4A (Expenses $ 236130814 including grants of $ 0) (Revenue $ 263165232)
RICHMOND UNIVERSITY MEDICAL CENTER IS A 478 LICENSED BED, ACUTE CARE HOSPITAL SERVING NEARLY 500,000 RESIDENTS OF STATEN ISLAND, NEW YORK.THE MAIN CAMPUS, LOCATED IN THE WEST BRIGHTON SECTION OF STATEN ISLAND, IS LICENSED FOR 448 BEDS AND THE SECONDARY CAMPUS, LOCATED IN THE CLIFTON SECTION OF STATEN ISLAND, IS LICENSED FOR 30 BEDS. SERVICES PROVIDED AT THE WEST BRIGHTON CAMPUS, A DESIGNATED STROKE CENTER AND LEVEL 1 TRAUMA CENTER, ENCOMPASS NUMEROUS INPATIENT AND OUTPATIENT SERVICES INCLUDING MEDICAL/SURGICAL, PEDIATRICS,OBSTETRICS/GYNECOLOGY, NICU, ADULT AND ADOLESCENT PSYCHIATRY, COMPREHENSIVE PSYCHIATRY EMERGENCY PROGRAM (CPEP) AND CLINIC SERVICES.SERVICES PROVIDED AT THE CLIFTON CAMPUS CONSIST PRIMARILY OF INPATIENT AND OUTPATIENT PSYCHIATRY SERVICES. OUTPATIENT PSYCHIATRY SERVICES. OUTPATIENT PSYCHIATRY SERVICES. OUTPATIENT PSYCHIATRY SERVICES.

PART V LINE 3
STATEN ISLAND HEART SOCIETY, SI CENTER FOR INDEPENDENT LIVING, EGER FOUNDATION, ST. PHILLIPS BATIST CHURCH, NORTH SHORE

PART V LINE 5
PROVIDED TO LOCAL ELECTED OFFICALS FOR DISTRIBUTION TO THEIR CONSTITUENTS IN THEIR OFFICES.

PART LINE 12H
SEE DESCRIBTION PART VI

PART I, LINE 7:
"THE COSTS ASSOCIATED WITH CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMS WERE DETERMINED USING THE RATIO OF PATIENT CARE COSTS TO PATIENT CHARGES UTILIZING WORKSHEET 2 OF THE 2013 INSTRUCTIONS FOR SCHEDULE H (FORM 990). THE COSTS ASSOCIATED WITH ""OTHER BENEFITS"" WERE DETERMINED USING THE ACTUAL COSTS INCURRED BY THE PROGRAM USING AN INDIRECT OVERHEAD ALLOCATION, ADJUSTED FOR THE ACTUAL LOCATION OF THE PROGRAM."

PART I, LINE 7G:
THE ORGANIZATION DID NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC IN THE AMOUNT REPORTED FOR SUBSIDIZED HEALTH SERVICES ON PART I, LINE 7G.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART VIII, LINE 2A, COLUMN (B), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ -15,666,074.

PART II:
"TO FOSTER AND IMPROVE COMMUNITY HEALTH REQUIRES A BROAD AND COMPREHENSIVE APPROACH TO MEET DOCUMENTED HEALTHCARE NEEDS FOR STATEN ISLAND. RUMCS SELECTED PREVENTION AGENDA PRIORITIES, BASED ON COMMUNITY HEALTH NEEDS ASCERTAINED FROM STATISTICAL EVIDENCE THROUGH NEW YORK AND NEW YORK CITY DEPARTMENTS OF HEALTH INCLUDE SMOKING CESSATION, HEALTHY MOTHERS/HEALTHY BABIES, EMERGENCY PREPAREDNESS, PRIMARY CARE EXPANSION AND YOUTH SUBSTANCE ABUSE PREVENTION. PRIORITY I: SMOKING CESSATION. SINCE AUGUST, 2009, RUMC HAS BEEN DESIGNATED THE RICHMOND COUNTY TOBACCO CESSATION CENTER. FUNDED BY THE NYS DEPARTMENT OF HEALTH TOBACCO CONTROL PROGRAM, THE CENTER WORKS WITH LOCAL HEALTH CARE PROVIDERS AND HEALTH CARE ORGANIZATIONS TO IMPLEMENT SYSTEMS FOR IDENTIFYING AND TREATING TOBACCO DEPENDENCE, PROVIDES ONGOING TRAINING AND TECHNICAL ASSISTANCE, QUALITY ASSURANCE EFFORTS, PERFORMANCE IMPROVEMENT PROJECTS, AND PROGRESS REPORTS. PRIORITY II: HEALTHY MOTHERS/HEALTHY BABIES. IN AN EFFORT TO INCREASE HEALTH OUTCOMES FOR MOTHERS AND BABIES, RUMC HAS TAKEN ON THE CENTERING PREGNANCY (CP) MODEL OF PRENATAL CARE AND IS PROMOTING BREASTFEEDING TO NEW MOTHERS. THE SPECIFIC AIM OF SERVICES PROVIDED IS TO EDUCATE HIGH-RISK, UNDERSERVED WOMEN OF CHILDBEARING AGE ABOUT THE IMPORTANCE OF BREASTFEEDING, AND TO ENSURE THAT THEY HAVE THE INFORMATION TO MAKE AN INFORMED DECISION ABOUT FEEDING THEIR NEWBORNS AND THE SUPPORT THEY NEED TO SUCCEED. PARTICIPANTS IN THE CENTERING PREGNANCY HAVE DEMONSTRATED IMPROVED KNOWLEDGE OF PREGNANCY, HIGHER BIRTH WEIGHT, HIGHER BREASTFEEDING RATES, AND REDUCED EMERGENCY DEPARTMENT VISITS. RUMC HAS ALSO ADOPTED ""LATCH ON NYC"" INITIATIVES DESIGNED TO PROMOTE BREASTFEEDING BY NEW MOTHERS AND AS PART OF AN OVERALL AGENDA TO BECOME A ""BABY FRIENDLY"" HOSPITAL. PRIORITY III: EMERGENCY PREPAREDNESS. RUMC PARTICIPATES IN THE STATEN ISLAND EMERGENCY MANAGEMENT COALITION, ESTABLISHED BY THE RICHMOND COUNTY MEDICAL SOCIETY. THE HOSPITAL, ALONG WITH OTHER HEALTH CARE FACILITIES, HOSPICES AND VOLUNTARY AMBULANCES MAKE UP THE COALITION. THE HOSPITAL PARTICIPATES IN SEVERAL DRILLS THROUGHOUT THE YEAR, BOTH INTERNALLY AND THROUGH THE COALITION TO HELP DEFINE SHORTCOMINGS IN OUR INTERNAL AND EMERGENCY OPERATIONS PLAN (EOP). ONCE IDENTIFIED, THE POLICIES ARE RE-WRITTEN AND DRILLED AGAIN TO ENSURE ACCURACY. IN ADDITION TO THE FOUR PRIORITY AREAS, RICHMOND UNIVERSITY MEDICAL CENTER EDUCATES, INFORMS, AND ENGAGES THE COMMUNITY WE SERVE BY PROVIDING A COMPREHENSIVE SERIES OF DIVERSE HEALTH PROGRAMS THROUGHOUT THE YEAR,INCLUDING LECTURES, WORKSHOPS, AND SCREENINGS. OUR SPEAKERS BUREAU BRINGS MEDICAL EXPERTISE AND EDUCATION PROGRAMS TO COMMUNITY GROUPS. SPEAKERS INCLUDE PHYSICIANS,NURSES, DIETICIANS, AND OTHER HEALTHCARE EXPERTS WHO PROVIDE INFORMATION ON A VARIETY OF HEALTH TOPICS. WE DISSEMINATE HEALTH INFORMATION AT LOCAL HEALTH FAIRS AND EXPOSITIONS THROUGHOUT THE ISLAND. WE WORK COLLABORATIVELY WITH PARISH NURSE PROGRAMS, SCHOOLS, AND SENIOR CENTERS TO ENCOURAGE HEALTHY LIVING AND PREVENT ILLNESS THROUGHOUT THE COMMUNITY OF STATEN ISLAND. PRIORITY IV: PRIMARY CARE EXPANSION. RICHMOND UNIVERSITY MEDICAL CENTER WAS AWARDED A GRANT BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO EXPAND ITS INTERNAL MEDICINE RESIDENCY PROGRAM TO PROMOTE CAREERS IN PRIMARY CARE. THE PROGRAM TRAINS RESIDENTS IN COMMUNITY-BASED SITES SERVING THE POOREST AND UNDERSERVED ADULT POPULATION OF STATEN ISLAND. THIS INITIATIVE ENSURES THAT HIGH-QUALITY PRIMARY CARE SERVICES ARE AVAILABLE TO STATEN ISLANDS MEDICALLY UNDERSERVED POPULATION, IMPROVE ACCESS TO CARE, AND IMPROVE PATIENT OUTCOMES FOR OPTIMAL HEALTH. THE PROGRAM PLAYS AN INTEGRAL ROLE IN PROVIDING QUALITY HEALTH CARE TO STATEN ISLANDS MINORITY, INDIGENT AND MARGINALIZED POPULATION. PRIORITY V: YOUTH SUBSTANCE ABUSE PREVENTION. RICHMOND UNIVERSITY MEDICAL CENTER IS A MEMBER OF THE STATEN ISLAND PARTNERSHIP FOR COMMUNITY WELLNESS, A BROAD COALITION OF HEALTH AND SOCIAL SERVICE AGENCIES THAT ADVOCATE FOR AND SUPPORT PROGRAMS THAT ENCOURAGE HEALTH AND WELLNESS. THE PARTNERSHIPS AGENDA IN 2013 WAS YOUTH SUBSTANCE ABUSE (ALCOHOL AND DRUGS) AND TOBACCO PREVENTION. STATEN ISLAND HAS RECENTLY SEEN A SURGE IN PRESCRIPTION DRUG ABUSE CASES, PARTICULARLY AMONG YOUTH. RUMCS CLINICAL CHAIR FOR PSYCHIATRY AND ITS ASSISTANT VICE PRESIDENT OF OPERATIONS SERVE ON THE STEERING COMMITTEE OF THE POLICY AND ADVOCACY WORK GROUP OF THE TACKLING YOUTH SUBSTANCE ABUSE COLLABORATIVE. IN SO DOING, THEY HAVE ASSISTED WITH VARIOUS INITIATIVES INCLUDING A DRUG TAKE-BACK DAY IN CONJUNCTION WITH THE US DRUG ENFORCEMENT AGENCY TO ENCOURAGE RESIDENTS TO RETURN UNWANTED AND EXPIRED MEDICATIONS. OTHER PRIORITIES: RUMC HAS ALSO UNDERTAKEN OTHER MEASURES DESIGNED TO ASSIST THE COMMUNITY WITH HEALTH INFORMATION AND SERVICES. RUMC RECEIVED A GRANT FROM SUSAN G. KOMEN GREATER NEW YORK CITY TO ADMINISTER A BREAST CANCER NAVIGATION PROGRAM WHEREBY WOMEN DIAGNOSED WITH THE DISEASE ARE PROVIDED ASSISTANCE TO MANAGE THEIR CARE. THE NAVIGATOR WORKS WITH EACH PATIENT INDIVIDUAL THROUGH TESTING, DIAGNOSIS, TREATMENT AND FOLLOWUP CARE AS APPROPRIATE. RUMC IS ALSO A DESIGNATED ""SAFE"" CENTER, WHICH PROVIDES ASSISTANCE TO VICTIMS OF SEXUAL ASSAULT AND WORKS WITH A TEAM OF SOCIAL WORKERS, LAW ENFORCEMENT PERSONNEL AND CLINICAL STAFF TO ADDRESS THE NEEDS OF THE VICTIM. FINALLY, RUMC HAS PROVIDED PERIPHERAL ARTERY DISEASE SCREENINGS, INFORMATION SESSIONS ON BARRETTS ESOPHAGUS, LACTATION FORUMS,COLORECTAL AWARENESS EVENTS, AND A HOST OF OTHER SERVICES ON AN AS NEEDED BASIS AS REQUESTED BY ITS COMMUNITY PARTNERS."

