRENGTHENED ITS ABILITY TO LEVERAGE RESOURCES FROM PUBLIC HEALTH PARTNERS AND PRIVATE ENTITIES ALIKE. SIGNIFICANT PROGRESS ON THE COUNTY'S CHIP HAS BEEN MADE CAPITALIZING ON THIS SYSTEM OF PARTNERSHIP CREATED THROUGH THE CONSORTIUM. THE AFH CONSORTIUM MEETS BIMONTHLY FOR UPDATES, ISSUE DISCUSSION, AND INFORMATION SHARING. A MINIMUM OF SIX MEETING ARE SCHEDULED EACH YEAR, WITH ADDITIONAL GATHERINGS SCHEDULED AS NEEDED. SUBCOMMITTEES OF MEMBERS WITH EXPERTISE RELATED TO SELECTED PRIORITY AREAS MEET MORE FREQUENTLY AND KEEP THE GROUP APPRISED OF THEIR WORK. CCHD TRACKS PROGRESS ON THE CHIP CONTINUALLY AND PREPARES A YEAR-END REPORT WHICH INCLUDES UPDATES ON WORK RELATED TO THE TWO FEATURED PRIORITY AREAS AND A SUMMARY OF ACCOMPLISHMENTS BY LOCAL PARTNERS RELATED TO EACH OF THE NYSDOH PREVENTION PLAN PRIORITY AREAS. CAPTURED ACTIVITIES DEMONSTRATE WORK ON ALL TIERS OF THE PUBLIC HEALTH IMPACT PYRAMID. MORE INFORMATION ON THE PUBLIC HEALTH PYRAMID IS INCLUDED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN.

CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MED
PART V, SECTION B, LINE 11: THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY WERE IDENTIFIED AS FOLLOWS, MODELED AFTER THE NEW YORK STATE PREVENTION AGENDA:1. PREVENT CHRONIC DISEASESA. FOCUS AREA: HEALTHY EATING AND FOOD SECURITYB. FOCUS AREA: PHYSICAL ACTIVITYC. FOCUS AREA: CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENTD. FOCUS AREA: TOBACCO PREVENTION2. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERSA. FOCUS AREA: PROMOTE WELL-BEINGB. FOCUS AREA: PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION3. DISPARITIESA. INCOMEB. GEOGRAPHIC LOCATIONC. AGE

PART I, LINE 7:
THE RCC-PERCENTAGE WAS CALCULATED AS FOLLOWS: THE FACILITY'S ADJUSTED PATIENT CARE COST OF 393,171,270 WAS DIVIDED BY THE GROSS PATIENT CHARGES OF 1,243,306,064 TO DETERMINE THE RCC OF 31.62%.

PART I, LN 7 COL(F):
AMOUNT OF BAD DEBT EXPENSE INCLUDED IN FORM 990 PART IX LINE 25 COLUMN (A), BUT REMOVED FROM THIS FIGURE FOR PURPOSES OF CALCULATING THE RCC PERCENTAGE WAS $4,357,808 AS REFLECTED ON PART IX LINE 24(E).PART III, LINE 3:IN ACCORDANCE WITH IRS 990 INSTRUCTIONS, CVPH APPLIED THE CALCULATED RATIO OF COST TO CHARGES TO THE FACILITY'S 2022 BAD DEBT EXPENSE OF $13,780,487 IN ORDER TO CALCULATE THE BAD DEBT EXPENSE (AT COST) AS REPORTED ON PART III LINE 2. THE RCC USED WAS 31.62%. THEREFORE, THE BAD DEBT EXPENSE (AT COST) FOR 2022 WAS $4,357,808. WE ATTRIBUTE APPROXIMATELY 40% OF THIS AMOUNT TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, CAUSING THE PORTION OF BAD DEBT AS A COMMUNITY BENEFIT TO BE $1,743,123.

PART III, LINE 4:
THE BAD DEBT EXPENSE FOOTNOTE IS DISCLOSED IN ATTACHED AUDITED FINANCIAL STATEMENTS ON PAGE 14.

