4A (Expenses $ 1212201037 including grants of $ 599550) (Revenue $ 1378664919)
SEE SCHEDULE OKALEIDA HEALTH IS A VOLUNTARY, NOT-FOR-PROFIT; NEW YORK STATE DEPARTMENT OF HEALTH ARTICLE 28 LICENSED HOSPITAL-BASED HEALTHCARE DELIVERY SYSTEM SERVICING THE COMMUNITIES OF WESTERN NEW YORK STATE AT VARIOUS LEVELS AND WITH FACILITIES IN MULTIPLE LOCATIONS THROUGHOUT THE REGION. KALEIDA HEALTH INCLUDES THE BUFFALO GENERAL MEDICAL CENTER (BUFFALO GENERAL), MILLARD FILLMORE SUBURBAN HOSPITAL (MILLARD SUBURBAN), JOHN R. OISHEI CHILDREN'S HOSPITAL (OISHEI CHILDREN'S HOSPITAL, FORMERLY THE WOMEN & CHILDREN'S HOSPITAL OF BUFFALO), AND DEGRAFF MEMORIAL HOSPITAL (DEGRAFF). IN ADDITION TO THE FOUR KALEIDA HEALTH (KALEIDA) HOSPITALS, KALEIDA OPERATES TWO SKILLED NURSING FACILITIES, AND NUMEROUS OUTPATIENT CLINICS. THE ABOVE FACILITIES OPERATE UNDER ONE TAX IDENTIFICATION NUMBER.OUR FAMILY OF HEALTH CARE ORGANIZATIONS IS BLENDED TOGETHER INTO ONE FRAMEWORK FOR LEADERSHIP, GOVERNANCE, SHARED SERVICES, FINANCIAL INFRASTRUCTURE AND INFORMATION TECHNOLOGY PLATFORMS. COLLECTIVELY, KALEIDA HEALTH'S MARKET SHARE IS 32.9% IN WESTERN NEW YORK, 41.39% IN ERIE COUNTY AND 34.37% IN NIAGARA COUNTY. ANNUALLY $1.2 MILLION COMBINED INPATIENT, EMERGENCY DEPARTMENT AND OUTPATIENT VISITS OCCUR AT THE HEALTH CARE FACILITIES IN THE KALEIDA HEALTH SYSTEM, WHICH EMPLOYS APPROXIMATELY 8,700 STAFF AND HAVE APPROXIMATELY 2,450 MEDICAL STAFF MEMBERS. DURING 2021, THERE WERE 53,006 INPATIENT DISCHARGES, OF WHICH 27% WERE MEDICAID AND MEDICAID MANAGED, 48% MEDICARE AND MEDICARE MANAGED CARE AND 0.4% WERE UNINSURED, AND 25% WERE OTHER. KALEIDA HEALTH'S MISSION IS TO ADVANCE THE HEALTH OF OUR COMMUNITY. OUR VISION IS TO PROVIDE COMPASSIONATE, HIGH-VALUE, QUALITY CARE, IMPROVING HEALTH IN WESTERN NEW YORK AND BEYOND, EDUCATING FUTURE HEALTH CARE LEADERS AND DISCOVERING INNOVATIVE WAYS TO ADVANCE MEDICINE. OUR VALUES CLEARLY STATE WHO WE ARE AND HOW WE PERFORM OUR WORK:CENTERED: REMAIN CENTERED AROUND THE PATIENT AND FAMILY.ACCOUNTABLE: BE ACCOUNTABLE TO PATIENTS AND EACH OTHER.RESPECT: SHOW RESPECT AND INTEGRITY.EXCELLENCE: PROVIDE EXCELLENCE IN ALL WE DO.KALEIDA HEALTH'S PROGRAMS AND AFFILIATES ARE LICENSED BY THE STATE OF NEW YORK DEPARTMENT OF HEALTH AND ACCREDITED BY DNV. KALEIDA IS CERTIFIED BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR PARTICIPATION IN MEDICARE AND MEDICAID. THE ACCREDITATION COUNSEL FOR GRADUATE MEDICAL EDUCATION APPROVES ALL RESIDENCY PROGRAMS FOR PHYSICIANS, AND THE AMERICAN DENTAL ASSOCIATION APPROVES ITS DENTAL AND ORAL SURGERY PROGRAMS. KALEIDA IS ALSO A MEMBER OF THE COUNCIL OF TEACHING HOSPITALS, THE AMERICAN DENTAL ASSOCATION, THE AMERICAN MEDICAL ASSOCATION AND THE GREATER NEW YORK HOSPITAL ASSOCATION.OPERATION OF EMERGENCY ROOMS:KALEIDA HEALTH OPERATES FOUR EMERGENCY ROOMS, ONE IN EACH OF THE ACUTE CARE HOSPITALS, GENERATING A TOTAL OF 157,353 PATIENT VISITS DURING 2021. THE EMERGENCY DEPARTMENTS, WHICH OPERATE 24 HOURS A DAY, SEVEN DAYS EACH WEEK, ARE OPEN TO ANYONE, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES.BOARD OF DIRECTORS AND COMMUNITY GUIDANCE:KALEIDA HEALTH MAINTAINS COMMUNITY CONTROL OVER THE CORPORATION THROUGH ITS BOARD OF DIRECTORS, COMPRISED OF COMMUNITY AND FAITH LEADERS, AND LEADERS IN BUSINESS AND INDUSTRY, HEALTHCARE AND PHYSICIANS REPRESENTING THE MEDICAL STAFF OF KALEIDA HEALTH. THE MAJORITY OF THE DIRECTORS RESIDE IN WESTERN NEW YORK AND EACH DIRECTOR SERVES A THREE-YEAR TERM. OPEN MEDICAL STAFF:AS CONFERRED BY THE BOARD OF DIRECTORS, MEDICAL STAFF MEMBERSHIP IS OFFERED TO PROFESSIONALLY COMPETENT PHYSICIANS, DENTISTS, PODIATRISTS AND OTHER SPECIFIED INDIVIDUALS, WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS OUTLINED IN THE BYLAWS, RULES AND REGULATIONS, POLICIES OF THE MEDICAL STAFF AND KALEIDA HEALTH, CONSISTENT WITH THE NEEDS OF KALEIDA HEALTH'S PATIENTS. STAFF MEMBERSHIP OR PARTICULAR CLINICAL PRIVILEGES SHALL NOT BE DENIED ON THE BASIS OF AGE, SEX, SEXUAL ORIENTATON, RACE, COLOR, CREED, NATIONAL ORIGIN, A DISABILITY UNRELATED TO THE ABILITY TO FULFILL PATIENT CARE AND MEDICAL STAFF RESPONSIBILITIES OR ANY OTHER CRITERION UNRELATED TO THE EFFICIENT DELIVERY OF QUALITY PATIENT CARE, TO PROFESSIONAL QUALIFICATIONS OR TO THE NEEDS OF THE COMMUNITY, OR TO THE PURPOSES, NEEDS AND CAPABILITIES OF KALEIDA HEALTH. EVERY MEMBER OF THE MEDICAL STAFF ASSISTS THE HOSPITALS IN FULFILLING OUR MISSION AND RESPONSIBILITY TO PROVIDE EMERGENCY AND UNCOMPENSATED CARE FOR THOSE IN NEED.USE OF SURPLUS FUNDS:SURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF KALEIDA HEALTH, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY.COMMUNITY BENEFIT PROGRAMS AND SERVICES:KALEIDA HEALTH OFFERS NUMEROUS COMMUNITY BENEFIT PROGRAMS AND SERVICES IN RESPONSE TO THE COMMUNITY'S NEEDS, BY IMPROVING ACCESS TO CARE, IMPROVE PUBLIC HEALTH, ADVANCE KNOWLEDGE AND RELIEVE GOVERNMENT PROGRAMS. THESE PROGRAMS ARE CONDUCTED IN COMMUNITY-BASED SETTINGS SUCH AS SCHOOLS, CHURCHES, COMMUNITY CENTERS, SENIOR CENTERS AND PROGRAMS ARE ALSO OFFERED AT KALEIDA'S HOSPITAL CAMPUSES AND FACILITIES. COMMUNITY BENEFIT PROGRAMS AND SERVICES INCLUDE HEALTH FAIRS, HEALTH SCREENINGS, HEALTH EDUCATION LECTURES AND WORKSHOPS FOR COMMUNITY GROUPS AND THE GENERAL PUBLIC, SCHOOL HEALTH EDUCATION PROGRAMS, AND CONSUMER HEALTH INFORMATION IN THE KALEIDA HEALTH LIBRARIES. KALEIDA ALSO OFFERS A NUMBER OF SUBSIDIZED HEALTH SERVICES SUCH AS OUTPATIENT CLINICS, LONG-TERM CARE SERVICES, WOMEN'S HEALTH CENTERS, DIALYSIS SERVICES, BEHAVIORAL HEALTH SERVICES, SCHOOL-BASED HEALTH CENTERS, EARLY CHILDHOOD PROGRAM, EARLY INTERVENTION SERVICES, FAMILY PLANNING SERVICES, WESTERN NEW YORK CLINICAL INFORMATION EXCHANGE AND HEALTH-E-LINK AND DIAGNOSTIC, THERAPEUTIC AND REHABILITATION SERVICES FOR CHILDREN WITH SPECIAL NEEDS. KALEIDA'S HOSPITALS SERVE AS A MAJOR TEACHING AFFILIATE OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO'S SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES AND DENTAL MEDICINE, WITH TRAINING TO 400 MEDICAL AND DENTAL RESIDENTS EACH YEAR. KALEIDA IS INVOLVED IN AND SPONSORS RESEARCH PROJECTS, AND WE PROVIDE LOAN FORGIVENESS FOR PHYSICIANS TO ESTABLISH OR JOIN EXISTING PRACTICES THAT SERVE THE UNDERSERVED COMMUNITIES OF BUFFALO AND WESTERN NEW YORK. KALEIDA OFFERS CLINICAL TRAINING FACILITIES AND SUPPORT FOR NURSING AND A NUMBER OF ALLIED HEALTH PROFESSIONAL TRAINING PROGRAMS AT LOCAL COLLEGES AND UNIVERSITIES, AND OTHER PROFESSIONAL DEVELOPMENT/CONTINUING EDUCATION TRAINING PROGRAMS FOR COLLEAGUES FROM HEALTH CARE ORGANIZATIONS ACROSS THE REGION.