PART III, SECTION A:
"LINE 2: THE AMOUNT REPORTED ON LINE 2 IS EQUAL TO THE PROVISION FOR BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS (""AFS""). THE EXPLANATION OF THE METHODOLOGY USED TO ESTIMATE THIS AMOUNT CAN BE FOUND IN FOOTNOTE #1 ON PAGES 8 AND 10 OF THE ATTACHED AFS. LINE 3: THE COSTING METHODOLOGY USED TO ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE POLICY WAS THE RATIO OF APPROVED CHARITY CARE APPLICATIONS TO TOTAL APPLICATIONS APPLIED TO SELF PAY BAD DEBTS ASSOCIATED WITH PATIENTS WHO DID NOT ADEQUATELY COMPLETE THE CHARITY CARE PAPERWORK. WE BELIEVE THAT A PORTION OF OUR BAD DEBT RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNWILLING OR UNABLE TO PROVIDE THE APPROPRIATE DOCUMENTATION TO ALLOW THAT CLASSIFICATION. HOW THE ORGANIZATION ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE: DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE REFLECTED AS A REDUCTION OF REVENUE/ACCOUNTS RECEIVABLE AND ARE NOT COMPONENTS OF BAD DEBT EXPENSE. LINE 4: THE TEXT OF THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 8 & 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS."

PART III, SECTION B, LINE 8:
COSTING METHODOLOGY/SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS: MEDICARE COSTS WERE DETERMINED USING THE RATIO OF PATIENT CARE COSTS TO PATIENT CHARGES UTILIZING WORKSHEET 2 OF THE 2013 INSTRUCTIONS FOR SCHEDULE H (FORM 990).

PART III, SECTION C, LINE 9B:
ALL PATIENTS WITH SELF PAY BALANCES RELATED TO SERVICES RENDERED AT RICHMOND UNIVERSITY MEDICAL CENTER ARE GIVEN THE OPPORTUNITY TO ADDRESS THEIR RESPONSIBILITY THROUGH A PAYMENT ARRANGEMENT OR A REDUCED FEE, BASED ON THE CRITERIA OF OUR FINANCIAL ASSISTANCE PROGRAM. A SLIDING FEE SCALE IS UTILIZED AND IS BASED UPON FAMILY INCOME AND NUMBER OF FAMILY MEMBERS. ALL PATIENTS WILL RECEIVE STATEMENTS AND/OR LETTERS AND ARE GIVEN THE OPPORTUNITY TO SATISFY THEIR OBLIGATION TO THE FACILITY PRIOR TO TRANSFER TO A COLLECTION AGENCY AND WRITE-OFF TO A BAD DEBT. PATIENTS WHO CANNOT AFFORD TO PAY ARE OFFERED INSTALLMENT PAYMENTS OR A REDUCTION IN BALANCE THROUGH THE FINANCIAL ASSISTANCE PROGRAM (FAP).