PART III, LINE 8:
USED MEDICARE ONLY TOTAL CHARGES FROM INSTITUTIONAL COST REPORT FOR 2022 AND APPLIED THE RATIO OF COST TO CHARGES FROM THE 2022 COST REPORT DATA. APPROXIMATELY 44% OF OUR REVENUE IS DERIVED FROM MEDICARE PATIENTS. WE FEEL THE SHORTFALL FROM THIS PROGRAM IS DIRECTLY A COMMUNITY BENEFIT IN THAT WE ARE A SOLE COMMUNITY HOSPITAL.

PART III, LINE 9B:
CVPH HAS A FORMAL CREDIT AND COLLECTION POLICY. ALL PATIENT ACCOUNTS WILL BE BILLED AND FOLLOWED UP ON IN A TIMELY FASHION. ALL DISCOUNTS WILL BE APPLIED AND OFFERED PER POLICY, UNIFORMLY AND WITHOUT PREJUDICE OR DISCRIMINATION. THE POLICY CONSISTS OF DOCUMENTED PROCEDURES FOR INSURANCE, CREDIT BALANCES, SELF PAY OUTPATIENT, AND SELF PAY INPATIENT (NO INSURANCE & AFTER INSURANCE). THERE ARE SPECIFIED PAYMENT ARRANGEMENTS THAT ARE OFFERED AND THE TIME FRAME ALLOTTED FOR REPAYMENT IS GRADUATED BASED ON THE AMOUNT OWED, RANGING FROM 30 DAYS TO 36 MONTHS. CUSTOMER SERVICE REPRESENTATIVES PLACE PHONE CALLS TO PATIENTS TO RESOLVE ACCOUNTS OR ESTABLISH PAYMENT ARRANGEMENTS. AFTER ACCOUNTS HAVE BEEN AT THE PRIMARY BAD DEBT AGENCY FOR A PERIOD OF 6 MONTHS WITHOUT PAYMENTS, THE ACCOUNTS ARE FORWARDED TO A SECOND PLACEMENT AGENCY FOR ATTEMPTED RECOVERY. AS AN ACCOMMODATION TO PATIENTS AND FAMILIES, COLLECTION ACTIVITY WAS SUSPENDED IN MARCH 2020 IN RECOGNITION OF THE FINANCIAL CHALLENGES ASSOCIATED WITH THE COVID-19 PANDEMIC. COLLECTION ACTIVITIES RESUMED IN JULY 2020.

PART VI, LINE 2:
CVPH WORKS COLLABORATIVELY TO ASSESS HEALTH NEEDS AND THEN IMPLEMENT STRATEGIES TO ADDRESS THE HEALTH PRIORITIES OF THE COMMUNITY IT SERVES. CVPH HAS WORKED WITH OTHER HOSPITALS, HEALTH DEPARTMENTS, AND AGENCIES IN CLINTON, ESSEX, AND FRANKLIN COUNTIES THROUGH PARTICIPATION IN A VARIETY OF PROGRAMS. BY BRINGING THE VARIOUS PROVIDERS TOGETHER FROM A THREE-COUNTY AREA, IT IS BELIEVED THAT