PART V, SECTION B, LINE 5
"IN CONDUCTING ITS 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP), KALEIDA HEALTH TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITALS LOCATED IN ERIE AND NIAGARA COUNTIES, THE PRIMARY SERVICE AREA. FOR EACH COUNTY, KALEIDA HEALTH PARTICIPATED IN COLLABORATIVE WORK GROUPS LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH AND COMPRISED OF REPRESENTATIVES FROM OTHER HOSPITALS, ORGANIZATIONS, AGENCIES, AND SCHOOLS; AND INCLUDED INPUT FROM THE COMMUNITY INCLUDING THE MEDICALLY UNDERSERVED.THE ERIE COUNTY WORK GROUP LAUNCHED THEIR EFFORTS ON MAY 17, 2018 AND HELD REGULAR MEETINGS THROUGHOUT 2018-2019. COUNTY-WIDE ASSESSMENT ACTIVITIES WERE CONDUCTED IN 2019 INCLUDING A CONSUMER SURVEY WITH 1,725 RESPONDENTS TO DETERMINE HEALTH STATUS AND COMMUNITY HEALTH NEEDS, HEALTH BEHAVIORS, BARRIERS TO HEALTH, HEALTHCARE ACCESS AND UTILIZATION, AND DEMOGRAPHIC INFORMATION. INPUT WAS RECEIVED FROM THE UNDERSERVED WITH 16% OF RESPONDENTS HAVING INCOMES OF LESS THAN $25,000 AND 22% HAVING INCOMES OF $25,000-$50,000. THERE WERE SEVERAL DISTRIBUTION SITES TARGETING THE LOW INCOME AND UNDERSERVED. KALEIDA HEALTH POSTED THE SURVEY ON THE KALEIDA HEALTH PUBLIC WEBSITE, KALEIDA HEALTH EMPLOYEE WEBSITE, AND ON FACEBOOK AND TWITTER. THROUGHOUT MARCH TO MAY 2019, SIX FOCUS GROUP SESSIONS WERE CONDUCTED TO CAPTURE COMMUNITY INPUT ON THE STATUS OF HEALTH AND HEALTHCARE NEEDS. SESSION LOCATIONS TARGETED A GEOGRAPHIC CROSS-SECTION OF SITES, AGES, AND INCOME LEVELS. IN FEBRUARY AND MARCH 2019, KALEIDA HEALTH COLLABORATED WITH CATHOLIC HEALTH SYSTEM AND THE POPULATION HEALTH COLLABORATIVE TO HOST THREE COMMUNITY STAKEHOLDER SESSIONS WITH PROFESSIONALS FROM HEALTH, MENTAL HEALTH AND SOCIAL SERVICES ORGANIZATIONS AND OBTAINED INPUT ON THE COMMUNITY'S CURRENT HEALTH STATUS, NEEDS AND ISSUES. IN ADDITION TO THE REVIEW OF DATA FROM THE NYS PREVENTION AGENDA DASHBOARD AND OTHER RELIABLE SOURCES, THESE ACTIVITIES HELPED TO PRIORITIZE THE HEALTH CARE NEEDS OF THE COUNTY AND THE RESULTING IMPLEMENTATION STRATEGIES; AND ARE INCLUDED IN KALEIDA HEALTH'S 2019-2021 CHNA-CSP AND ALIGNED WITH THE ERIE COUNTY DEPARTMENT OF HEALTH, COMMUNITY HEALTH IMPROVEMENT PLAN.THE NIAGARA COUNTY WORK GROUP LAUNCHED THEIR EFFORTS ON SEPTEMBER 17, 2018 AND HELD REGULAR MEETINGS THROUGHOUT 2018-2019. COUNTY-WIDE ASSESSMENT ACTIVITIES WERE CONDUCTED IN 2019 INCLUDING A CONSUMER SURVEY WITH 1,492 RESPONDENTS TO DETERMINE HEALTH STATUS AND COMMUNITY HEALTH NEEDS, HEALTH BEHAVIORS, BARRIERS TO HEALTH, HEALTHCARE ACCESS AND UTILIZATION, AND DEMOGRAPHIC INFORMATION. INPUT WAS RECEIVED FROM THE UNDERSERVED WITH 11.11% OF RESPONDENTS HAVING INCOMES OF $10,000-$15,000, 9.01% HAVING INCOMES OF $25,000-$35,000, AND 15.77% HAVING INCOMES OF $35,000-$50,000. SURVEY LINKS WERE PROVIDED ON THE NIAGARA COUNTY DEPARTMENT OF HEALTH'S WEBSITE AND FACEBOOK PAGE AND SHARED WITH THE PARTNERING HOSPITALS FOR ADDITIONAL ELECTRONIC AND PRINT DISSEMINATION. IN-PERSON SURVEY DISTRIBUTION WAS ALSO CONDUCTED BY VARIOUS NIAGARA COUNTY PUBLIC AGENCIES AND ORGANIZATIONS. KALEIDA HEALTH AND DEGRAFF MEDICAL PARK POSTED THE SURVEYS ON THE KALEIDA HEALTH PUBLIC WEBSITE, KALEIDA HEALTH EMPLOYEE WEBSITE, AND ON FACEBOOK AND TWITTER. DEGRAFF ALSO DISTRIBUTED PAPER COPIES THROUGHOUT ITS FACILITIES AND AT VARIOUS COMMUNITY LOCATIONS. SIX FOCUS GROUP SESSIONS WERE CONDUCTED IN FEBRUARY- MARCH 2019 AT FIVE NIAGARA COUNTY LOCATIONS INCLUDING HOSPITALS, SUBSIDIZED HOUSING FACILITIES AND COMMUNITY/SENIOR CENTERS. THE FOCUS GROUPS WERE FACILITATED BY EASTERN NIAGARA HOSPITAL, DEGRAFF MEDICAL PARK, MOUNT ST. MARY'S HOSPITAL AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH. ADDITIONALLY, A COUNTYWIDE KEY STAKEHOLDER MEETING WAS CONVENED ON AUGUST 6, 2019 WITH REPRESENTATION FROM AREA HEALTH, MENTAL HEALTH, AND HUMAN SERVICE AGENCIES. INFORMATION AND DATA WAS SHARED FROM THE CONSUMER HEALTH SURVEYS AND COMMUNITY FOCUS GROUP SESSIONS AND EACH ORGANIZATION HAD AN OPPORTUNITY TO SHARE THEIR EXPERIENCES AND PROVIDE INPUT ON COUNTY-WIDE HEALTH PRIORITIES. IN ADDITION TO THE REVIEW OF DATA FROM THE NYS PREVENTION AGENDA DASHBOARD AND OTHER RELIABLE SOURCES, THESE ACTIVITIES HELPED TO PRIORITIZE THE HEALTH CARE NEEDS OF THE COUNTY AND THE RESULTING IMPLEMENTATION STRATEGIES INCLUDED IN KALEIDA HEALTH'S CHNA-CSP AND ALIGNED WITH THE NIAGARA COUNTY DEPARTMENT OF HEALTH, COMMUNITY HEALTH IMPROVEMENT PLAN.THE KALEIDA HEALTH 2019-2021 CHNA-CSP WAS APPROVED BY THE KALEIDA HEALTH BOARD OF DIRECTORS ON DECEMBER 2, 2019. IT IS AVAILABLE TO THE PUBLIC IN THE COMMUNITY HEALTH SECTION OF THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/. A PAPER VERSION IS AVAILABLE UPON REQUEST AT NO CHARGE AT THE HOSPITALS. WRITTEN COMMENTS ON THE CHNA-CSP ARE INVITED FROM THE PUBLIC THROUGH A LINK ENTITLED ""COMMENT ON PLAN"" LOCATED NEXT TO THE DOCUMENT THROUGH THE ABOVE LINK. THIS INFORMATION IS DOCUMENTED IN THE CHNA-CSP IN THE DISSEMINATION TO THE PUBLIC SECTION. NO COMMENTS ON THE 2019-2021 CHNA-CSP WERE RECEIVED FROM THE PUBLIC IN 2021."

PART V, SECTION B, LINE 6A
KALEIDA HEALTH'S FOUR HOSPITALS ARE INCLUDED IN ITS 2019-2021 CHNA-CSP: BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, AND OISHEI CHILDREN'S HOSPITAL, ALL LOCATED IN ERIE COUNTY AND DEGRAFF MEDICAL PARK LOCATED IN NIAGARA COUNTY. IN ERIE COUNTY, KALEIDA HEALTH COLLABORATED ON THE CHNA-CSP PROCESS THROUGH A PARTNERSHIP LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND INCLUDED UNRELATED HOSPITAL FACILITIES OF CATHOLIC HEALTH SYSTEM AND BERTRAND CHAFFEE HOSPITAL. IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED ON THE CHNA-CSP PROCESS THROUGH A PARTNERSHIP LED BY THE NIAGARA COUNTY DEPARTMENT OF HEALTH, AND INCLUDED THE FOLLOWING UNRELATED HOSPITAL FACILITIES: NIAGARA FALLS MEMORIAL MEDICAL CENTER, MOUNT ST. MARY HOSPITAL, AND EASTERN NIAGARA HOSPITAL SYSTEM.

PART V, SECTION B, LINE 6B
IN ERIE COUNTY, KALEIDA HEALTH COLLABORATED ON THE 2019-2021 CHNA-CSP PROCESS WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: ERIE COUNTY DEPARTMENT OF HEALTH, UNITED WAY OF BUFFALO & ERIE COUNTY, BUFFALO STATE COLLEGE, D'YOUVILLE COLLEGE, STATE UNIVERSITY OF NEW YORK AT BUFFALO, AMERICAN HEART ASSOCIATION, AND THE POPULATION HEALTH COLLABORATIVE.IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED ON THE 2019-2021 CHNA-CSP PROCESS WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: NIAGARA COUNTY DEPARTMENT OF HEALTH, NIAGARA COUNTY DEPARTMENT OF MENTAL HEALTH, AND THE POPULATION HEALTH COLLABORATIVE.