PART V, SECTION B, LINE 12H:
RICHMOND MEDICAL CENTER: NUMBER OF DEPENDENTS; ESTIMATED LIVING COSTS; OTHER HARDSHIPS BAYLEY SETON HOSPITAL: NUMBER OF DEPENDENTS; ESTIMATED LIVING COSTS; OTHER HARDSHIPS

PART VI, LINE 2:
"COMMUNITY BENEFIT PLANNING IS FORUMULATED AROUND INFORMATION GATHERED FROM CONSOLIDATING DATA FROM NY STATE AND NEW YORK CITY DEPARTMENTS OF HEALTH AND OBTAINING PERSPECTIVES FROM KEY COMMUNITY ORGANIZATIONS AND STAKEHOLDERS ON THE CRITICAL HEALTHCARE ISSUES FACING STATEN ISLAND. THE NY STATE DEPARMENT OF HEALTH'S STATE PLANNING AND RESEARCH SYSTEM (SPARCS) AND THE COMMUNITY HEALTH ASSESSMENT CLEARINGHOUSE PROVIDE PREVENTION QUALITY INDICATORS WHICH RUMC USES TO DETERMINE THE MOST PRESSING HEALHTCARE NEEDS OF THE COMMUNITY. RUMC UTILIZES INFORMATION FROM THE COUNTY HEALTH ASSESSMENT INDICATORS AND COUNTY HEALTH INDICATOR PROFILES. PREVENTION QUALITY INDICATORS (PQIS) AT THE ZIP CODE LEVEL IN NEW YORK STATE ARE USED TO IDENTIFY RATES OF ADMISSION TO THE HOSPITAL FOR CONDITIONS FOR WHICH GOOD OUTPATIENT CARE CAN POTENTIALLY PREVENT THE NEED FOR HOSPITALIZATION, OR FOR WHICH EARLY INTERVENTION CAN PREVENT COMPLICATIONS OR MORE SEVERE DISEASE. PQI PROVIDES INDICATOR SETS THAT DRILL DOWN TO RICHMOND COUNTY FOR SPECIFIC DISEASE PROCESSES. OTHER DISEASE SPECIFIC TRACKING DATA SUCH AS THE NY STATE CANCER REGISTRY AND THE NY STATE HEART AND STROKE REGISTRY HELP RUMC IDENTIFY THE MOST SERIOUS HEALTH NEEDS OF OUR COMMUNITY. RUMC USES THE NY STATE IDENTIFIED PREVENTION AGENDA'S TEN PRIORITIES FOR IMPACTING THE HEALTH OF ALL NEW YORK WHEN DETERMINING COMMUNITY BENEFIT PROGRAM DEVELOPMENT. THROUGH DATA OBTAINED FROM THE NEW YORK STATE DEPARTMENT OF HEALTH AND NEW YORK CITY DEPARTMENT OF HEALTH, AS WELL AS COLLABORATIONS WITH HEALTHCARE AND OTHER KEY COMMUNITY STAKEHOLDERS, RUMC COORDINATES A UNIFIED EFFORT TO PROVIDE PROGRAMS THAT IMPACT THE HEALTH AND WELL BEING OF OUR COMMUNITY. THROUGH MEETINGS WITH THE HOSPITAL'S COMMUNITY HEALTH ADVISORY BOARD, THE LOCAL CHAPTERS OF THE AMERICAN CANCER SOCIETY, MARCH OF DIMES, STATEN ISLAND PARTNERSHIP FOR COMMUNITY WELLNESS AND COMMUNITY LEADERS, RUMC DEVELOPS AN OVERALL STRATEGY TO ADDRESS THE CRITICAL HEALTHCARE ISSUES FACING OUR COMMUNITY. RUMC'S SELECTED PREVENTION AGENDA PRIORITIES BASED ON COMMUNITY HEALTH NEEDS INCLUDED SMOKING CESSATION AND HEALTHY MOTHERS/HEALTHY BABIES, EMERGENCY PREPAREDNESS, PRIMARY CARE EXPANSION AND YOUTH SUBSTANCE ABUSE PREVENTION. PRIORITY I: SMOKING CESSATION. RUMC HAS TAKEN THE ROLE OF THE LEAD AGENCY IN COMBATING TOBACCO USE AND DEPENDENCE IN RICHMOND COUNTY, WHICH HAS THE HIGHEST RATE OF SMOKING OF THE FIVE BOROUGHS. SINCE AUGUST OF 2009, RUMC HAS BEEN DESIGNATED THE RICHMOND COUNTY TOBACCO CESSATION CENTER. THE CESSATION CENTER, CALLED ASSIST (ANTI-SMOKING STATEN ISLAND SUPPORT TEAM) IS FUNDED BY THE NEW YORK STATE DEPARTMENT OF HEALTH, TOBACCO CONTROL PROGRAM. THE GOAL OF THE PROGRAM IS TO WORK WITH LOCAL HEALTHCARE PROVIDERS TO IMPLEMENT A SYSTEM FOR IDENTIFYING AND TREATING TOBACCO DEPENDENCE. ASSIST HAS CREATED A ""SUPPORT TEAM"""" OF EXPERTS IN THE FIELD OF TOBACCO DEPENDENCE, WHO WORK WITH PHYSICIANS ON ADDRESSING THE IMPORTANCE OF QUITTING SMOKING WITH PATIENTS. BECAUSE TOBACCO DEPENDENCE IS A CHRONIC, RELAPSING DISEASE, WE BELIEVE THAT HEALTHCARE PROVIDERS ARE IN THE BEST POSITION TO PROVIDE MESSAGES TO THEIR PATIENTS ABOUT THE IMPORTANCE OF QUITTING AND OFFER THE HELP THEY MAY NEED. THE CESSATION CENTER PROVIDES ON-GOING STAFF TRAINING FOR PHYSICIANS AND OTHER HEALTHCARE PROVIDERS ON TREATMENT INTERVENTIONS AND EFFECTIVE COUNSELING TECHNIQUES AND TECHNICAL ASSISTANCE INCLUDING CHART REVIEWS, QUALITY ASSURANCE EFFORTS, PERFORMANCE IMPROVEMENT PROJECTS AND PROGRESS REPORTS. ALL ASSIST STAFF ARE TRAINED CERTIFIED TOBACCO TREATMENT SPECIALISTS, WHICH ENABLES THE PROGRAM TO OFFER DIRECT PATIENT CESSATION SERVICES INCLUDING A QUIT SMOKING SUPPORT GROUP, PROVIDING NICOTINE REPLACEMENT THERAPY AND OTHE RESOURCES AND SUPPORT FOR QUITTING. THE ASSIST PROGRAM ALSO WORKS WITH THE NYS DEPARTMENT OF HEALTH ON REFERRALS OF INDIVIDUAL CLIENTS TO THE ""QUIT LINE"" - A TOLL FREE NUMBER FOR INDIVIDUALS LOOKING TO END THEIR SMOKING HABIT. PRIORITY II: HEALTHY MOTHERS/HEALTHY BABIES. RUMC'S COMMITMENT TO THE NEEDS OF THE POOR PREGNANT, POSTPARTUM, BREASTFEEDING WOMEN, INFANTS AND CHILDREN CAN BE DEMONSTRATED ON MANY LEVELS. RUMC HAS EARNED 5 STARS, THE HIGHEST ACHIEVEMENT LEVEL FROM THE INDEPENDENT HEALTH GRADES, WHICH INDICATES THE LEVEL OF CARE IS EXCELLENT. RUMC'S NEONATAL INTENSIVE CARE UNIT (NICU) HAS ONE OF THE LOWEST MORTALITY RATES IN NEW YORK CITY. ALL