THIS PROVIDES A BROADER, MORE REPRESENTATIVE DETERMINATION OF THE NEEDS THAT EXIST. A FOUR-STEP PROCESS IS USED TO ESTABLISH PRIORITIES AS PART OF THE FORMALIZED COMMUNITY HEALTH ASSESSMENT. DATA IS COMPILED AND ANALYZED, PRIORITIES ARE DETERMINED, FOCUS GROUPS SEEK CONSENSUS AND REPORT OUT, DATA IS FURTHER WEIGHTED AND A FINAL SELECTION OF PRIORITIES IS MADE. TO THAT END, CVPH HAS DIRECTED RESOURCES TO SUPPORT OF THE ADIRONDACK REGION MEDICAL HOME, PHYSICIAN RECRUITMENT, ITS DIABETES EDUCATION CENTER AND COMMUNITY EFFORT RELATED TO THE IMPORTANCE OF PROPER NUTRITION AND EXERCISE. WORKING INDEPENDENTLY, CVPH ASSESSES NEEDS BY ENCOURAGING AN OPEN DIALOGUE WITH ITS VARIOUS COMMUNITY CONSTITUENCIES. THE MEDICAL CENTER HOSTS MEETINGS, VISITS CLUBS AND ORGANIZATIONS, SURVEYS ITS PATIENTS, AND ENCOURAGES FEEDBACK THROUGH ITS WEB SITE AND PATIENT ADVOCATE ROLES. CVPH IS A VOLUNTARY, NOT-FOR-PROFIT, ARTICLE 28 ORGANIZATION THAT IS GOVERNED BY A VOLUNTARY BOARD OF DIRECTORS AND IS LICENSED FOR 300 BEDS. CVPH IS LOCATED AT 75 BEEKMAN STREET IN PLATTSBURGH, NEW YORK WITH SATELLITE SERVICES AT A NUMBER OF OTHER AUTHORIZED LOCATIONS WITHIN THE PLATTSBURGH AREA. CVPH IS PART OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS COMPRISED OF SIX HOSPITALS, A HOME HEALTH AND HOSPICE AGENCY, AND AN EMPLOYED MEDICAL GROUP. IT IS AFFILIATED WITH AN ACADEMIC MEDICAL CENTER IN BURLINGTON, VERMONT. CVPH OFFERS A VARIETY OF SERVICES INCLUDING CARDIOVASCULAR, ORTHOPEDICS, OBSTETRICS, PSYCHIATRY, LONG TERM CARE, AND PRIMARY CARE. IT HAS A FAMILY MEDICINE RESIDENCY PROGRAM TO HELP ADDRESS PRIMARY CARE SHORTAGES IN THE COMMUNITY. CVPH PROVIDES CANCER SERVICES THROUGH THE FITZPATRICK CANCER CENTER. IN ADDITION, CVPH HAS A ROBUST MEDICAL HOME AS WELL AS THE ADIRONDACK REGION ACO WHICH ARE KEY PARTNERS IN ADDRESSING COMMUNITY HEALTH NEEDS.