PART V, SECTION B, LINE 11
"WITH HOSPITALS IN BOTH ERIE AND NIAGARA COUNTIES, KALEIDA HEALTH WORKED COLLABORATIVELY WITH WORK GROUPS LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH TO REVIEW HEALTH CARE DATA, DISSEMINATE CONSUMER SURVEYS AND CONDUCT FOCUS GROUP SESSIONS TO PRIORITIZE SIGNIFICANT HEALTH NEEDS AND IMPLEMENTATION STRATEGIES FOR EACH COUNTY. THE STRATEGIES FURTHER ALIGN WITH THE PRIORITY AREAS OF THE NEW YORK STATE PREVENTION AGENDA. KALEIDA HEALTH INCLUDED THESE COLLABORATIVE PRIORITY AREAS ITS 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICES PLAN (CHNA-CSP).THROUGHOUT 2021, KALEIDA HEALTH MADE PROGRESS IMPLEMENTING THE INTERVENTIONS OUTLINED IN ITS CHNA-CSP AND AS ALIGNED WITH THE NYS PREVENTION AGENDA, AND ADDRESSING THE NEEDS OF THE UNDERSERVED. HOWEVER, THE COVID 19 PANDEMIC PRESENTED SOME IMPLEMENTATION CHALLENGES. DURING 2020 AND THROUGHOUT 2021, KALEIDA HEALTH HOSPITALS EXPERIENCED AN INFLUX OF PATIENTS AFFECTED BY THE CORONAVIRUS IN BOTH INPATIENT AND OUTPATIENT CARE. IT WAS CRITICAL FOR EMPLOYEES TO HAVE APPROPRIATE PPE AND BE PROVIDED THE MOST UP TO DATE INFORMATION RELATED TO THE CARE AND TREATMENT OF THE DISEASE. ALL EMPLOYEE AND CORPORATE EFFORTS TO EDUCATE, SCREEN AND TEST EMPLOYEES, PATIENTS AND THE COMMUNITY WAS A TOP PRIORITY AND CONTINUES IN 2022. OUTPATIENT CARE AND ELECTIVE SURGERIES AT KALEIDA HEALTH HOSPITALS WERE CUT BACK IN 2020 AND 2021 DUE TO NYS MANDATES AND KALEIDA HEALTH OUTPATIENT CLINICS ENLISTED TELEHEALTH PROGRAMS TO HELP MEET PATIENT CARE NEEDS. THROUGHOUT THE PANDEMIC, KALEIDA HEALTH CONTINUED TO IMPLEMENT THE COMMUNITY INTERVENTIONS THAT WERE NOT HAMPERED BY PANDEMIC RESTRICTIONS; AND CONTINUES TO WORK TO RE-ASSESS THE IMPACT OF COVID 19 ON OTHER INTERVENTIONS AND IN THE ADVANCEMENT OF ITS NYS PREVENTION AGENDA PRIORITY AREAS. COMMUNITY NEED AND INTERVENTION PROGRESS IN 2022 AND ANY RESULTING IMPACTS DUE TO COVID 19 ARE OUTLINED BELOW. HEALTH CARE NEEDS ADDRESSED IN KALEIDA HEALTH'S 2019-2021 CHNA-CSPCHRONIC DISEASEHEART DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN ERIE AND NIAGARA COUNTIES ACCOUNTING FOR 183.2 PER 100,000 POPULATION OF ALL DEATHS IN ERIE COUNTY AND 232.4 PER 100,000 IN NIAGARA COUNTY (2019 COUNTY HEALTH RANKINGS), AND THERE IS A HIGH INCIDENCE OF RISK FACTORS AMONG RESIDENTS INCLUDING HIGH BLOOD PRESSURE, DIABETES, OBESITY AND SMOKING. HEART DISEASE FURTHER AFFECTS MINORITY AND UNDERSERVED POPULATIONS DISPROPORTIONALLY. THE MORTALITY RATE FOR DISEASES OF THE HEART PER 100,000 POPULATION (AGE-ADJUSTED) FOR ERIE COUNTY IS 217.5 FOR NON-HISPANIC, AFRICAN AMERICANS, 174.5 FOR WHITES, AND 135.2 FOR HISPANICS; AND IN NIAGARA COUNTY, THE MORTALITY RATES ARE 293.4 FOR NON-HISPANIC, AFRICAN AMERICANS, 220.9 FOR WHITES, AND 197.7 FOR HISPANICS (2014-2016, ERIE COUNTY AND NIAGARA COUNTY HEALTH INDICATORS BY RACE/ETHNICITY, NYS DEPARTMENT OF HEALTH). IN COLLABORATION WITH THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH WORK GROUPS, KALEIDA HEALTH SELECTED ""PREVENT CHRONIC DISEASE"" AS ONE OF ITS NYS PREVENTION AGENDA PRIORITIES. KALEIDA HEALTH HOSPITALS IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES TO ADDRESS CHRONIC DISEASE IN ITS 2019-2021 CHNA-CSP: ERIE COUNTY - HEALTHY EATING AND FOOD SECURITY - COMMUNITY DIABETES AND PRE-DIABETES NUTRITION EDUCATION AND MOBILE FOOD MARKET (DISPARITY - LOW INCOME POPULATION), WORKSITE NUTRITION AND PHYSICAL ACTIVITY PROGRAMS- PREVENTIVE CARE AND MANAGEMENT - CARDIOVASCULAR EDUCATION AND SCREENING PROGRAM IN OB-GYN CENTERS (DISPARITY - FEMALE, MEDICAID POPULATION), CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS FOR THE COMMUNITY, HEALTH LITERACY TASK FORCE (COLLABORATIVE COUNTY PROJECT)NIAGARA COUNTY - HEALTHY EATING AND FOOD SECURITY - HEALTH EDUCATION FOR CHILDREN, LITTLE FREE PANTRY (DISPARITY - FOOD INSECURE POPULATION), NUTRITION AND HEALTHY COOKING EDUCATION- PREVENTIVE CARE AND MANAGEMENT - CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS FOR THE COMMUNITYIN 2021, KALEIDA HEALTH HOSPITALS PROVIDED THE FOLLOWING CHRONIC DISEASE INTERVENTIONS:- BUFFALO GENERAL MEDICAL CENTER HOSTED ALEX WRIGHT'S AFRICAN HERITAGE MOBILE FOOD CO-OP, AN OUTDOOR MARKET OF HEALTHY FRUITS AND VEGETABLES AND NUTRITIONAL EDUCATION SERVING THE CAMPUS AND ADJACENT LOW-INCOME FRUIT BELT NEIGHBORHOOD. THE MARKET WAS HELD EVERY OTHER WEEK FROM MAY THROUGH OCTOBER 2021. TO BETTER SERVE LOW-INCOME INDIVIDUALS, EVERY THIRD THURSDAY DURING COVID WAS DESIGNATED AS ""PAY AS YOU CAN"". -IN 2021, THE PARTNERSHIP BETWEEN KALEIDA HEALTH AND ITS FOOD VENDOR METZ CULINARY MANAGEMENT AND THE BUFFALO NIAGARA MEDICAL CAMPUS CONTINUED TO HELP BRING MORE LOCALLY GROWN AND SOURCED PRODUCE, MEATS AND OTHER MENU ITEMS TO THE CAFETERIAS AT BUFFALO GENERAL MEDICAL CENTER, JOHN R. OISHEI CHILDREN'S HOSPITAL, AND HIGHPOINTE ON MICHIGAN. KALEIDA HEALTH EMPLOYEES, PATIENTS AND VISITORS WERE PROVIDED INFORMATION ON HEALTHY EATING AND NUTRITION, AND WERE INTRODUCED TO THE FARMERS BEHIND THE PRODUCTS. THE METZ CHEFS AND GENERAL MANAGERS VISITED LOCAL FARMS TO LEARN NEW AGRICULTURAL METHODS AND SUSTAINABLE PRACTICES. THROUGH THE METZ FARM TO HOSPITAL PARTNERSHIP, KALEIDA HEALTH PROVIDES EMAILS VIA CAMPUS E-NEWS TO EMPLOYEES OF PARTICIPATING FACILITIES, PROMOTING FACTS ON THE BENEFITS OF LOCAL FRUIT AND VEGETABLES, AS THEY ARE FRESHER AND SAFER THAN MANY STORE-BOUGHT OPTIONS.-NUTRITION TUNE-UP DAYS FOR EMPLOYEES WERE NOT HELD IN 2020 AND 2021 DUE TO COVID-19 RESTRICTIONS. IN THE ABSENCE OF THE NUTRITION TUNE-UP DAYS, IN 2021, APPROXIMATELY 10 EMPLOYEES PER MONTH VISITED A KALEIDA HEALTH DIETICIAN AT VARIOUS TIMES AT BUFFALO GENERAL MEDICAL CENTER FOR NUTRITION/WELLNESS CONCERNS AND RECEIVED NUTRITION EDUCATION AND PRINT MATERIALS. UNFORTUNATELY NUTRITION EDUCATION SESSIONS IN THE COMMUNITY CONTINUED TO BE POSTPONED THROUGHOUT 2021 DUE TO COVID-19 RESTRICTIONS.-IN 2021, WELLNESS ACTIVITIES FOR EMPLOYEES OF BUFFALO GENERAL MEDICAL CENTER AND JOHN R. OISHEI CHILDREN'S HOSPITAL IN COLLABORATION WITH THE BUFFALO NIAGARA MEDICAL CAMPUS (BNMC) WERE PRIMARILY ON HOLD DUE TO COVID-19 RESTRICTIONS. HOWEVER, THE WALKS ON WEDNESDAY PROGRAM DID SUCCESSFULLY RESUME IN 2021. -CARDIOVASCULAR EDUCATION AND SCREENING TARGETING LOW-INCOME PATIENTS WAS PROVIDED AT KALEIDA HEALTH'S OB-GYN CENTERS WHERE AN ESTIMATED 81.5% (2018) OF PATIENT VISITS ARE REIMBURSED THROUGH MEDICAID. IN 2021, 244 CLINIC PATIENTS WERE SCREENED FOR CARDIOVASCULAR DISEASE AND PROVIDED COUNSELING AND EDUCATION. -DUE TO COVID 19 RESTRICTIONS AND THE NEED FOR COMMUNITY SAFETY FROM THE VIRUS, IN-PERSON CHRONIC DISEASE RISK FACTOR EDUCATION AND SCREENING EVENTS THROUGH KALEIDA HEALTH HOSPITALS IN ERIE AND NIAGARA COUNTIES WERE REPLACED WITH VIRTUAL PROGRAMS. - IN 2021, 17,756 INDIVIDUALS PARTICIPATED IN VIRTUAL HEALTHY U PROGRAMS VIA FACEBOOK LIVE AND 309 INDIVIDUALS ENGAGED WITH THE SPEAKER OR RESPONDED TO THE PRESENTATION. - IN 2021, 52 WEEKLY MEDICAL MINUTE VIDEOS REACHING 83,178 INDIVIDUALS WERE PRESENTED ON WIVB-TV, CH. 4 AND KALEIDA HEALTH SOCIAL MEDIA ON HEALTH RELATED TOPICS. - IN 2021, THE MEDICALLY SPEAKING INTERVIEW SERIES PROVIDED 21 COMMUNITY HEALTH EDUCATION VIDEOS ON VARIOUS HEALTH TOPICS INCLUDING THE COVID-19 PANDEMIC TO 48,053 VIEWERS ON KALEIDA HEALTH FACEBOOK AND AT WWW.KALEIDAHEALTH.ORG/MEDICALLY-SPEAKING.1,077 INDIVIDUALS FURTHER ENGAGED WITH THE SPEAKER OR RESPONDED TO THE PRESENTATION.- IN 2021, THE LITTLE FREE PANTRY AT DEGRAFF MEDICAL PARK CONTINUED TO PROVIDE COMMUNITY ACCESS TO A FREE SOURCE OF FOOD AT AN ON-SITE, SELF-CONTAINED OUTDOOR PANTRY TO PROMOTE FOOD SECURITY AMONG UNDERSERVED POPULATIONS. DEGRAFF PROVIDES HEALTH EDUCATION LITERATURE AND EMPLOYEES AND COMMUNITY MEMBERS WORK TO KEEP THE PANTRY STOCKED WITH HEALTHY, NUTRITIONAL ITEMS. THE TEDDY BEAR CLINICS PROVIDING HEALTH EDUCATION AT LOCAL SCHOOLS THROUGH DEGRAFF MEDICAL PARK WERE CANCELLED IN 2020 AND 2021 DUE TO COVID-19 RESTRICTIONS. MENTAL AND SUBSTANCE USE DISORDERSKALEIDA HEALTH, IN COLLABORATION WITH THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH IDENTIFIED THE RISING OPIOID ADDICTION PROBLEM AS A DIRE AREA OF CONCERN FOR THEIR COMMUNITIES. THE PROBLEM HAS BEEN ON THE RISE NATIONALLY AND BOTH COUNTIES HAVE BEEN SIGNIFICANTLY AFFECTED. IN 2015 AND 2016, OPIOID USE INCREASED DRAMATICALLY IN NEW YORK STATE (NYS) AND THE COUNTIES OF ERIE AND NIAGARA WERE LARGELY IMPACTED. IN 2016, THE OPIOID BURDEN (CRUDE RATE PER 100,000 POPULATION) WAS 352.2 IN ERIE COUNTY AND 416.5 IN NIAGARA COUNTY, SOME OF THE HIGHEST RATES IN NYS. IN ADDITION TO STATISTICAL DATA ON OPIOID USE, RESULTS FROM ERIE COUNTY AND NIAGARA COUNTY CONSUMER SURVEYS AND FOCUS GROUP SESSIONS INDICATED THE NEED TO ADDRESS THE PROBLEM."