NICU INFANTS WHO ARE DISCHARGED BECOME PART OF AN AUTOMATED FOLLOW -UP PROGRAM WITH THE INSTITUTE OF BASIC RESEARCH FOR EARLY DETECTION OF ANY PROBLEMS. IN ACCORDANCE WITH BEST-PRACTICE POLICIES THAT IMPROVE OUTCOMES IN INFANTS, RUMC COLLABORATES WITH THE NYC DEPARTMENT OF HEALTH AND THE UNITED HOSPITAL FUND TO DEVELOP AND IMPLEMENT POLICIES THAT SUPPORT SKIN-TO-SKIN CONTACT AT BIRTH AND THAT ENCOURAGE THE INITIATION OF BREASTFEEDING WITHIN THE FIRST HOUR OF BIRTH. PHYSICIANS ARE EDUCATED ON BREASTFEEDING, STAFF IS TRAINED AS CERTIFIED LACTATION CONSULTANTS, AND A MULTIDISCIPLINARY TEAM MEETS MONTHLY TO ENSURE THAT BREASTFEEDING PROTOCOLS AND PROCEDURES ARE FOLLOWED. THE MEDICAL CENTER FOLLOWS THE MARCH OF DIMES CENTERING PREGNANCY (CP) MODEL OF PRENATAL CARE TO PROVIDE WOMEN WITH A HOLISTIC AND COMPREHENSIVE APPROACH THAT INCLUDES EDUCATION, SUPPORT, AND ACTIVE PARTICIPATION. THE CP PROGRAM ADDRESSES AT RISK BEHAVIORS, PROVIDES GROUP SUPPORT, AND ENCOURAGES SELF MONITORING SKILLS WHICH FOSTER PATIENT KNOWLEDGE AND INVOLVEMENT. PROGRAM PARTICIPANTS DEMONSTRATE IMPROVED KNOWLEDGE OF PREGNANCY, HIGHER BIRTH WEIGHT, ESPECIALLY FOR INFANTS DELIVERED PRETERM, HIGH BREASTFEEDING RATES AND FEWER ER VISITS. RUMC IS PLANNING TO BECOME AN OFFICIAL ""BABY FRIENDLY"" HOSPITAL BY SUMMER 2015. PRIORITY III: EMERGENCY PREPARDNESS. THE LAST SEVERAL YEARS HAVE SHOWN THE COUNTRY JUST HOW IMPORTANT IT IS TO BE PREPARED FOR NATURAL DISASTERS, TERRORIST ATTACKS AND MAJOR ACCIDENTS. AT RICHMOND UNIVERSITY MEDICAL CENTER, WE TAKE EMERGENCY PREPARDNESS VERY SERIOUSLY AND ARE WORKING WITH COMMUNITY AGENCIES TO ENSURE THE BEST POSSIBLE OUTCOMES FOR ALL STATEN ISLANDERS. STATEN ISLAND HAS UNIQUE GEOGRAPHIC PROPERTIES THAT PRESENT MANY CHALLENGES FOR EMERGENCY PREPARDNESS. BEING AN ISLAND WITH ONE COMMUNTER FERRY AND FOUR BRIDGES, STATEN ISLAND, ALTHOUGH PART OF NEW YORK CITY, IS HEAVILY ISOLATED. IN THE INTEREST OF HAVING THE ISLAND BE ABLE TO MANAGE ITSELF FOR THE FIRST 96 HOURS OF A WIDE SCALE OR LOCAL DISASTER, THE NEW YORK STATE DEPARTMENT OF HEALTH AND MENTAL HYGIENE SUPPORTED AN IDEA TO CREATE AN INITIATIVE FOR STATEN ISLAND IN THE EVENT OF A DISASTER. IN ADDITION TO ITS OWN INTERNAL INITIATIVES, RUMC SUBSEQUENTLY JOINED THE STATEN ISLAND EMERGENCY MANAGEMENT COALITION, WHICH WAS ESTABLISHED BY THE RICHMOND COUNTY MEDICAL SOCIETY. THE COALITION IS COMPRISED OF RUMC ALONG WITH OTHER HEALTH CARE FACILITIES, HOSPICES, VOLUNTARY AMBULANCES, AND OTHER HEALTH AND SOCIAL SERVICE ORGANIZATIONS. AS PART OF THE INITIATIVE, THE STATEN ISLAND MEDICAL COMMUNICATIONS AND OPERATIONS NODE (SIMCON) WAS CREATED. THIS SYSTEM IS TESTED ON A REGULAR BASIS WITH THE MEDICAL CENTER'S PARTICIPATION. THE HOSPITAL PARTICIPATES IN SEVERAL DRILLS THROUGHOUT THE YEAR- BOTH INTERNALLY AND THROUGH THE COALITION. THESE DRILLS HELP TO DEFINE SHORTCOMINGS IN BOTH OUR INTERNAL AND EMERGENCY OPERATION PLANS (EOP). ONCE IDENTIFIED, THE POLICIES ARE RE-WRITTEN AND DRILLED AGAIN TO ENSURE ACCURACY. PRIORITY IV: PRIMARY CARE EXPANSION. STATEN ISLAND RESIDENTS DEMONSTRATE SOME OF THE WORST HEALTH STATISTICS CITYWIDE FOR SUCH CHRONIC CONDITIONS AS DIABETES, HEART DISEASE, STROKE AND CANCER. THIS CAN BE ATTRIBUTED TO POOR DIET, SMOKING AND OBESITY AS WELL AS TO A LACK OF PRIMARY CARE SERVICES. RUMC RECOGNIZES THAT PREVENTATIVE PRIMARY CARE IS ESSENTIAL TO STEMMING THE CURRENT HEALTH CRISES EXPERIENCED BY STATEN ISLANDERS. TOWARD THIS END, RUMC HAS ASSISTED WITH THE ESTABLISHMENT OF 4 PRIMARY CARE PRACTICES ACROSS STATEN ISLAND. PRIORITY V: YOUTH SUBSTANCE ABUSE PREVENTION. RICHMOND UNIVERSITY MEDICAL CENTER IS A MEMBER OF THE STATEN ISLAND PARTNERSHIP FOR COMMUNITY WELLNESS, A BROAD COALITION OF HEALTH AND SOCIAL SERVICE AGENCIES THAT ADVOCATE FOR AND SUPPORT PROGRAMS THAT ENCOURAGE HEALTH AND WELLNESS. THE PARTNERSHIP'S AGENDA IN 2013 WAS YOUTH SUBSTANCE ABUSE (ALCOHOL AND DRUGS) AND TOBACCO PREVENTION. STATEN ISLAND HAS RECENTLY SEEN A SURGE IN PRESCRIPTION DRUG ABUSE CASES, PARTICULARLY AMONG YOUTH. RUMC'S CLINICAL CHAIR FOR PSYCHIATRY, ADMINISTRATIVE DIRECTOR OF PSYCHIATRY, AVP OF OPERATIONS, ALONG WITH A BOARD MEMBER SERVE ON THE STEERING COMMITTEE OF THE POLICY AND ADVOCACY WORK GROUP OF THE TACKLING YOUTH SUBSTANCE ABUSE COLLABORATIVE. IN SO DOING, THEY HAVE ASSISTED WITH VARIOUS INITIATIVES INCLUDING TWO DRUG TAKE-BACK DAYS IN CONJUNCTION WITH THE US DRUG ENFORCEMENT AGENCY TO ENCOURAGE RESIDENTS TO RETURN UNWANTED AND EXPIRED MEDICATIONS. THE AVP OF OPERATIONS ALSO WORKED TO COORDINATE SEVERAL PARENT WORKSHOPS IN COLLABORATION TYSA AND WORKING TO INCREASE THE AMOUNT OF WORKSHOP TRAI"