PART VI, LINE 3:
"THE FOLLOWING INFORMATION IS LISTED ON EVERY PATIENT STATEMENT: ""FINANCIAL AID MAY BE AVAILABLE TO QUALIFIED PATIENTS. PLEASE CALL OUR OFFICE AT 562-7074 TO SEE IF YOU QUALIFY."" WE ALSO HAVE INFORMATIONAL FLYERS AT THE CASHIERS DESK AND SEVERAL OTHER AREAS IN THE HOSPITAL. AT TIME OF REGISTRATION FOR EVERY SELF PAY PATIENT, WE ASK PERMISSION TO HAVE THE PATIENT CONTACTED TO SEE IF THEY QUALIFY FOR MEDICAID. ALSO WHEN MAKING A CALL TO COLLECT ON PATIENT ACCOUNTS, THE PATIENT IS OFFERED TO TAKE PART IN CVPH'S CARES PROGRAM WHERE APPROPRIATE TO DO SO."

PART VI, LINE 4:
THE PRIMARY SERVICE AREA FOR CVPH IS DEFINED AS CLINTON COUNTY. CVPH'S SECONDARY SERVICE AREA FOR TERTIARY SERVICES NOT AVAILABLE IN THOSE COMMUNITIES ARE ESSEX, FRANKLIN, AND EASTERN ST. LAWRENCE COUNTIES. THE DEMOGRAPHIC CHARACTERISTICS AND HEALTH NEEDS OF THESE COUNTIES REFLECT THOSE IN CLINTON COUNTY. OUR PAYER MIX CONSINSTS OF APPROXIMATELY 53% MEDICARE AND MEDICAID PROGRAMS. CVPH IS THE ONLY HOSPITAL IN CLINTON COUNTY. CLINTON COUNTY'S POPULATION IS 80,320. SIMILAR TO THE REST OF UPSTATE NEW YORK, CLINTON COUNTY'S POPULATION IS LIMITED IN ITS ETHNIC AND RACIAL DIVERSITY; OVER 90% OF RESIDENTS ARE WHITE/NON-HISPANICS, FOLLOWED BY 4.2% BLACK/AFRICAN AMERICAN, NON-HISPANICS AND 2.8% HISPANIC/LATINOS. WHILE THERE ARE NO SIGNIFICANT HEALTH DISPARITIES BASED ON RACE AND ETHNICITY IN CLINTON COUNTY, THERE ARE ACCESS TO CARE ISSUES. IN FACT, IN A RECENT RESIDENT SURVEY, OVER 60% OF THE RESPONDENTS REPORTED EXPERIENCING AT LEAST ONE BARRIER TO MEDICAL CARE FOR THEMSELVES OR THEIR FAMILY IN THE PAST YEAR. THE MOST COMMONLY REPORTED BARRIERS INCLUDED: NO APPOINTMENTS AVAILABLE (TO A SPECIALIST (32.8%), NO SPECIALIST AVAILABLE LOCALLY (32.8%), INSURANCE WAS NOT ACCEPTED (27.8%), CO-PAYS OR DEDUCTIBLES WERE TOO HIGH (25.7%), AND NO APPOINTMENT WAS AVAILABLE FOR PRIMARY CARE (23.2%). THE PERCENTAGE OF ADULTS WITH HEALTH INSURANCE IN CLINTON COUNTY IS AT 94.17%, WITH 78.3% OF THE POPULATION HAVING A REGULAR HEALTH CARE PROVIDER. THE RATE OF AGE-ADJUSTED PREVENTABLE HOSPITALIZATIONS PER 10,000 POPULATION AMONG THOSE 18 YEARS OF AGE AND OLDER (121.0) IS HIGHER THAN THE RATE FOR UPSTATE NEW YORK (120.4), AND THE PREVENTION AGENDA BENCHMARK (115.0) RATE. THE RATE OF ED VISITS PER 10,000 POPULATION IN CLINTON COUNTY (4,970.3) IS HIGHER THAN THE ARHN REGION (4,964.3) AND SIGNIFICANTLY HIGHER THAN UPSTATE NEW YORK (3,843). OVER 16.8% OF THE POPULATION IS 65 YEARS OF AGE AND OLDER; THIS DEMOGRAPHIC HAS BEEN INCREASING OVER MULTIPLE ASSESSMENTS. THE PERCENTAGE OF ADULTS 18 YEARS OF AGE AND OLDER IN CLINTON COUNTY WITH A DISABILITY (25.7%) IS HIGHER THAN THE ARHN REGION (29.2%) AND UPSTATE NEW YORK (24.6%).HOUSEHOLD INCOME ON AVERAGE IS $75,442, WITH PER CAPITA INCOME AT $29,960. THE PERCENTAGE OF INDIVIDUALS IN CLINTON COUNTY LIVING BELOW THE FEDERAL POVERTY LEVEL HAS REMAINED STABLE AT 12.3%. IN TOTAL, THERE ARE 31,392 HOUSEHOLDS IN CLINTON COUNTY. THE PERCENTAGE OF INDIVIDUALS ENROLLED IN MEDICAID IS 23.3%.OF THE TOTAL POPULATION IN CLINTON COUNTY, APPROXIMATELY 35.3% OF INDIVIDUALS 25 YEARS OF AGE AND OLDER HAVE A HIGH SCHOOL DIPLOMA OR EQUIVALENT. ANOTHER 35.3% HAVE AN ASSOCIATE'S OR BACHELOR'S DEGREE OR HIGHER. THE HIGHEST PERCENTAGE OF WORKING INDIVIDUALS ARE IN THE FIELD OF EDUCATION (26.6%), FOLLOWED BY RETAIL TRADE (13.4%) AND MANUFACTURING (12.5%).