PART V, SECTION B, LINE 11, CONTINUED
KALEIDA HEALTH IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES IN ITS 2019-2021 CHNA-CSP TO ADDRESS THE OPIOID ADDICTION PROBLEM:ERIE COUNTY AND NIAGARA COUNTY -BUFFALO MATTERS BUPRENORPHINE AND TREATMENT REFERRAL PROGRAM-AVAILABILITY AND ACCESS AND LINKAGE TO OPIOID OVERDOSE REVERSAL MEDICATIONS-MEDICATION AND SYRINGE DROP BOXES IN HOSPITAL EMERGENCY DEPARTMENTS -DRUG TAKE-BACK DAYSIN 2021, KALEIDA HEALTH HOSPITALS PROVIDED THE FOLLOWING SUBSTANCE USE DISORDER INTERVENTIONS:-IN 2021, KALEIDA HEALTH HOSPITALS PARTICIPATED IN NEW YORK MATTERS, A HOSPITAL-INITIATED BUPRENORPHINE AND TREATMENT REFERRAL PROGRAM. THIS ONLINE, REAL-TIME REFERRAL PROGRAM CONNECTS PATIENTS PRESENTING IN THE EMERGENCY ROOM WITH OPIATE USE DISORDERS TO A NETWORK OF 20 WESTERN NEW YORK TREATMENT AGENCIES. IN 2020, 18 REFERRALS WERE MADE TO NEW YORK MATTERS AT KALEIDA HEALTH EMERGENCY DEPARTMENTS-KALEIDA HEALTH EMERGENCY DEPARTMENTS AT BUFFALO GENERAL MEDICAL CENTER AND MILLARD FILLMORE SUBURBAN HOSPITAL AND DEGRAFF MEDICAL PARK PROVIDE PATIENT ACCESS TO OVERDOSE REVERSAL MEDICATION INCLUDE NALOXONE THROUGH THE KALEIDA HEALTH PHARMACY. IN 2021, 27 NALOXONE KITS, AN OVERDOSE REVERSAL MEDICATIONS, WERE PROVIDED TO PATIENTS/FAMILIES IN KALEIDA HEALTH EMERGENCY DEPARTMENTS. ADDITIONALLY, IN 2021, FENTANYL TEST STRIPS WERE ADDED TO THE NARCAN KITS TO HELP TO DECREASE ACCIDENTAL OVERDOSE DUE TO FENTANYL-LACED PRODUCTS. -IN PARTNERSHIP WITH THE ERIE COUNTY DEPARTMENT OF HEALTH, MEDICATION AND SYRINGE DROP BOXES ARE PROVIDED AT THE EMERGENCY DEPARTMENTS OF KALEIDA HEALTH HOSPITALS. NIAGARA COUNTY SHERIFF'S OFFICES PICK UP AND TRANSPORT CONTENTS OF DROP BOXES ON A REGULAR BASIS FOR INCINERATION.-PRESCRIPTION DRUG TAKE BACK DAYS WERE HELD ON APRIL 24, 2021 AND OCTOBER 23, 2021 AT MILLARD FILLMORE SUBURBAN HOSPITAL IN ERIE COUNTY AND AT DEGRAFF MEDICAL PARK IN NIAGARA COUNTY.MATERNAL, INFANT, AND CHILD HEALTHTHE HEALTH OF WOMEN, INFANTS, CHILDREN AND THEIR FAMILIES IS FUNDAMENTAL TO POPULATION HEALTH AND IS A PRIORITY AREA FOR THE 2019-2024 NYS PREVENTION AGENDA. ERIE COUNTY AND NIAGARA COUNTY BOTH HAVE HIGH RATES OF INFANT AND MATERNAL MORTALITY, PREMATURE BIRTH, LOW BIRTHWEIGHT BABIES, AND TEEN PREGNANCY RATES. THESE RATES ARE AFFECTED BY MULTIPLE DISPARITIES INCLUDING RACE, POVERTY, AND LACK OF ACCESS TO QUALITY PRENATAL CARE, AS WELL AS OTHER SOCIAL DETERMINANTS OF HEALTH SUCH AS OBESITY, SMOKING, SUBSTANCE USE, AND MENTAL HEALTH DISORDERS. ERIE COUNTY AND NIAGARA COUNTY INFANT MORTALITY RATES ARE SIGNIFICANTLY HIGHER THAN NYS RATES PER 2014-2016 NYS VITAL STATISTICS DATA:-THE INFANT MORTALITY RATE PER 1,000 LIVE BIRTHS (<1 YEAR) FOR ERIE COUNTY IS 7.3, AND THE RATE FOR NIAGARA COUNTY IS 6.8 WHILE THE NYS RATE IS 4.5. -THE PERCENTAGE OF LOW BIRTHWEIGHT BIRTHS (<2.5 KG) IS 8.6% IN ERIE COUNTY, 7.5% IN NIAGARA COUNTY VERSUS THE NYS RATE OF 7.8%. DISPARITIES EXIST AMONG MINORITY POPULATIONS GIVEN THAT THE PERCENTAGE OF LOW BIRTHWEIGHT BABIES IN ERIE COUNTY IS 7.0% AMONG THE WHITE POPULATION AND 13.7% AMONG THE AFRICAN AMERICAN/BLACK POPULATION.-WHILE THE HEALTH BENEFITS OF BREASTFEEDING ARE WELL DOCUMENTED AND PROMOTED AMONG NEW MOTHERS, THERE IS MORE WORK TO BE DONE TO INCREASE RATES THROUGHOUT ERIE AND NIAGARA COUNTIES. THE PERCENTAGE OF INFANTS FED ANY BREAST MILK IN A DELIVERY HOSPITAL IS 75.2% IN ERIE COUNTY, 69.3% IN NIAGARA COUNTY, MUCH LOWER THAN THE NYS RATE OF 87.3%.KALEIDA HEALTH'S DELIVERY HOSPITALS OF OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) ARE LOCATED IN ERIE COUNTY. THEREFORE, KALEIDA HEALTH SELECTED MATERNAL, INFANT, AND CHILD HEALTH AS ONE OF ITS NYS PREVENTION AGENDA PRIORITIES FOR ERIE COUNTY AND IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES TO ADDRESS IN ITS 2019-2021 CHNA-CSP:ERIE COUNTY-MATERNAL AND WOMEN'S HEALTH CENTERING PREGNANCY PROGRAM (DISPARITY- MEDICAID POPULATION)-PERINATAL AND INFANT HEALTH - SAFE SLEEP INITIATIVE, YOMINGO ONLINE PARENT EDUCATION - BREASTFEEDING PROMOTION AND EDUCATION PROGRAMIN 2021, KALEIDA HEALTH PROVIDED THE FOLLOWING MATERNAL, INFANT, CHILD HEALTH INTERVENTIONS: -THROUGH THE SAFE SLEEP INITIATIVE, IN 2021, OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) PROVIDED SAFE SLEEP EDUCATION AND THE HALO SLEEP SACK FOR ALL NEWBORNS; AND AT OCH FOR ADMITTED PEDIATRIC PATIENTS UP TO ONE YEAR OF AGE AS PROVIDED BY CORPORATE PARTNERS: PEGULA SPORTS + ENTERTAINMENT, THE BUFFALO BILLS AND THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION. IN 2021, AT OCH, 3,626 NEWBORN CAREGIVERS AT OCH AND 2,146 NEWBORN CAREGIVERS AT MFS WERE PROVIDED SAFE SLEEP EDUCATION; AND SAFE SLEEP SWADDLES WERE ALSO DISTRIBUTED. -MILLARD FILLMORE SUBURBAN HOSPITAL OFFERED CHILDBIRTH EDUCATION TO PREGNANT WOMEN AND PARENTS WITH INFORMATION ON PRENATAL, PERINATAL, INFANT AND CHILD CARE THROUGH THE USE OF THE YOMINGO APP (WWW.MYYOMINGO.COM) TO IMPROVE MATERNAL AND INFANT HEALTH OUTCOMES. IN 2021, MILLARD FILLMORE SUBURBAN HOSPITAL RECORDED 492 ACTIVE USERS ON YOMINGO AND THE PROGRAM WAS PROMOTED THROUGH YOMINGO FLYERS DELIVERED TO 250 PHYSICIANS/PROVIDERS THROUGHOUT THE COMMUNITY.-THROUGHOUT 2021, JOHN R. OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) CONTINUED THEIR BREASTFEEDING PROMOTION AND EDUCATION ACTIVITIES TO INCREASE INITIATION AND EXCLUSIVE BREASTFEEDING RATES. AT OCH, A HOSPITAL WITH 65% OF PATIENTS WITH MEDICAID, THE AVERAGE BREASTFEEDING RATES IN 2021 WERE 71.3% INITIATION AND 36.2% EXCLUSIVE (3,626 BIRTHS). AT MFS, THE AVERAGE RATES IN 2021 WERE 80.0% INITIATION AND 46.0% EXCLUSIVE (2,874 BIRTHS).THE CENTERING PREGNANCY PROGRAM WAS NOT PROVIDED AT KALEIDA HEALTH OB-GYN CLINICS IN 2021 DUE TO COVID-19 RESTRICTIONS. PLANNING IS UNDERWAY TO CONTINUE THE PROGRAM POST-COVID.HEALTH CARE NEEDS NOT ADDRESSED IN KALEIDA HEALTH 2019-2021 CHNA-CSPCANCERWHILE CANCER IS THE NUMBER TWO CAUSE OF DEATH IN ERIE AND NIAGARA COUNTIES, THE COUNTY WORK GROUPS AGREED TO INSTEAD PRIORITIZE CARDIOVASCULAR DISEASE, THE NUMBER ONE CAUSE OF DEATH, IN THEIR 2019-2021 PLANS. THE IMPACT OF CANCER ON THE HEALTH OF RESIDENTS IS WELL RECOGNIZED AND ADDRESSED WITH SEVERAL ONGOING CANCER PREVENTION, EDUCATION, SCREENING AND TREATMENT INITIATIVES IN PLACE IN THE REGION. ROSWELL PARK COMPREHENSIVE CANCER CENTER, LOCATED IN BUFFALO, HOLDS THE NATIONAL CANCER INSTITUTE DESIGNATION AS A COMPREHENSIVE CANCER CENTER AND HAS A PROVEN MULTIDISCIPLINARY APPROACH. OISHEI CHILDREN'S HOSPITAL PARTNERS WITH ROSWELL ON THE ROSWELL PARK OISHEI CHILDREN'S CANCER AND BLOOD DISORDERS PROGRAM PROVIDING BOTH INPATIENT AND OUTPATIENT CARE AND A MULTIDISCIPLINARY APPROACH FOR CHILDREN AND ADOLESCENTS WITH CANCER AND HEMATOLOGIC DISORDERS. KALEIDA HEALTH'S MILLARD FILLMORE SUBURBAN HOSPITAL AND DEGRAFF MEDICAL PARK OFFER CANCER REHABILITATION AND RECOVERY THROUGH THE SURVIVOR STEPS PROGRAM. KALEIDA HEALTH PARTICIPATES IN THE GREAT LAKES CANCER CARE COLLABORATIVE, IN PARTNERSHIP WITH CANCER CARE OF WESTERN NEW YORK, ECMC, GASTROENTEROLOGY ASSOCIATES, LLP, GENERAL PHYSICIAN, PC, GREAT LAKES MEDICAL IMAGING, UBMD PHYSICIANS' GROUP, WESTERN NEW YORK UROLOGY ASSOCIATES, WINDSONG, AND THE VISITING NURSING ASSOCIATION OF WESTERN NEW YORK- WITH THE GOAL TO HARNESS THE REGION'S TOP TALENT AND MOST ADVANCED TECHNOLOGY IN A UNIQUE COLLABORATION TO DIAGNOSE, TREAT AND ELIMINATE CANCER. TOBACCOTOBACCO CESSATION PROGRAMS ARE PROVIDED THROUGHOUT ERIE AND NIAGARA COUNTIES, AND KALEIDA HEALTH'S INPATIENT AND OUTPATIENT PROGRAMS CONTINUE TO PROVIDE PATIENT EDUCATION ON THE HEALTH BENEFITS OF NOT SMOKING AND WILL CONTINUE TO REFER PATIENTS TO THESE PROGRAMS. ENVIRONMENTAIR AND WATER QUALITY, FOOD SAFETY, BUILT ENVIRONMENTS TO PROMOTE PHYSICAL HEALTH, SUSTAINABILITY, HEALTHY HOME AND SCHOOL ENVIRONMENTS ARE ADDRESSED THROUGH FEDERAL, STATE AND LOCAL GOVERNMENTS AND NEIGHBORHOOD AND COMMUNITY-BASED ORGANIZATIONS. KALEIDA HEALTH'S OISHEI CHILDREN'S HOSPITAL PARTNERS WITH THE WNY ASTHMA COALITION TO IMPROVE AIR QUALITY IN THE HOME TO IMPROVE ADULT AND CHILDHOOD ASTHMA RATES. THE HOSPITAL FURTHER ADDRESSES HOME SAFETY THROUGH ITS LEAD POISONING PREVENTION PROGRAM.MENTAL HEALTHKALEIDA HEALTH PROVIDES INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES FOR CHILDREN THROUGH THE CHILDREN'S PSYCHIATRY CENTER OF OISHEI CHILDREN'S HOSPITAL. THE CENTER ALSO PARTNERS WITH OTHER COMMUNITY-BASED PROVIDERS TO ASSURE IMPROVED ACCESS TO THE MOST APPROPRIATE CARE FOR CHILDREN WITH MENTAL HEALTH CONDITIONS. KALEIDA HEALTH IS A PARTNER WITH ERIE COUNTY MEDICAL CENTER, HOME OF THE REGIONAL CENTER OF EXCELLENCE FOR BEHAVIORAL HEALTH OFFERING MENTAL HEALTH AND PSYCHIATRY SERVICES, AS WELL AS ALCOHOL AND DRUG ADDICTION DETOXIFICATION AND REHAB.