PART VI, LINE 3:
IN KEEPING WITH ITS CHARITABLE PURPOSES, RUMC PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY WAY, REGARDLESS OF RACE, COLOR, CREED OR ETHNICITY. RUMC CONTINUES TO PROVIDE REDUCED-FEE OR FREE CARE IN ACCORDANCE TO PUBLIC LAW 2807(K)(9-A). ALTHOUGH NOT REQUIRED BY THIS LAW, WE DO EXTEND THIS POLICY TO INDIVIDUALS WHO MAY NOT BE QUALIFIED BASED ON THE GUIDELINES OF OUR FINANCIAL ASSISTANCE POLICY, BUT DO DEMONSTRATE AN INABILITY TO PAY ALL OF THEIR MEDICAL EXPENSES. AS PART OF BEST-PRACTICE CARE, RUMC IS IN COMMUNICATION WITH LOCAL COMMUNITY-BASED CONSUMER ADVOCATE ORGANIZATIONS TO BE CERTAIN THAT THEY ARE AWARE OF THE PROVISIONS OF OUR FINANCIAL AID POLICY. THE PATIENT ACCESS DEPARTMENT HAS RECEIVED SUMMARY DATA OF THE LAW AND OUR REQUIREMENTS. ASSISTANCE CONTINUES TO BE OFFERED BY OUR FINANCIAL SCREENING STAFF AND MEDICAL APPLICATION OFFICE TO THOSE INDIVIDUALS NOT ELIGIBLE FOR MEDICAID, AS WELL AS FINANCIAL SCREENING STAFF LOCATED IN OUR EMERGENCY DEPARTMENT. RUMC POSTS THE HOSPITAL'S CHARITY CARE POLICY SUMMARY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN MANY DIFFERENT LANGUAGES (AS DETERMINED BY RUMC'S ANNUAL LANGUAGE NEEDS ASSESSMENT) IN LOCATIONS SUCH AS THE EMERGENCY DEPARTMENT, INTAKE, REGISTRATION AND ADMISSION AREAS. PATIENTS ARE PROVIDED A SUMMARY OF THE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION AS PART OF THE INTAKE PROCESS AND FINANCIAL SCREENING PROCESS. PATIENT BILLS INCLUDE A STATEMENT ON FINANCIAL ASSISTANCE. EVERY PATIENT SEEN IN THE FINANCIAL OFFICE HAS A DISCUSSION ON THE AVAILABILITY OF GOVERNMENT BENEFITS SUCH AS MEDICAID AND AT THE SAME TIME QUALIFICATIONS ON THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. RUMC HAS AN INTERDISCIPLINARY TEAM THAT INTERACTS WITH FINANCIAL ASSISTANCE COUNSELORS SUCH AS SOCIAL WORKERS AND CASE MANAGERS TO IDENTIFY AND ASSIST ELIGIBLE PATIENTS. STAFF TRAINING ON FINANCIAL ASSISTANCE IS DONE ANNUALLY THROUGH AN IN-SERVICE PROGRAM THAT INCLUDES A REVIEW OF HOW TO QUALIFY PATIENTS FOR MEDICAID AND OTHER GOVERNMENT PROGRAMS. ALL THIRD PARTIES THAT WORK FOR RUMC IN THE COLLECTION OF FEES ARE REQUIRED TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. RUMC'S FINANCIAL ASSISTANCE POLICY CLEARLY STATES THAT MEDICAL CARE IS PROVIDED TO INDIVIDUALS IN NEED, REGARDLESS OF THEIR ABILITY TO PAY AND MAKES CERTAIN THAT ALL REQUESTS FOR FINANCIAL ASSISTANCE ARE EVALUATED AND PROCESSED FAIRLY AND CONSISTENTLY WITH DIGNITY, COMPASSION AND IN A RESPECTFUL MANNER, CONSISTENT WITH RUMC MISSION AND VALUES.