PART VI, LINE 5:
CVPH MEDICAL CENTER PLAYS AN IMPORTANT ROLE IN PROMOTING HEALTH IN THE COMMUNITY BY, FOR INSTANCE, HOSTING FREE COMMUNITY LECTURES, SUPPORT GROUPS, AND SCREENINGS. CVPH SPONSORS A NUMBER OF FREE SUPPORT GROUPS INCLUDING PROGRAMS ON DIABETES, MULTIPLE CANCER GROUPS, AND BEREAVEMENT. AN ARRAY OF FOCUSED CLASSES ARE HELD FOR EXPECTANT MOTHERS AS PART OF AN OVERALL CHILDBIRTH EDUCATION INITIATIVE. REGULAR CAR-SEAT SAFETY CHECKS ARE HELD TO ENSURE THAT INFANTS AND TODDLERS ARE APPROPRIATELY SECURED IN THEIR VEHICLES. CVPH AND THE FOUNDATION OF CVPH WORKS IN CONJUNTION WITH THE ADIRONDACK SAFE KIDS NETWORK FOR AN ANNUAL BIKE AND SKATEBOARD SAFETY FAIR THAT DISTRIBUTES HUNDREDS OF FREE SAFETY HELMETS. CVPH IS A REGULAR PARTICIPANT AT VARIOUS HEALTH FAIRS IN THE REGION DISPENSING EDUCATION INFORMATION AND PROVIDING FREE HEALTH SCREENINGS. CVPH ALSO WORKS WITH OTHER AGENCIES TO FACILITATE INSURANCE COVERAGE FOR ELIGIBLE INDIVIDUALS AND FAMILIES. CVPH MEDICAL CENTER OVERSEES THE NEW YORK STATE GRANT-FUNDED CANCER SERVICES PROGRAM (CSP) OF CLINTON COUNTY. THE PROGRAM PROVIDES CLINTON COUNTY RESIDENTS WHO HAVE NO INSURANCE OR WHO ARE UNDERINSURED WITH FREE SCREENINGS FOR BREAST, CERVICAL AND COLORECTAL CANCERS. THE SERVICES ARE PROVIDED VIA LOCAL PROVIDERS AND CLINICS. CVPH ALSO PARTICIPATES IN THE ACTION FOR HEALTH COALITION. THIS GROUP HAS AN ACTIVE ROLE IN TRACKING PROGRESS MADE IN IMPLEMENTING CHANGES TO IMPACT THE HEALTH OF THE COMMUNITY AS WELL AS MAKING ADJUSTMENTS TO THE STRATEGIES IDENTIFIED TO ADDRESS THESE NEEDS. SOME OF THE ACCOMPLISHMENTS OF THE ACTION FOR HEALTH COALITION INCLUDE CVPH HOSTING NEW VISIONS PROGRAM FOR SELECTED COLLEGE BOUND HIGH SCHOOL SENIORS PLANNING TO MAJOR IN A HEALTH RELATED FIELD OF STUDY, MOVING TOBACCO PRODUCTS OUT OF SIGHT IN MANY RETAIL ESTABLISHMENTS, IMPROVING NUTRITION IN SCHOOLS, AND FOCUSING ON POSITIVELY IMPACTING CHRONIC DISEASE MANAGEMENT IN CLINTON COUNTY.

PART VI, LINE 6:
CVPH MEDICAL CENTER, IS A MEMBER OF THE UNIVERSITY OF VERMONT HEALTH NETWORK (FORMERLY FLETCHER ALLEN PARTNERS, INC.), ALSO COVERING THE BURLINGTON AND BERLIN, VERMONT AREAS.CVPH IS A VOLUNTARY, NOT-FOR-PROFIT, ARTICLE 28 ORGANIZATION THAT IS GOVERNED BY A VOLUNTARY BOARD OF DIRECTORS AND IS LICENSED FOR 300 BEDS. CVPH IS LOCATED AT 75 BEEKMAN STREET IN PLATTSBURGH, NEW YORK WITH SATELLITE SERVICES AT A NUMBER OF OTHER AUTHORIZED LOCATIONS WITHIN THE PLATTSBURGH AREA. CVPH IS PART OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS COMPRISED OF SIX HOSPITALS, A HOME HEALTH AND HOSPICE AGENCY, AND AN EMPLOYED MEDICAL GROUP. IT IS AFFILIATED WITH AN ACADEMIC MEDICAL CENTER IN BURLINGTON, VERMONT. CVPH OFFERS A VARIETY OF SERVICES INCLUDING CARDIOVASCULAR, ORTHOPEDICS, OBSTETRICS, PSYCHIATRY, LONG TERM CARE, AND PRIMARY CARE. IT HAS A FAMILY MEDICINE RESIDENCY PROGRAM TO HELP ADDRESS PRIMARY CARE SHORTAGES IN THE COMMUNITY. CVPH PROVIDES CANCER SERVICES THROUGH THE FITZPATRICK CANCER CENTER. IN ADDITION, CVPH HAS A ROBUST MEDICAL HOME AS WELL AS THE ADIRONDACK REGION ACO WHICH ARE KEY PARTNERS IN ADDRESSING COMMUNITY HEALTH NEEDS.