PART V, SECTION B, LINE 11, CONTINUED
COMMUNICABLE DISEASE BOTH ERIE COUNTY AND NIAGARA COUNTY PROVIDE PUBLIC AWARENESS AND EDUCATION ON COMMUNICABLE DISEASES INCLUDING COVID-19, HIV, SEXUALLY TRANSMITTED DISEASES, HEPATITIS C VIRUS AS WELL AS THE IMPORTANCE OF VACCINES, AND THE IMPROVEMENT OF INFECTION CONTROL IN HEALTHCARE FACILITIES. ALL OF THESE AREAS ARE PRIORITIES FOR KALEIDA HEALTH AND ITS HOSPITALS AND CLINICS; AND ADHERE TO ALL NEW YORK STATE REQUIREMENTS FOR COMMUNICABLE DISEASES INCLUDING INFECTION CONTROL, AND VACCINES INCLUDING PEDIATRIC IMMUNIZATION, COVID-19, AND FLU VACCINES FOR PATIENTS AND EMPLOYEES. KALEIDA HEALTH'S OISHEI CHILDREN'S HOSPITAL PROVIDES THE FOLLOWING:-YOUTH LINK AND BE PREPARED PROGRAM - SUPPORTIVE SERVICES TO YOUTH AND YOUNG ADULTS, AGES 13-24, WHO IDENTIFY AS LGBTQ+, ARE LIVING WITH OR ARE AT RISK FOR HIV AND STIS, ARE EXPERIENCING HOMELESSNESS, SEXUAL ABUSE, SUBSTANCE USE AND/OR MENTAL HEALTH RELATED ISSUES.-THE FAMILY PLANNING CLINIC AND THE WOMEN'S HEALTH CENTERS ADDRESS STIS, HIV AND HCV.ALL KALEIDA HEALTH HOSPITALS ASSURE AND ALSO PROVIDE COVID-19 TESTING AND VACCINES FOR ITS EMPLOYEES AND PATIENTS.

PART V, SECTION B, LINE 16J
INFORMATION THAT EXPLAINS HOW QUALIFIED PATIENTS CAN ACCESS FINANCIAL ASSISTANCE THROUGH THE HOSPITAL IS INCLUDED ON BILLS AND STATEMENTS TO PATIENTS.APPLICATION MATERIALS INCLUDE A NOTICE TO PATIENTS THAT ONCE THEY SUBMIT A COMPLETED APPLICATION AND DOCUMENTATION, THEY MAY DISREGARD ANY BILLS UNTIL THE HOSPITAL HAS RENDERED A WRITTEN DECISION ON THE APPLICATION. THE HOSPITAL MAY NOT FORWARD ACCOUNTS TO COLLECTION WHILE AND APPLICATION IS PENDING.

PART I, LINE 3C:
KALEIDA HEALTH HAS IMPLEMENTED AND COMMUNICATES ITS FINANCIAL ASSISTANCE (CHARITY CARE) POLICY, WHICH ASSISTS LOW INCOME, UNINSURED OR UNDERINSURED INDIVIDUALS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR MEDICAL SERVICES RENDERED. LEVELS OF DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION AND IN ACCORDANCE WITH THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. INDIVIDUALS ARE PROVIDED FINANCIAL ASSISTANCE CONTACT INFORMATION DURING INTAKE AND REGISTRATION. THE APPLICANT FOR FREE OR REDUCED PRICE CARE WORKS DIRECTLY WITH A MEMBER OF THE FINANCIAL COUNSELING OR CHARITY CARE TEAM FOR FINANCIAL SCREENING AND ENROLLMENT IN A GOVERNMENT-FUNDED PROGRAM, IF ELIGIBLE.AFTER REVIEW OF INCOME AND ASSETS, AN INDIVIDUAL MAY BE APPROVED FOR FREE CARE (100% DISCOUNT) OR A DISCOUNT LEVEL OF 50, 60, 75, OR 90%, FOR MEDICALLY NECESSARY SERVICES RENDERED AT A KALEIDA HEALTH FACILITY, AS FOLLOWS: LESS THAN 200% OF FEDERAL POVERTY GUIDELINE IS AWARDED 100% DISCOUNT200% - 249% OF FEDERAL POVERTY GUIDELINE IS AWARDED 90% DISCOUNT250% - 299% OF FEDERAL POVERTY GUIDELINE IS AWARDED 75% DISCOUNT300% - 349% OF FEDERAL POVERTY GUIDELINE IS AWARDED 60% DISCOUNT350% - 400% OF FEDERAL POVERTY GUIDELINE IS AWARDED 50% DISCOUNT

PART I, LINE 7:
THE AMOUNTS REPORTED IN THE TABLE UNDER PART 1, LINE 7 WERE DETERMINED USING THE HEALTH SYSTEM'S DECISION SUPPORT SOFTWARE PROGRAM AND REVENUE AND EXPENSES FROM THE GENERAL LEDGER. THE OVERALL REVENUE AND EXPENSES INCLUDED IN THE DECISION SUPPORT SOFTWARE PROGRAM WERE RECONCILED TO THE GENERAL LEDGER WHICH RECONCILES TO THE AUDITED FINANCIAL STATEMENTS. THE DECISION SUPPORT SOFTWARE PROGRAM ALLOCATES DIRECT COSTS TO EACH PATIENT ACCOUNT BASED ON THE RESOURCES USED BY THAT PATIENT WITHIN THE SPECIFIC COST CENTER. INDIRECT COSTS ARE ALLOCATED USING SIMILAR STEPDOWN METHODOLOGY USED BY CMS IN THE INSTITUTIONAL COST REPORT.

PART III, LINE 8:
THERE ARE NO MEDICARE SHORTFALLS INCLUDED IN THE CALCULATION OF COMMUNITY BENEFIT.COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT, AS REFLECTED IN PART III, LINE 6: KALEIDA HEALTH USED THE FILED, BUT UNAUDITED 2021 CMS MEDICARE COST REPORT TO DETERMINE THE AMOUNTS REPORTED ON THESE LINES.

PART III, LINE 9B:
ONCE PATIENT LIABILITY HAS BEEN DETERMINED FOLLOWING PROCESSING OF APPLICATIONS FOR GOVERNMENT ASSISTANCE, CHARITY CARE, AND/OR INSURANCE CARRIER REMITTANCE, THE PATIENT STATEMENT IS MAILED FOR PAYMENT RECOVERY. KALEIDA HEALTH HAS A PRE-COLLECTION PROCESS FOR ACCOUNTS WITH A POSITIVE PATIENT BALANCE GREATER THAN $4.99 AND A FIRST BILL DATE OLDER THAN 60 DAYS, BUT NOT PREVIOUSLY PAID IN FULL BY THE PATIENT (EXCLUDING ACCOUNTS FOR PATIENTS THAT HAVE SUBMITTED A COMPLETED APPLICATION FOR CHARITY CARE, MEDICAID, OR CHILD HEALTH PLUS, AND AN ELIGIBILITY DETERMINATION IS PENDING).UPON A PATIENT EXPRESSING FINANCIAL CONCERN, THE PATIENT WILL BE OFFERED THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE (CHARITY CARE). ONCE THE PATIENT SUBMITS THE COMPLETED APPLICATION, THE ACCOUNT IS PLACED ON HOLD AND ALL COLLECTION ACTIVITIES ARE SUSPENDED UNTIL AN ELIGIBILITY DETERMINATION IS MADE. IF THE PATIENT IS ELIGIBLE FOR CHARITY CARE, THEN THE PATIENT IS NOTIFIED OF THE LEVEL OF CHARITY CARE AWARDED. IF 100% CHARITY CARE IS AWARDED, THEN NO BILL IS SENT TO THE PATIENT. IF LESS THAN 100% CHARITY CARE IS AWARDED, THEN THE PATIENT WILL RECEIVE A BILL PURSUANT TO THE PRIVATE PAY COLLECTION POLICY.

PART VI, LINE 2:
"KALEIDA HEALTH ASSESSES THE NEEDS OF THE COMMUNITY THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP) WITH ITS MOST RECENT PLAN COMPLETED IN 2019. THE 2019-2021 CHNA-CSP IS AVAILABLE TO THE PUBLIC ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/ AND A PRINTED COPY IS AVAILABLE UPON REQUEST AT NO CHARGE. WRITTEN COMMENTS ON THE 2019-2021 CHNA-CSP ARE INVITED FROM THE PUBLIC THROUGH A LINK ENTITLED ""COMMENT ON PLAN"", LOCATED NEXT TO THE DOCUMENT THROUGH THE ABOVE LINK. IN ADDITION TO THE 2019-2021 CHNA-CSP (AS REPORTED IN PART V, SECTION B), KALEIDA HEALTH STAFF ENGAGE IN OTHER METHODS TO ASSESS THE NEEDS OF THE COMMUNITY. POVERTY TRENDS, COMMUNITY HEALTH RESEARCH, AND LOCAL COMMUNITY HEALTH NEEDS ARE REVIEWED ON A REGULAR BASIS WHILE PLANNING SERVICES AND PROGRAMS. RESPONSIVE TO COMMUNITY PRIORITIES, PROGRAM DEVELOPMENT AND SERVICES FILL IDENTIFIED GAPS OR SUPPLEMENT EXISTING PROGRAMS."