PART VI, LINE 4:
"RUMC'S MISSION IS TO PROVIDE PREMIER QUALITY PATIENT CARE FOR THE ETHNICALLY DIVERSE COMMUNITY OF STATEN ISLAND AND ITS NEIGHBORS. OUR POPULATION IS A CROSS MIX OF THE OVERALL POPULATION ON STATEN ISLAND; HOWEVER, SINCE WE ARE LOCATED ON THE NORTH SHORE, RUMC TREATS A SIGNIFICANTLY HIGHER NUMBER OF THE UNDERSERVED AND UNDER INSURED THAN HEALTHCARE PROVIDERS LOCATED IN OTHER AREAS OF STATEN ISLAND. THE PRIMARY SERVICE AREA OF RESIDENTS ON THE NORTH SHORE INCLUDES: WEST BRIGHTON (10310), MARINER'S HARBOR (10303), PORT RICHMOND (10302), ST. GEORGE (10301), AND STAPLETON (10304). OUR SECONDARY SERVICE AREA IS FROM ZIP CODES MARINER'S HARBOR/WILLOBROOK (10314) AND ROSEBANK (10305). THE OFFICE OF THE STATE DEPUTY INDICATES THAT STAPLETON HAS A 21% POVERTY RATE, WHILE PORT RICHMOND HAS A 17.5% , MARINER'S HARBOR AT 17.4% , AND WEST BRIGHTON WITH 15.4%; THESE ARE THE NEIGHBORHOODS WITH THE HIGHEST RATE OF POVERTY IN STATEN ISLAND AND ALL ARE LOCATED IN THE RUMC CATCHMENT AREA. THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES AND SERVICES ADMINISTRATION HAS DESIGNATED THE FOLLOWING PRIMARY SERVICE AREAS, SERVED BY RUMC, AS PRIMARY HEALTH PROFESSIONAL SHORTAGE AREAS: ST. GEORGE (10301) AND STAPLETON (10304) PRIMARY CARE HPSA ID # 13699936E8; AND PORT RICHMOND (10302) AND MARINER'S HARBOR (10303) PRIMARY CARE HPSA ID # 136999365F. NORTH SHORE RESIDENTS (10302, 10304, 10303, 10310) ARE EXPERIENCING A SERIOUS SHORTAGE AND (10314) A STRESSED SHORTAGE OF PRIMARY CARE PROVIDERS SERVING MEDICAID ENROLLEES. ZIP CODES 10302, 10301, 10304 AND 10305 HAVE AMBULATORY CARE SENSITIVE CONDITIONS (ACSC) ADMISSION RATES THAT ARE 100-150% HIGHER THAN THE CITYWIDE RATE. AMENDABLE MORTALITY (AM) IS A BROAD INDICATOR THAT MEASURES THE EXTENT TO WHICH A HEALTH CARE SYSTEM CONTROLS PREMATURE MORTALITY AMENABLE TO HEALTH CARE INTERVENTIONS, FROM DISEASE PREVENTION SERVICES TO PRIMARY CARE, AS WELL AS TO SPECIALTY SERVICES. A NEIGHBORHOOD COMPARISON SHOWS PORT-RICHMOND (10302) WITH AN AGE-ADJUSTED AM THAT IS 27% HIGHER THAN NEW YORK CITY AND ADJUSTED RATES OF AVOIDABLE HOSPITAL CONDITION (AHC), FOR ST. GEORGE (10301) THAT IS 38% HIGHER THAN NEW YORK CITY. THE REPORT THAT STATES: ""THERE ARE SIGNIFICANT DISPARITIES IN ACCESS TO HEALTH CARE, WHICH AFFECT MORE THAN 178,000 STATEN ISLANDERS (40% OF THE POPULATION, MOSTLY ON THE NORTH SHORE IN ST. GEORGE AND PORT RICHMOND), THE HEALTH CARE SYSTEM FOR THIS POPULATION COULD BE IMPROVED BY TARGETING THESE AREAS FOR INCREASED AVAILABILITY OF HEALTH SERVICES RANGING FROM CLINICAL PREVENTION TO PRIMARY."" THIS REPORT CONCLUDES THAT IT WILL BE IMPORTANT TO DEVELOP AN INTEGRATED RESPONSE TO THE AREAS OF HIGH RISK AND TO ASSEMBLE A MIX OF CLINICAL PREVENTION, PRIMARY CARE, AND SPECIALTY SERVICES THAT RE-TAILORED TO THE NEEDS OF STATEN ISLANDERS. THERE ARE STARTLING STATISTICS THAT CLEARLY INDICATE THE MOST SERIOUS LACK OF HEALTHCARE RESOURCES, COMBINED WITH POOR HEALTH STATUS AND POVERTY IS FOUND ON THE NORTH SHORE OF STATEN ISLAND. PORT RICHMOND, STAPLETON, ST. GEORGE AND MARINER'S HARBOR RESIDENTS HAVE AN ANNUAL HEART DISEASE HOSPITILIZATION 20% HIGHER THAN NYC; 1 OUT OF 4 RESIDENTS ARE OBESE, 8-9% OF THESE COMMUNITY RESIDENTS HAVE DIABETES; 22% OF ADULTS SMOKE IN THE NORTH SHORE AND 33% IN WILLOBROOK (10314). MARINER'S HARBOR (10303) AND WILLOWBROOK (10314) NORTHERN-MID ISLAND HAVE A 60% HIGHER RATE OF HOSPITILIZATION FROM FALLS WITH FALL RELATED HIP FRACTURE HOSPITILIZATION RATES THAT ARE 50% HIGHER THAN NYC OVERALL. STAPLETON, ST. GEORGE, AND PORT RICHMOND COMMUNITIES HAVE A CANCER RATE THAT IS 20% HIGHER THAN NEW YORK CITY OVERALL. THE AVERAGE BIRTHRATE OF TEENAGERS IN 2003-2004 IN PORT RICHMOND WAS 106/1,000; THE REMAINDER OF STATEN ISLAND HAS A RATE OF 55/1,000 AND NYC HAS AN OVERALL RATE OF 75/1,000. THE INCIDENT OF INFANT MORTALITY FOR STAPLETON/ST. GEORGE IS 6/1,000 AND PORT RICHMOND IS 5.8/1,000, WHICH IS SIGNIFICANTLY HIGHER THAN THE 4.2/1,000 SOUTH SHORE AND 4/1,000 MID-ISLAND INFANT MORTALITY RATES. THERE ARE TWICE AS MANY NEW HIV DIAGNOSIS (.48 VS. 24 PER 1,000 FOR STATEN ISLAND) FOR RESIDENTS IN THE BAYLEY SETON AREA PER THE NYC DEPARTMENT OF HEALTH AND MENTAL HYGEINE. THE OVERALL DEATH RATES FOR STATEN ISLAND WAS 828/100,000, 15.3% HIGHER THAN THE RATE FOR THE CITY. IN THE UNITED STATES THE PROPORTION OF THE POPULATION AGED >65 YEARS IS EXPECTED TO INCREASE FROM APPROXIMATELY 35 MILLION IN 2000 TO AN ESTIMATED 71 MILLION IN 2030, AND THE NUMBER OF PERSONS AGED >80 YEARS IS EXPECTED TO INCREASE FROM 9.3 MILLION IN 2000 TO 19.5 MILLION BY 2030. IN 1995, THE MOST POPULOUS STATES HAD THE LARGEST NUMBER OF OLDER PERSONS; NINE STATES (CALIFORNIA, FLORIDA, ILLINOIS, MICHIGAN, NEW JERSEY, NEW YORK, OHIO, PENNSYLVANIA, AND TEXAS) EACH HAD MORE THAN ONE MILLION PERSONS AGED >65 YEARS. IN 2010, SIMILAR TO THE USE AS A WHOLE, 13.5% OF NEW YORK STATE'S POPULATION WAS AGE 65 OR OLDER. THE PROPORTION OF ELDERLY IS PROJECTED TO CLIMB TO 20% OR MORE BY 2030, INCREASING FROM 3.2 MILLION TO OVER 5.3 MILLION AND THE STATE'S POPULATION AGE 85 AND OLDER IS PROJECTED TO INCREASE BY 76%, FROM 315,000 TO 556,000. CURRENTLY 12.7% OF THE STATEN ISLAND POPULATION IS 65 YEARS OF AGE AND OVER (59,344). WITH THIS STEADY INCREASE IN POPULATION AND RISING TREND IN THE AGING OF THE STATEN ISLAND POPULATION, THE COMMUNITY IS EXPERIENCING A RISE IN HEALTHCARE NEEDS AND HEALTHCARE COSTS. AS MORE BABY BOOMERS DEVELOP CHRONIC ILLNESSES THE DEMAND ON THE HEALTHCARE SYSTEMS WILL RISE. WITH THIS IN MIND RICHMOND UNIVERSITY MEDICAL CENTER RECOGNIZES THAT OUR FOCUS MUST SHIFT TO PREVENTION ISSUES AND KEEPING PEOPLE HEALTHY. ONE COMMUNTER FERRY AND FOUR BRIDGES, STATEN ISLAND, ALTHOUGH PART OF NEW YORK CITY, IS HEAVILY ISOLATED. IN THE INTEREST OF HAVING THE ISLAND BE ABLE TO MANAGE ITSELF FOR THE FIRST 96 HOURS OF A WIDE SCALE OR LOCAL DISASTER, THE NEW YORK STATE DEPARTMENT OF HEALTH AND MENTAL HYGIENE SUPPORTED AN IDEA TO CREATE AN INITIATIVE FOR STATEN ISLAND IN THE EVENT OF A DISASTER. IN ADDITION TO ITS OWN INTERNAL INITIATIVES, RUMC SUBSEQUENTLY JOINED THE STATEN ISLAND EMERGENCY MANAGEMENT COALITION, WHICH WAS ESTABLISHED BY THE RICHMOND COUNTY MEDICAL SOCIETY. THE COALITION IS COMPRISED OF RUMC ALONG WITH OTHER HEALTH CARE FACILITIES, HOSPICES, VOLUNTARY AMBULANCES, AND OTHER HEALTH AND SOCIAL SERVICE ORGANIZATIONS. AS PART OF THE INITIATIVE, THE STATEN ISLAND MEDICAL COMMUNICATIONS AND OPERATIONS NODE (SIMCON) WAS CREATED. THIS SYSTEM IS TESTED ON A REGULAR BASIS WITH THE MEDICAL CENTER'S PARTICIPATION. THE HOSPITAL PARTICIPATES IN SEVERAL DRILLS THROUGHOUT THE YEAR- BOTH INTERNALLY AND THROUGH THE COALITION. THESE DRILLS HELP TO DEFINE SHORTCOMINGS IN BOTH OUR INTERNAL AND EMERGENCY OPERATION PLANS (EOP). ONCE IDENTIFIED, THE POLICIES ARE RE-WRITTEN AND DRILLED AGAIN TO ENSURE ACCURACY. PRIORITY IV: PRIMARY CARE EXPANSION. STATEN ISLAND RESIDENTS DEMONSTRATE SOME OF THE WORST HEALTH STATISTICS CITYWIDE FOR SUCH CHRONIC CONDITIONS AS DIABETES, HEART DISEASE, STROKE AND CANCER. THIS CAN BE ATTRIBUTED TO POOR DIET, SMOKING AND OBESITY AS WELL AS TO A LACK OF PRIMARY CARE SERVICES. RUMC RECOGNIZES THAT PREVENTATIVE PRIMARY CARE IS ESSENTIAL TO STEMMING THE CURRENT HEALTH CRISES EXPERIENCED BY STATEN ISLANDERS. TOWARD THIS END, RUMC HAS ASSISTED WITH THE ESTABLISHMENT OF 4 PRIMARY CARE PRACTICES ACROSS STATEN ISLAND. PRIORITY V: YOUTH SUBSTANCE ABUSE PREVENTION. RICHMOND UNIVERSITY MEDICAL CENTER IS A MEMBER OF THE STATEN ISLAND PARTNERSHIP FOR COMMUNITY WELLNESS, A BROAD COALITION OF HEALTH AND SOCIAL SERVICE AGENCIES THAT ADVOCATE FOR AND SUPPORT PROGRAMS THAT ENCOURAGE HEALTH AND WELLNESS. THE PARTNERSHIP'S AGENDA IN 2013 WAS YOUTH SUBSTANCE ABUSE (ALCOHOL AND DRUGS) AND TOBACCO PREVENTION. STATEN ISLAND HAS RECENTLY SEEN A SURGE IN PRESCRIPTION DRUG ABUSE CASES, PARTICULARLY AMONG YOUTH. RUMC'S CLINICAL CHAIR FOR PSYCHIATRY, ADMINISTRATIVE DIRECTOR OF PSYCHIATRY, AVP OF OPERATIONS, ALONG WITH A BOARD MEMBER SERVE ON THE STEERING COMMITTEE OF THE POLICY AND ADVOCACY WORK GROUP OF THE TACKLING YOUTH SUBSTANCE ABUSE COLLABORATIVE. IN SO DOING, THEY HAVE ASSISTED WITH VARIOUS INITIATIVES INCLUDING TWO DRUG TAKE-BACK DAYS IN CONJUNCTION WITH THE US DRUG ENFORCEMENT AGENCY TO ENCOURAGE RESIDENTS TO RETURN UNWANTED AND EXPIRED MEDICATIONS. THE AVP OF OPERATIONS ALSO WORKED TO COORDINATE SEVERAL PARENT WORKSHOPS IN COLLABORATION TYSA AND WORKING TO INCREASE THE AMOUNT OF WORKSHOP TRAINERS INTERNALLY FOR THE HOSPITAL TO BETTER SERVE THE COMMUNITY. OTHER PRIORITIES: RUMC HAS ALSO UNDERTAKEN OTHER MEASURES DESIGNED TO ASSIST THE COMMUNITY WITH HEALTH INFORMATION AND SERVICES. RUMC RECEIVED A GRANT FROM SUSAN G. KOMEN GREATER NEW YORK CITY TO ADMINISTER A BREAST CANCER NAVIGATION PROGRAM WHEREBY MEN AND WOMEN DIAGNOSED WITH THE DISEASE ARE PROVIDED ASSISTANCE TO MANAGE THEIR CARE. THE NAVIGATOR WORKS WITH EACH PATIENT INDIVIDUALLY THROUGH TESTING, DIAGNOSIS, TREATMENT AND FOLLOWUP CARE AS APPROPRIATE. RUMC IS ALSO A DESIGNATED ""SAFE"" CENTER, W"