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE KALEIDA HEALTH INFORMS INDIVIDUALS OF FINANCIAL ASSISTANCE MADE AVAILABLE AT THE TIME OF REGISTRATION INTO THE INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, AND LONG-TERM CARE FACILITY. POSTERS INFORMING THE PATIENT/FAMILY OF ASSISTANCE ARE AVAILABLE THROUGHOUT THE KALEIDA LOCATIONS. BROCHURES AND PAMPHLETS INFORMING THE COMMUNITY ARE WIDELY DISTRIBUTED IN THE COMMUNITY AT HEALTH FAIRS, CHURCHES, SCHOOLS AND OTHER PUBLIC LOCATIONS. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AS WELL AS APPLICATION IS ALSO MADE AVAILABLE THROUGH KALEIDA HEALTH'S WEBSITE. KALEIDA HEALTH OFFERS ASSISTANCE TO INDIVIDUALS IN OUR COMMUNITY FOR ACCESSING AFFORDABLE HEALTH CARE, INCLUDING:- FACILITATED ENROLLMENT: ASSISTS ELIGIBLE INDIVIDUALS WITH HEALTH INSURANCE ENROLLMENT BY OFFERING EDUCATION AND APPLICATION ASSISTANCE FOR MEDICAID, CHILD HEALTH PLUS, ESSENTIAL PLANS, STATE AID PROGRAM FOR CHILDREN WITH SPECIAL NEEDS AND ALL QUALIFIED HEALTH PLANS MADE AVAILABLE THROUGH THE NEW YORK STATE OF HEALTH, HEALTH PLAN MARKETPLACE. A DEDICATED TELEPHONE NUMBER IS AVAILABLE AND INFORMATION IS PUBLISHED IN BROCHURES AT KALEIDA SITES AND AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY. - FINANCIAL ASSISTANCE PROGRAM: AS DESCRIBED ABOVE, THE KALEIDA FINANCIAL ASSISTANCE PROGRAM IF ELIGIBLE PROVIDES FREE OR REDUCED-PRICES FOR PATIENTS TREATED AT KALEIDA HEALTH HOSPITALS OR LONG-TERM CARE FACILITIES. DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION. - PRESUMPTIVE ELIGIBILITY: KALEIDA HEALTH HAS SHOWN A WILLINGNESS TO EXTEND FINANCIAL ASSISTANCE TO NEEDY PATIENTS WITH OUTSTANDING BILLS WHO HAVE NOT COMPLETED THE CHARITY APPLICATION PROCESS. THIS IS ACHIEVED THROUGH AN AUTOMATED PARO SCORING PROCESS USING PUBLIC RECORDS, REGIONAL COST OF LIVING, ESTIMATED HOUSEHOLD INCOME THRESHOLDS, COMMUNITY DEMOGRAPHICS TO DERIVE AN ESTIMATED FINANCIAL POSITION FOR EACH PATIENT. THOSE PATIENTS SCREENED THROUGH THIS AUTOMATED PROCESS AND DEEMED ELIGIBLE ARE ADJUSTED OFF TO CHARITY CARE IN LIEU OF BAD DEBT.

PART VI, LINE 7, REPORTS FILED WITH STATES
NY

PART II, LINE 7
"KALEIDA HEALTH'S COMMUNITY HEALTH SERVICES SUPPORTS A COMPREHENSIVE PROGRAM OF COMMUNITY HEALTH IMPROVEMENT ADVOCACY. OUTREACH IS CONDUCTED IN MULTIPLE WESTERN NEW YORK COMMUNITIES TARGETING VARIED POPULATIONS OF ALL AGES AND ETHNICITIES, INCLUDING THE MEDICALLY UNDERSERVED. PROGRAMS AND EVENTS PROMOTE THE REDUCTION OF HEALTH DISPARITIES, ACCESS TO CARE, AND PROMOTE OVERALL COMMUNITY HEALTH AND WELLNESS; AND INCLUDE HEALTH EDUCATION AND SCREENING, SPEAKERS ON HEALTH-RELATED TOPICS, AND COMMUNITY REFERRALS. TOPICS RANGE FROM HEALTH INSURANCE ENROLLMENT TO DIABETES, STROKE, HEART DISEASE, MATERNAL AND CHILD HEALTH, AND HEALTH CAREER EXPLORATION.IN 2021, COVID-19 RESTRICTIONS CONTINUED AND LIMITED KALEIDA HEALTH'S ABILITY TO PROVIDE THE SAME COMPREHENSIVE PROGRAM OF COMMUNITY OUTREACH AND EDUCATION IT HAD IN PREVIOUS YEARS. HOWEVER, WORKING AROUND THE PANDEMIC SURGE, KALEIDA HEALTH PARTNERED WITH VARIOUS ORGANIZATIONS AND PARTICIPATED IN 83 IN-PERSON AND VIRTUAL EVENTS TO REACH 12,439 INDIVIDUALS WITH COMMUNITY SERVICE PROGRAMMING. ALL OF THE OUTREACH PROGRAMS ARE FREE AND REACH CROSS SECTION OF CULTURES, ETHNICITIES, ECONOMIC DEMOGRAPHICS, LANGUAGES, RELIGIONS AND ALL GENDERS INCLUDING LGBTQ+ COMMUNITY. MATERIALS PROVIDED TO THE COMMUNITY DURING OUTREACH EVENTS INCLUDED: INFORMATION ON FREE PSA SCREENINGS; BREAST, PROSTATE, COLON CANCER; STROKE PREVENTION; DIABETES PREVENTION; HEART DISEASE AND RISK FACTORS; CHILDREN'S HEALTH; BARIATRIC / OBESITY / BMI; FAMILY PLANNING; HPV/ STD/STI; CHILDREN'S MEDICAID HEALTH HOMES; NUTRITION; WOMEN'S HEALTH; MATERNITY INCLUDING BREASTFEEDING; KALEIDA HEALTH WELLNESS SERIES / ""HEALTHY YOU"".ADDITIONALLY, KALEIDA HEALTH EMAILED HEALTH AND WELLNESS INFORMATION ON A MONTHLY BASIS TO A LIST-SERVE OF 150 DIVERSE COMMUNITY MEMBERS. KALEIDA HEALTH COMMUNITY OUTREACH EXTENDED THROUGHOUT ITS SERVICE AREA AND PRIMARILY IN THE CITY OF BUFFALO, A CITY WITH A POVERTY RATE OF 28.3% AND A HIGH MINORITY POPULATION WITH 35.2% BLACK/AFRICAN AMERICAN AND 12.2% HISPANIC (US CENSUS 2020). BUFFALO HAS SEVERAL CENSUS TRACTS THAT ARE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS AND HEALTH PROFESSIONAL SHORTAGE AREAS. IN-PERSON AND VIRTUAL OUTREACH IN BUFFALO INCLUDED THE FOLLOWING:-BUFFALO PUBLIC SCHOOLS, MATH SCIENCE TECHNOLOGY SCHOOL-VIRTUAL-NAACP BUFFALO BRANCH -VIRTUAL-EVERY PERSON INFLUENCES CHILDREN - VIRTUAL-NAACP BUFFALO BRANCH-VIRTUAL-HOLY CROSS HEAD START -WILLIAM EMSLIE YMCA - SENIOR LUNCHEON -BUFFALO NIAGARA MEDICAL CAMPUS -WESTMINSTER CHARTER SCHOOL - FARMERS MARKET -GREATER BUFFALO UNITED ACCOUNTABLE HEALTHCARE NETWORK (GBUAHN) -BPS INTERNATIONAL SCHOOL - SINGLE MOMS CLUB -HIGH POINTE ON MICHIGAN LONG TERM CARE FACILITY-BUFFALO PUBLIC SCHOOL 54 BACK TO SCHOOL/MEET THE TEACHER-UB EDUCATION OPPORTUNITY CENTER -HISPANIC HERITAGE COUNCIL -CITY OF BUFFALO CLEAN SWEEP PROGRAM-CENTENNIAL AME CHURCH -BLACK ACHIEVERS DINNER -SENECA ONE TOWER -RECOVERY IN CHRIST CHURCH -DOWNTOWN BUFFALO PUBLIC LIBRARY - BABY EXPO -KOMEN BREAST CANCER WALK -BUFFALO FEDERATION NEIGHBORHOOD CENTERS -BUFFALO BUSINESS FIRST- EMPLOYEE NETWORKING EVENT -BROADWAY MARKET - PASSPORT TO WELLNESS EVENT-SAY YES BUFFALO, BUFFALO PUBLIC SCHOOLS - COMMUNITY SCHOOL PROGRAM -NEAR EAST & WEST SIDE TASK FORCE - VIRTUAL KALEIDA HEALTH FURTHER ENGAGED IN CANCER SCREENING INITIATIVES THROUGH COLLABORATIONS WITH GREAT LAKES CANCER CARE AND WESTERN NEW YORK UROLOGY. PSA COLON CANCER SCREENINGS WERE HELD IN COMMUNITIES WHERE NYS DATA IDENTIFIED ZIP CODES WITH HIGH LEVELS OF CANCER AND HEALTH DISPARITIES AND INCLUDED THE FOLLOWING:-MOUNT MORIAH BAPTIST CHURCH, MEN'S PROGRAM & COMMUNITY WELLNESS FUN DAY - BUFFALO-MOUNT OLIVE BAPTIST CHURCH, EAST DELEVAN - BUFFALO -AMHERST SENIOR CENTER, NYS SENATOR RATH FAMILY HEALTH FAIR - AMHERST-MACEDONIA BAPTIST CHURCH BUFFALO-WUFO 1080 AM/POWER 96.5 FM - BUFFALOKALEIDA HEALTH COMMUNITY OUTREACH WAS ALSO PROVIDED TO THE AREA'S UNDERSERVED AND MINORITY POPULATIONS AS FOLLOWS:-THE GREAT LAKES HEALTH RADIO PROGRAM HOSTED BY KALEIDA HEALTH, AIRED TWO TIMES PER MONTH IN 2021 ON WUFO 1080 AM/POWER 96.5 FM AND FEATURED 30 MINUTE INTERVIEWS WITH GUEST SPEAKERS INCLUDING PHYSICIANS, NURSES AND OTHER HEALTH PROFESSIONALS ON A VARIETY OF HEALTH AND WELLNESS TOPICS. A SENIOR MOMENT PROGRAM ALSO AIRED ON POWER 96.5 FM AND FEATURED 30 MINUTE INTERVIEWS WITH GUEST SPEAKERS ON HEALTH AND WELLNESS TOPICS FOR AGES 60+. IN 2021, LISTENERSHIP WAS 81,600 FOR THE GREAT LAKES HEALTH PROGRAM AND 20,400 FOR THE SENIOR MOMENT PROGRAM. THESE PROGRAMS REACH A PREDOMINATELY URBAN POPULATION OF, ALL AGES, RACES, SEXUAL ORIENTATIONS, AND ETHNIC GROUPS IN WESTERN NEW YORK, AND MAY ALSO BE ACCESSED ACROSS THE COUNTRY THROUGH WWW.POWER965RADIO.COM OR GOOGLE WUFO 1080 AM, BUFFALO, NY OR GOOGLE POWER 96.5FM, BUFFALO, NY.-BUFFALO PUBLIC SCHOOL, MATH SCIENCE TECHNOLOGY (MST) HIGH SCHOOL SPEAKER SERIES WAS HELD VIRTUALLY AND IN-PERSON AS PERMITTED DURING COVID-19. KALEIDA HEALTH EMPLOYEES SHARED THEIR KNOWLEDGE AND EXPERIENCES ON THEIR CAREERS WITH HIGH SCHOOL STUDENTS PREPARING FOR COLLEGE AND CAREERS AS CERTIFIED NURSING ASSISTANTS (CNAS). MST IS LOCATED IN A PRIMARILY AFRICAN AMERICAN COMMUNITY IN ZIP CODE 14215, A NEIGHBORHOOD WITH HIGH RATES OF HEALTH DISPARITIES, UNEMPLOYMENT, AND UNDEREMPLOYMENT AND IS A FOOD DESERT. IN 2021, 10 KALEIDA HEALTH SPEAKER PRESENTATIONS, IN PERSON AND VIRTUAL WERE CONDUCTED FOR THE MST CNA PROGRAM. ADDITIONALLY, KALEIDA HEALTH'S COMMUNITY RELATIONS SPECIALIST ACTIVELY PARTICIPATES IN THE FOLLOWING COMMUNITY ORGANIZATIONS:-NEAR EAST AND WEST SIDE TASK FORCE - EXECUTIVE DIRECTOR-CRISIS SERVICES- OUTREACH, MEMBERSHIP-WNED - COMMUNITY ADVISORY COMMITTEE-UB MINI MEDICAL SCHOOL - COMMUNITY COMMITTEE MEMBER-NAACP - BOARD OF DIRECTORS 2ND VP, BUFFALO; CHAIR HEALTH COMMITTEE, BUFFALO AND NEW YORK STATE-LEADERSHIP BUFFALO -CLASS CHAIR-HISPANIC WOMEN'S LEAGUE- MEMBERSHIP CHAIR AND SPECIAL PROJECTS-ALBRIGHT-KNOX ART GALLERY - ADVANCEMENT COMMITTEE -EPIC - OUTREACH COMMITTEE -LIVE WELL ERIE -BOARD OF DIRECTORS AND OLDER ADULT AND FAMILY WORKING GROUPS-ST. JOHN BAPTIST CHURCH - CHAIR, HEALTH COMMITTEE AND OUTREACH-BUFFALO NIAGARA MEDICAL CAMPUS - NEIGHBORHOOD ENGAGEMENT & GOVERNMENT AFFAIRS COUNCIL-UB MEDICAL SCHOOL CURRICULUM REVISION COMMITTEE - COMMUNITY ADVISORY COMMITTEE -HEALTH SCIENCES CHARTER SCHOOL - BOARD OF DIRECTORSPART III, SECTION A, LINE 2BAD DEBT EXPENSEDUE TO THE ADOPTION OF ASU NO. 2014-09 - REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION. PLEASE SEE THE FOLLOWING 2021 AUDITED FINANCIAL STATEMENT FOOTNOTE WHICH DESCRIBES THIS.KALEIDA ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT'S CARE MAY BE CLASSIFIED AS CHARITY CARE IN ACCORDANCE WITH CERTAIN ESTABLISHED POLICIES OF KALEIDA. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED.TO ENHANCE AND ACCELERATE THE CHARITY CARE QUALIFICATION PROCESS, KALEIDA UTILIZES A PRESUMPTIVE CHARITY SCORING SYSTEM IN ORDER TO DETERMINE CHARITY CARE ELIGIBILITY. THE SYSTEM USES DEMOGRAPHIC AND PUBLIC FINANCIAL INFORMATION TO QUALIFY PATIENT ACCOUNTS FOR CHARITY CARE. IN ADDITION, KALEIDA MAKES AND RECEIVES PAYMENTS TO AND FROM A STATEWIDE POOL TO SUPPORT THE DELIVERY OF CHARITY CARE TO PATIENTS THROUGHOUT NEW YORK. THESE NET PAYMENTS ARE REPORTED AS A COMPONENT OF PATIENT SERVICE REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS."

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"KALEIDA HEALTH SERVES WESTERN NEW YORK'S EIGHT COUNTIES OF ALLEGANY, CATTARAUGUS, CHAUTAUQUA, ERIE, GENESEE, NIAGARA, ORLEANS, AND WYOMING. THE POPULATION FOR THE REGION IS APPROXIMATELY 1.5 MILLION WITH ERIE COUNTY AND NIAGARA COUNTY COMPRISING AN ESTIMATED 1.1 MILLION OF THIS TOTAL. THREE KALEIDA HEALTH HOSPITALS INCLUDING BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, AND OISHEI CHILDREN'S HOSPITAL ARE LOCATED IN ERIE COUNTY, THE HOSPITALS' PRIMARY SERVICE AREA. DEGRAFF MEDICAL PARK IS LOCATED IN NIAGARA COUNTY, ITS PRIMARY SERVICE AREA. DEGRAFF ALSO SERVES A NUMBER OF ERIE COUNTY RESIDENTS GIVEN ITS LOCATION LESS THAN ONE MILE FROM THE ERIE COUNTY BORDER. EACH FACILITY'S PRIMARY SERVICE AREA IS DEFINED AS THE COUNTY WITH THE HIGHEST PERCENTAGE OF ALL WNY COUNTIES FOR 2019 INPATIENT DISCHARGES, EMERGENCY DEPARTMENT VISITS, AND OUTPATIENT VISITS AS IDENTIFIED IN THE 2019-2021 CHNA-CSP.ERIE COUNTYERIE COUNTY IS LOCATED IN THE WESTERN PORTION OF NEW YORK STATE BORDERING LAKE ERIE, AND ALSO LIES ON THE INTERNATIONAL BORDER BETWEEN THE UNITED STATES AND CANADA. THE FOLLOWING DEMOGRAPHIC STATISTICS FOR ERIE COUNTY ARE FROM THE US CENSUS, QUICK FACTS, POPULATION ESTIMATES, JULY 1, 2018 AS INDICATED IN KALEIDA HEALTH'S 2019-2021 CHNA-CSP. THE COUNTY'S TOTAL POPULATION IS 919,719 AND IS COMPRISED OF URBAN, SUBURBAN, AND RURAL CITIES, TOWNS, AND VILLAGES. ERIE COUNTY'S MEDIAN HOUSEHOLD INCOME IS $54,006, ITS POVERTY RATE IS 14.5%, AND 17.5% OF ITS POPULATION IS 65 YEARS AND OVER. ITS LARGEST CITY AND COUNTY SEAT IS BUFFALO WITH A POPULATION OF 256,304. THE CITY HAS A 30.9% POVERTY RATE THE MEDIAN HOUSEHOLD INCOME IN BUFFALO IS $34,268 WHILE THE MEDIAN HOUSEHOLD INCOME IN ERIE COUNTY IS $54,006 AND IN NEW YORK STATE, $62,765. BUFFALO HAS THE FOURTH HIGHEST YOUTH POVERTY RATE IN THE COUNTRY. OF THE 58,618 BUFFALO RESIDENTS UNDER 18 YEARS OF AGE, 27,678 OR 47% OF THOSE CHILDREN LIVE BELOW THE FEDERAL POVERTY LEVEL. THE ERIE COUNTY YOUTH POVERTY RATE IS 19.8% AND THE NYS RATE IS 20.8%. ONLY DETROIT, ROCHESTER AND CLEVELAND HAVE WORSE YOUTH POVERTY RATES (BUFFALO BUSINESS FIRST, 1-15-19). BUFFALO ALSO HAS A HIGH MINORITY POPULATION WITH 35.7% OF ITS RESIDENTS BEING BLACK NON-HISPANIC AND 11.7% HISPANIC AS COMPARED TO 13% BLACK NON-HISPANIC AND 5.3% HISPANIC FOR ALL OF ERIE COUNTY. PERSONS UNDER 65 WITHOUT HEALTH INSURANCE COMPRISE 6.9% OF ERIE COUNTY'S POPULATION AND 10.7% OF BUFFALO'S POPULATION. BUFFALO GENERAL MEDICAL CENTER AND OISHEI CHILDREN'S HOSPITAL ARE LOCATED IN THE CITY OF BUFFALO AND SERVE A HIGH PERCENTAGE OF BUFFALO'S POOR AND UNDERSERVED POPULATION. MOST CENSUS TRACTS IN BUFFALO ARE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS. THE TOWN OF AMHERST IS ONE OF THE COUNTY'S LARGEST SUBURBS WITH A POPULATION OF 125,659 AND IS HOME TO MILLARD FILLMORE SUBURBAN HOSPITAL. IN CONTRAST TO BUFFALO, THE TOWN OF AMHERST HAS A POVERTY RATE OF 10.8% AND THE MEDIAN HOUSEHOLD INCOME (IN 2017 DOLLARS) 2013-2017 IS $72,459. AMHERST'S POPULATION IS 80.7% WHITE NON-HISPANIC. THE TOWN ALSO HAS 8.9% ASIAN POPULATION, COMPARABLE TO THE NYS RATE OF 9.1% WHILE THE ERIE COUNTY RATE IS 3.1%. THE TOWN HAS A SIGNIFICANT SENIOR POPULATION WITH 19.2% OF RESIDENTS 65 YEARS AND OVER, AND MILLARD FILLMORE SUBURBAN HOSPITAL SERVES A HIGH PERCENTAGE OF THE TOWN'S AGING POPULATION. NIAGARA COUNTYNIAGARA COUNTY IS LOCATED IN THE WESTERN PORTION OF NEW YORK STATE, JUST NORTH OF BUFFALO (ERIE COUNTY) AND ADJACENT TO LAKE ONTARIO ON ITS NORTHERN BORDER AND THE NIAGARA RIVER AND CANADA ON ITS WESTERN BORDER. THE FOLLOWING DEMOGRAPHIC STATISTICS FOR ERIE COUNTY ARE FROM THE US CENSUS, QUICK FACTS, POPULATION ESTIMATES, JULY 1, 2018 AS INDICATED IN KALEIDA HEALTH'S 2019-2021 CHNA-CSP. THE COUNTY'S TOTAL POPULATION IS 210,433 AND IS COMPRISED OF URBAN, SUBURBAN, AND RURAL CITIES, TOWNS, AND VILLAGES. NIAGARA COUNTY'S MEDIAN HOUSEHOLD INCOME (IN 2017 DOLLARS) 2013-2017 IS $51,656, ITS POVERTY RATE IS 12.4%, AND 18.5% OF ITS POPULATION IS 65 YEARS AND OVER. ITS CITIES INCLUDE NIAGARA FALLS, POPULATION 48,148; NORTH TONAWANDA, POPULATION 30,372; AND ITS COUNTY SEAT OF LOCKPORT, POPULATION 20,434. THESE CITIES INCLUDE A HIGH PROPORTION OF THE COUNTY'S LOW INCOME AND UNDERSERVED POPULATION. 22.3% OF NIAGARA FALLS RESIDENTS IS BLACK/AFRICAN AMERICAN AND THE CITY HAS A 27.5% POVERTY RATE. ADDITIONALLY, NIAGARA FALLS IS FEDERALLY DESIGNATED AS AN AREA WITH A MEDICALLY UNDERSERVED POPULATION. THE POVERTY RATE FOR NORTH TONAWANDA IS 8.8%, AND 15.4% FOR LOCKPORT. THE PERCENTAGE OF RESIDENTS UNDER 65 YEARS WITHOUT HEALTH INSURANCE RANGES FROM 6.4% IN NIAGARA FALLS AND 5.1% IN NORTH TONAWANDA AND LOCKPORT. NIAGARA COUNTY IS ALSO HOME TO THE TUSCARORA RESERVATION WITH A POPULATION OF 1,288, A POVERTY RATE OF 13% AND A MEDIAN INCOME OF $32,500, MUCH LOWER THAN THAT OF NIAGARA COUNTY. (WIKIPEDIA, US CENSUS 2000) NORTH TONAWANDA IS HOME TO DEGRAFF MEDICAL PARK, AND, A COMMUNITY HOSPITAL A WITH A RECENTLY EXPANDED, NEW STATE-OF-THE ART EMERGENCY ROOM TO BETTER SERVE THE GROWING EMERGENCY CARE NEEDS OF THE COMMUNITY.DURING 2021, THERE WERE 53,006 INPATIENT DISCHARGES, OF WHICH 27% WERE MEDICAID AND MEDICAID MANAGED CARE, 48% MEDICARE AND MEDICARE MANAGED CARE, 0.4% WERE UNINSURED, AND 25% WERE OTHER.IN ADDITION TO KALEIDA HEALTH'S 3 HOSPITALS IN ERIE COUNTY AND 1 HOSPITAL IN NIAGARA COUNTY, THERE ARE 9 OTHER HOSPITALS IN ERIE COUNTY AND 3 OTHER HOSPITALS IN NIAGARA COUNTY SERVING WESTERN NEW YORK PER THE NEW YORK STATE DEPARTMENT OF HEALTH WEBSITE.MORE INFORMATION IS AVAILABLE IN THE KALEIDA HEALTH 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP). THE DOCUMENT WAS COMPLETED IN FALL 2019, AND CAN BE FOUND ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/. PRINTED COPIES AVAILABLE UPON REQUEST AT NO CHARGE AT KALEIDA HEALTH HOSPITALS. WRITTEN COMMENTS ON THE 2019-2021 CHNA-CSP ARE INVITED AND A ""COMMENT LINK"" IS PROVIDED NEXT TO THE PLAN FOUND ON THE KALEIDA HEALTH WEBSITE."