PART VI, LINE 5:
"RICHMOND UNIVERSITY MEDICAL CENTER IS A LICENSED 473-BED HOSPITAL, ONE OF TWO PRIVATE HOSPITALS SERVING NEARLY 500,000 RESIDENTS OF STATEN ISLAND. LOCATED ON THE NORTH SHORE OF STATEN ISLAND WHERE THERE IS THE HIGHEST POVERTY RATES, THE MEDICAL CENTER HAS FILLED THE ROLE OF A TRADITIONAL PUBLIC HOSPITAL BY CARING FOR THE IMPOVERISHED AND UNDERSERVED OF THE COMMUNITY. OUR COMMUNITY OUTREACH INITIATIVES, INCLUDING EDUCATION AND SCREENINGS, REACHED OVER 20,000 PEOPLE IN 2013. RUMC IS A MAJOR PARTICIPANT IN SEVERAL MAJOR ANNUAL HEALTH RELATED EVENTS ON STATEN ISLAND. RUMC PARTICIPATES IN THE ANNUAL STATEN ISLAND HEALTH AND WELLNESS EXPO WHICH OFFERS A FORUM FOR THOUSANDS OF RESIDENTS TO INCREASE AWARENESS AND TAKE ACTION STEPS TO ADOPT HEALTHY LIFESTYLES. DURING THIS ANNUAL EVENT ALL ATTENDEES ARE ABLE TO RECEIVE FREE SCREENINGS, OBSERVE HEALTHY MEALS DEMONSTRATIONS, PARTICIPATE IN FITNESS DEMONSTRATIONS AND ATTEND MANY HEALTH RELATED SEMINARS. THROUGH THE RUMC SPEAKERS BUREAU, PHYSICIANS PRESENT HEALTH TALKS THROUGHOUT THE COMMUNITY ON AN ONGOING BASIS TO EDUCATE THE PUBLIC ON WAYS TO STAY HEALTHY. RUMC PARTICIPATES IN THE ANNUAL BOARDWALK BASH: PROGRAM FOR SENIORS AND THE ""BACK TO THE BEACH"" FAIR SPONSORED BY THE OFFICE OF THE BOROUGH PRESIDENT. RICHMOND UNIVERSITY MEDICAL CENTER HAS A LONG STANDING AND STRONG COLLABORATIVE RELATIONSHIP WITH THE AMERICAN CANCER SOCIETY, EASTERN DIVISION IN PROVIDING HEALTH CARE SERVICES TO THE RESIDENTS OF STATEN ISLAND. RUMC MAINTAINS INFORMAL RELATIONSHIPS WITH COMMUNITY AND VOLUNTEER AGENCIES SUCH AS THE PORT RICHMOND COMMUNITY HEALTH CENTER, THE COMMUNITY HEALTH ACTION CENTER, THE WOMEN'S HEALTH OUTREACH NETWORK, STATEN ISLAND INTER-AGENCY COUNCIL FOR THE AGING, THE CHAMBER OF COMMERCE, THE STATEN ISLAND ECONOMIC DEVELOPMENT CORPORATION AND PROJECT HOSPITALITY. FOR THIRTY YEARS RICHMOND UNIVERSITY MEDICAL CENTER (RUMC) WIC PROGRAM HAS SUCCESSFULLY SERVED THE POOR WOMEN, INFANTS AND CHILDREN OF STATEN ISLAND. THE MISSION TO IMPROVE THE NUTRITION AND HEALTH STATUS OF ELIGIBLE WOMEN, INFANTS AND CHILDREN THROUGH THE PROVISION OF NUTRITIOUS FOODS, NUTRITION EDUCATION, COUNSELING, AND LINKING PARTICIPANTS TO HEALTH AND HUMAN SERVICES HAS BEEN SUPPORTED BY AND CONSISTENT WITH THE OVERALL MISSION OF RUMC. RUMC WIC PROGRAM HAS HELPED THOUSANDS OF FAMILIES BY PROVIDING NUTRITIOUS FOOD, NUTRITION AND HEALTH EDUCATION, AND ASSISTANCE FOR ADDITIONAL HEALTH AND HUMAN SERVICES WHEN NEEDED. THE INTERPLAY BETWEEN THE RUMC PCAP PROGRAM, NURSE-FAMILY PARTNERSHIP, HEALTHY FAMILIES, HEAD START, AND RUMC WIC CREATES A DYNAMIC RELATIONSHIP THAT FOSTERS IMPROVED HEALTH FOR PREGNANT WOMEN, NEW MOTHERS, AND THEIR INFANTS. RUMC WIC HAS ASSISTED THE MEDICAL CENTER IN EFFORTS FOR LONGER GESTATION PERIODS, HIGHER BIRTH WEIGHTS, AND LOWER INFANT MORTALITY. RUMC WIC SERVICES PROVIDE FOR THE NEEDS OF WOMEN AND CHILDREN WHO HAVE A LOW INCOME, ARE UNDOCUMENTED CITIZENS, THE UNINSURED, THE UNDER-INSURED, RECENT IMMIGRANTS FROM VARIOUS COUNTRIES, TEENAGERS, UNWED MOTHERS, VICTIMS OF DOMESTIC VIOLENCE AND FOSTER CHILDREN. THE POPULATION THAT ACCESSES SERVICES AT THE RUMC WIC SIT ARE 50.7% HISPANIC AND 49.3% NON HISPANIC WITH 57.8% OF THE NON-HISPANIC POPULATION BEING BLACK OR AFRICAN AMERICAN. ACCORDING TO THE NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S COMMUNITY HEALTH PROFILES FOR ZIP CODES 10303, 10302, 10310 (PORT RICHMOND) WHICH IS SERVED BY THE RUMC WIC SITE, THE THREE IMPORTANT MEASURES OF MATERNAL AND INFANT HEALTH INDICATE THAT THIS PLANNING AREA IS NEAR OR HIGHER THAN THE CITYWIDE AVERAGE FOR THE FOLLOWING: WOMEN RECEIVING LATE OR NO PRENATAL CARE FOR NYC IS 30% OF LIVE BIRTHS AND FOR PORT RICHMOND IS 28% WITH THE NATIONAL GOAL OF LESS THAN 10%, BABIES BORN WITH LOW BIRTH WEIGHT (<2,500 GRAMS/5.5 LBS.) FOR NYC IS 8% OF LIVE BIRTHS AND PORT RICHMOND IS 10% WITH A NATIONAL GOAL OF 5% INFANT MORTALITY RATES PER 1,000 LIVE BIRTHS ARE 6.2 FOR NYC AND 7.6 FOR PORT RICHMOND WITH A NATIONAL GOAL OF LESS THAN 4.5. IN THE STAPLETON/ST.GEORGE ZIP CODE AREAS (10301, 10304) SERVED BY RUMC, IT IS IMPORTANT TO NOTE THAT THE INFANT MORTALITY RATE COMPARED TO NYC IS SIGNIFICANTLY HIGHER AT 9.7 DEATHS PER 1,000 FOR PORT RICHMOND AND 6.2 FOR NYC WITH A NATIONAL GOAL OF 4.5. BECAUSE THERE IS SUCH A LARGE UNDOCUMENTED HISPANIC POPULATION IN STATEN ISLAND'S NORTH SHORE AND 50% OF THE RUMC WIC SITE POPULATION IS HISPANIC, OUR WORKING RELATIONSHIP WITH PROJECT HOSPITALITY, EL CENTRO, AND STATEN ISLAND FAMILY HEALTHCARE COALITION IS ESSENTIAL. PROJECT HOSPITALITY ASSISTS WOMEN WITH LITERACY, DOMESTIC VIOLENCE, LEGAL SERVICES, IMMIGRATION SERVICES AND NETWORKS CLOSELY WITH RUMC WIC STAFF ON A DAILY BASIS IN ORDER TO BEST MEET THE NEEDS OF THIS POPULATION. WIC COLLABORATES IN PROGRAMS SUCH AS THE SAFE NY, HELD IN CONJUNCTION WITH THE NYC DEPARTMENT OF TRANSPORTATION, WHICH GIVES YOUNG MOTHERS AN OPPORTUNITY TO RECEIVE CAR SEAT GIVE-A WAYS AND ESSENTIAL INFORMATION ON NUTRITION THROUGH WIC AND WAYS TO PROTECT THEIR CHILDREN AND KEEP THEM SAFE. BABY SHOWERS ARE GIVEN AT THE WIC OFFICE FOR ALL PRENATALS AND PROMOTING BREAST-FEEDING IS AN ESSENTIAL COMPONENT OF THESE CELEBRATIONS. RUMC ALSO OPERATES A BREAST HEALTH PATIENT NAVIGATOR PROGRAM THAT OFFERS NAVIGATION SERVICES AND ASSISTANCE TO UNDERSERVED WOMEN WHO HAVE RECEIVED A DIAGNOSIS OF SUSPICIOUS FINDINGS OR BREAST CANCER, FROM DIAGNOSIS THROUGH TREATMENT. RICHMOND UNIVERSITY MEDICAL CENTER IS COMMITTED TO PROVIDING SENSITIVE, TIMELY, COMPREHENSIVE AND HIGH QUALITY CARE TO SURVIVORS OF RAPE AND SEXUAL ASSAULT. RUMC IS PART OF THE STATEN ISLAND SEXUAL ASSAULT TASK FORCE AND WORKS WITH THE OFFICE OF THE DISTRICT ATTORNEY FOR RICHMOND COUNTY NYPD, RAPE VICTIMS' ADVOCACY GROUPS AND OTHER LOCAL ORGANIZATIONS TO ASSURE COORDINATION OF SERVICES FOR THE RAPE SURVIVOR. RUMC WORKED SUCCESSFULLY WITH THE NEW YORK CITY ALLIANCE AGAINST SEXUAL ASSAULT TO BECOME THE ONLY SEXUAL ASSAULT FORENSIC EXAMINER (SAFE) CENTER OF EXCELLENCE IN STATEN ISLAND. OUR CULTURALLY SENSITIVE, HOSPITAL- BASED PROGRAM TREATS ALL VICTIMS OF SEXUAL ASSAULT THROUGHOUT STATEN ISLAND, WITH SUPPORT FROM THE DEPARTMENT OF MEDICINE, OB/GYN, NURSING AND ADMINISTRATION. RUMC SERVES A FINANCIALLY DISADVANTAGED POPULATION THAT IS AT GREATER RISK THAN THE AVERAGE STATEN ISLAND RESIDENT. PROVIDING IN-PATIENT AND OUT-PATIENT BEHAVIORAL HEALTH SERVICES FOR STATEN ISLANDERS, AND, IN PARTICULAR, FOR THOSE WHO ARE MARGINALIZED AND DISENFRANCHISED, IS A HIGH PRIORITY FOR RUMC. RUMC HAS A WELL ESTABLISHED HISTORY WITH OTHER COMMUNITY MENTAL HEALTH ORGANIZATIONS AND PROVIDERS. RUMC HAS OUTREACH PROGRAMS TO EDUCATE RESIDENTS ON THE IMPORTANCE OF IDENTIFYING AND TREATING MENTAL HEALTH PROBLEMS. RUMC IS A MEMBER OF COMMUNITY BOARD 1 WHICH REPRESENTS THE HOSPITAL'S CATCHMENT AREA. ANNUALLY, THE ADMINISTRATION ATTENDS ADVOCACY DAY IN ALBANY TO SPEAK TO STATE OFFICIALS ON HEALTH RELATED ISSUES IMPORTANT FOR THE STATEN ISLAND COMMUNITY AND PROMOTE COMMUNITY-WIDE EFFORTS TO IMPROVE THE HEALTH OF THE POPULATION. RUMC BOARD MEMBERS AND ADMINISTRATORS MEET WITH LOCAL GOVERNMENT REPRESENTATIVES REGULARLY TO WORK OUT INITIATIVES THAT PROMOTE HEALTH FOR OUR COMMUNITY."

PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT:
NY

PART VI, LINE 2 CONTINUATION:
RUMC STAFFED AN EMERGENCY COMMAND CENTER FOR 168 CONSECUTIVE HOURS DURING WHICH STAFF IMPLEMENTED DISASTER PLANS TO ADDRESS SUPPLY AND INVENTORY ISSUES AFTER ALL 3 BRIDGES CONNECTING STATEN ISLAND TO THE MAINLAND WERE SHUT DOWN, PROVIDE ADEQUATE STAFFING AND FACILITIES FOR STAFF WHO REMAINED ON SITE THROUGHOUT THE DISASTER, PROVIDE EMERGENCY BACKUP UTILITIES AND POWER, RESPOND TO FACILITY DAMAGE AND REPAIRS AND ACCOMMODATE ADDITIONAL EMERGENCY CASES RESULTING FROM THE NATURE OF THE DISASTER AS WELL AS FROM SIUHS DIVERSION STATUS. PRIORITY IV: PRIMARY CARE EXPANSION. STATEN ISLAND RESIDENTS DEMONSTRATE SOME OF THE WORST HEALTH STATISTICS CITYWIDE FOR SUCH CHRONIC CONDITIONS AS DIABETES, HEART DISEASE, STROKE AND CANCER. THIS CAN BE ATTRIBUTED TO POOR DIET, SMOKING AND OBESITY AS WELL AS TO A LACK OF PRIMARY CARE SERVICES. RUMC RECOGNIZES THAT PREVENTATIVE PRIMARY CARE IS ESSENTIAL TO STEMMING THE CURRENT HEALTH CRISES EXPERIENCED BY STATEN ISLANDERS. TOWARD THIS END, RUMC HAS ASSISTED WITH THE ESTABLISHMENT OF 4 PRIMARY CARE PRACTICES ACROSS STATEN ISLAND. IN ADDITION, RUMC HAS SECURED A $2.8 MILLION GRANT TO EXPAND ITS INTERNAL MEDICINE RESIDENCY PROGRAM TO PROMOTE PRIMARY CARE SERVICES. THIS INITIATIVE TRAINS PHYSICIANS FROM DIVERSE BACKGROUNDS IN PATIENT-CENTERED, COST-EFECTIVE, AND EVIDENCE-BASED CARE TO ENSURE THEY DELIVER HIGH-QUALITY, CULTURALLY AND LINGUISTICALLY AND EFFECTIVE PRIMARY CARE SERVICES. EACH RESIDENT TRAINS IN A COMMUNITY BASED SITE THAT CARES FOR THE UNDERSERVED POPULATION OF STATEN ISLAND. THE RESIDENT ASSUMES THE ONGOING RESPONSIILITY FOR THE TOTAL CARE OF THE PATIENT. THE INITIATIVE ENSURES THAT HIGH-QUALITY PRIMARY CARE SERVICES ARE AVAILABLE TO MEDICALLY UNDERSERVED COMMUNITIES, ACCESS TO A PATIENT-CENTERED MEDICAL HOME MODEL OF CARE IS IMPROVED AND PATIENT OUTCOMES FOR OPTIMAL HEALTH ARE IMPROVED. PRIORITY V: YOUTH SUBSTANCE ABUSE PREVENTION. RICHMOND UNIVERSITY MEDICAL CENTER IS A MEMBER OF THE STATEN ISLAND PARTNERSHIP FOR COMMUNITY WELLNESS, A BROAD COALITION OF HEALTH AND SOCIAL SERVICE AGENCIES THAT ADVOCATE FOR AND SUPPORT PROGRAMS THAT ENCOURAGE HEALTH AND WELLNESS. IN 2013, THE PARTNERSHIP CREATED THE TACKLING YOUTH SUBSTANCE ABUSE INITIATIVE TO ADDRESS THE PREVALENCE OF OPIOID ABUSE BY STATEN ISLAND YOUTH. RUMC IS ON THE STEERING COMMITTEE OF THIS INITIATIVE WHICH HAS SPONSORED OUTREACH EVENTS AND FORUMS TO ADDRESS THIS ISSUE.