PART VI, LINE 5
"PROMOTION OF COMMUNITY KALEIDA HEALTH'S MISSION IS TO ""ADVANCE THE HEALTH OF ITS COMMUNITY AND ITS VISION IS TO ""PROVIDE COMPASSIONATE, HIGH-VALUE, QUALITY CARE, IMPROVING HEALTH IN WESTERN NEW YORK AND BEYOND, EDUCATING FUTURE HEALTH CARE LEADERS AND DISCOVERING INNOVATIVE WAYS TO ADVANCE MEDICINE."" KALEIDA HEALTH BOARD OF DIRECTORS KALEIDA HEALTH MAINTAINS CONTROL OVER THE CORPORATION THROUGH ITS SELF-PERPETUATING,15 MEMBER GOVERNING BOARD OF DIRECTORS. A MAJORITY OF THE BOARD OF DIRECTORS RESIDES IN KALEIDA HEALTH'S PRIMARY SERVICE AREA OF ERIE AND NIAGARA COUNTIES AND IS NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF KALEIDA HEALTH, NOR FAMILY MEMBERS THEREOF. THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY LEADERS FROM THE BUSINESS, INDUSTRY, AND HEALTHCARE SECTORS, INCLUDING PHYSICIANS WHO ARE ON THE MEDICAL STAFF. EACH DIRECTOR SIGNS A CONFLICT OF INTEREST STATEMENT AND SERVES A THREE-YEAR TERM. ROBERT NESSELBUSH, PRESIDENT AND CEO OF KALEIDA HEALTH SERVES AS AN EX-OFFICIO DIRECTOR WITH VOTING RIGHTS. USE OF SURPLUS FUNDS SURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF KALEIDA HEALTH, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY. IN ADDITION TO THE COMMUNITY SERVICE PROGRAMS ADDRESSED IN THE SECTION VI, PART II COMMUNITY BUILDING SECTION, KALEIDA HEALTH PROVIDES A NUMBER OF ADDITIONAL PROGRAMS AND COLLABORATIONS. KALEIDA HEALTH IS COMMITTED TO EDUCATION AND RESEARCH AS IT SERVES AS A MAJOR CLINICAL TEACHING AFFILIATE OF THE UNIVERSITY AT BUFFALO, JACOBS SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES. THROUGH AFFILIATIONS WITH A NUMBER OF EDUCATIONAL INSTITUTIONS, KALEIDA HEALTH ALSO PROVIDES A CLINICAL EXPERIENCE FOR HEALTH CARE PROFESSIONALS IN TRAINING IN THE FIELDS OF PHARMACY, NURSING, PHYSICIAN ASSISTANTS, SOCIAL WORK, AND REHABILITATION SERVICES. AS CONFERRED BY THE BOARD OF DIRECTORS, MEDICAL STAFF MEMBERSHIP IS OFFERED TO PROFESSIONALLY COMPETENT PHYSICIANS, DENTISTS, PODIATRISTS AND OTHER SPECIFIED INDIVIDUALS, WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS OUTLINED IN THE BYLAWS, RULES AND REGULATIONS, POLICIES OF THE MEDICAL STAFF AND KALEIDA HEALTH, CONSISTENT WITH THE NEEDS OF KALEIDA HEALTH'S PATIENTS. STAFF MEMBERSHIP OR PARTICULAR CLINICAL PRIVILEGES SHALL NOT BE DENIED ON THE BASIS OF AGE, SEX, SEXUAL ORIENTATION, RACE, COLOR, CREED, NATIONAL ORIGIN, A DISABILITY UNRELATED TO THE ABILITY TO FULFILL PATIENT CARE AND MEDICAL STAFF RESPONSIBILITIES OR ANY OTHER CRITERION UNRELATED TO THE EFFICIENT DELIVERY OF QUALITY PATIENT CARE, TO PROFESSIONAL QUALIFICATIONS OR TO THE NEEDS OF THE COMMUNITY, OR TO THE PURPOSES, NEEDS, AND CAPABILITIES OF KALEIDA HEALTH. EVERY MEMBER OF THE MEDICAL STAFF ASSISTS THE HOSPITALS IN FULFILLING KALEIDA HEALTH'S MISSION AND RESPONSIBILITY TO PROVIDE EMERGENCY AND UNCOMPENSATED CARE FOR THOSE IN NEED.KALEIDA HEALTH IS COMMITTED TO PROVIDING HEALTH CARE FOR THE UNINSURED AND UNDERINSURED, OFFERS PROGRAMS AND SERVICES IN COMMUNITY-BASED SETTINGS AND IN ITS CAMPUSES AND FACILITIES, AND WORKS WITH PARTNERING ORGANIZATIONS TO FURTHER MEET THE COMMUNITY'S HEALTH AND SOCIAL NEEDS. PROGRAMS AND EVENTS TARGET ALL AGES AND BACKGROUNDS, INCLUDING THE MEDICALLY UNDERSERVED; AND FOCUS ON THE REDUCTION OF HEALTH DISPARITIES, IMPROVED ACCESS TO CARE, EFFECTIVE USE OF HEALTH SERVICES, AND THE PROMOTION OF OVERALL COMMUNITY HEALTH AND WELLNESS.IN 2019, THE MED-LAW PARTNERSHIP OF WESTERN NEW YORK OPENED AT BUFFALO GENERAL MEDICAL CENTER/GATES VASCULAR INSTITUTE OFFERING PATIENTS LEGAL EXPERTISE AND SERVICES AT NO CHARGE TO ADDRESS PATIENTS' HEALTH-RELATED SOCIAL NEEDS.IN 2021, KALEIDA HEALTH CONTINUED ITS PARTNERSHIPS WITH CHARTER SCHOOLS LOCATED IN UNDERSERVED COMMUNITIES IN THE CITY OF BUFFALO AS IT BECAME A MEMBER OF THE HEALTH SCIENCES CHARTER SCHOOL AND A KALEIDA HEALTH STAFF MEMBER SERVES ON THE SCHOOL'S BOARD OF DIRECTORS. DUE TO COVID 19 RESTRICTIONS IN 2020 AND 2021, AND THE SCHOOL DISTRICT'S CHANGE TO PRIMARILY VIRTUAL LEARNING, MANY OF KALEIDA HEALTH'S PLANNED ACTIVITIES WERE CANCELLED INCLUDING STUDENT INTERNSHIPS, VOLUNTEERS AND HOSPITAL TOURS. KALEIDA HEALTH WELLNESS ACTIVITIES WERE ALSO CURTAILED FOR ITS PARTNER, BUFFALO UNITED CHARTER SCHOOL.A NYS MEDICAID HEALTH HOME SERVING CHILDREN WAS ESTABLISHED IN 2016 THROUGH OISHEI CHILDREN'S HOSPITAL TO PROVIDE CARE MANAGEMENT TO WNY CHILDREN WITH MEDICAID WHO HAVE COMPLEX PHYSICAL AND/OR BEHAVIORAL HEALTH CONDITIONS. THE HOSPITAL ALSO OPERATES SEVEN SCHOOL BASED HEALTH CENTERS IN BUFFALO PUBLIC SCHOOLS, A SCHOOL DISTRICT WITH 82% OF STUDENTS ECONOMICALLY DISADVANTED (2019-2020 DATA.NYSED.GOV).OISHEI CHILDREN'S HOSPITAL IS KNOWN FOR ITS COMMUNITY COLLABORATIONS TO ADDRESS PUBLIC HEALTH CONCERNS AND ASSURE ACCESS TO CARE FOR WOMEN AND CHILDREN, MANY OF WHOM ARE MEDICALY UNDERSERVED. IN ADDITION TO ITS WIDE RANGE OF SPECIALIZED PEDIATRIC AND MATERNAL SERVICES, THE HOSPITAL SERVES THE REGION AS A NEW YORK STATE REGIONAL PERINATAL CENTER, NYS DESIGNATED EBOLA PREPARED CENTER, AND THE PEDIATRIC & ADOLESCENT AIDS DESIGNATED CETNER OF WNY. IT HAS A LEVEL IV NEONATAL INTENSIVE CARE UNIT, LEVEL I PEDIATRIC TRAUMA UNIT, AND PEDIATRIC INTENSIVE CARE UNIT AND IS HOME TO THE ROBERT WARNER CENTER FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS, CHILDREN'S GUILD FOUNDATION AUTISM SPECTRUM DISORDER CENTER, REGIONAL LEVEL IV EPILEPSY MONITORING CENTER OF WNY, SAFE BABIES NEW YORK PROGRAM, LEAD POISONING PREVENTION RESOURCE CENTER OF WESTERN NEW YORK, SICKLE CELL & HEMOGLOBINOPATHY CENTER OF WESTERN NEW YORK, ROSWELL PARK AND OISHEI CHILDREN'S CANDER AND BLOOD DISORDER CENTER AND CYSTIC FIBROSIS CENTER OF WNY, AMONG OTHERS.INCREASING BREASTFEEDING RATES IS A PUBLIC HEALTH PRIORITY OF THE NEW YORK STATE PREVENTION AGENDA. AS DELIVERY HOSPITALS, BOTH OISHEI CHILDREN'S HOSPITAL AND MILLARD FILLMORE SUBURBAN HOSPITAL ARE ENGAGED IN SEVERAL EDUCATIONAL AND CLINICAL INITIATIVES TO IMPROVE EXCLUSIVE BREASTFEEDING RATES THROUGH NEW YORK STATE DEPARTMENT OF HEALTH GUIDELINES. IN 2019, ADDITIONALLY, KALEIDA HEALTH'S OB-GYN CENTERS HAVE ALL ACHIEVED NEW YORK STATE BABY-FRIENDLY PRACTICE DESIGNATION. IN 2018, OISHEI CHILDREN'S OPENED A BABY CAFE TO PROVIDE FREE BREASTFEEDING SUPPORT AND GUIDANCE TO PREGNANT AND BREASTFEEDING MOMS.CARDIOVASCULAR DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN BOTH ERIE AND NIAGARA COUNTIES AND KALEIDA HEALTH SUPPORTS SEVERAL CARDIOVASCULAR INITIATIVES. CARDIAC AND STROKE CARE IS A MAJOR SERVICE LINE FOR KALEIDA HEALTH AND THE GATES VASCULAR INISTITUTE OF BUFFALO GENERAL MEDICAL CENTER SERVES AS A REGIONAL SPECIALTY CARE AND RESEARCH FACILITY FOCUSING ON THE HEART, NEUROLOGICAL, AND RELATED VASCULAR SYSTEM. IN 2021, DUE TO COVID-19 RESTRICTIONS CHRONIC DISEASE RISK FACTOR EDUCATION AND SCREENING EVENTS WENT VIRUTAL WITH 17,756 INDIVIDUALS PARTIPATING IN HEALTHY U PROGRAMS VIA FACEBOOK. ADDITIONALLY, MEDICAL MINUTE VIDEOS ON HEALTH TOPICS AIRED ON WIVB-TV AND KALEIDA SOCIAL MEDIA REACHING 83,178 AND THE MEDICALLY SPEAKING INTERVIEW SERIES REACHED 48,053 VIA FACEBOOK AND THE KALEIDA WEBSITE. A TARGETED CARDIOVASCULAR EDUCATION AND SCREENING PROGRAM IS PROVIDED TO MEDICALLY UNDERSERVED FEMALES AT THE OB-GYN CENTERS OF OISHEI CHILDREN'S HOSPITAL, WHERE A MAJORITY OF PATIENT VISITS ARE REIMBURSED THROUGH MEDICAID.COLLABORATION AND ACCESS TO CARE ACROSS ALL OF WESTERN NEW YORK IS A PRIORTY FOR KALEIDA HEALTH. TO ADDRESS THE NEED FOR CARDIAC CATHETERIZATION SERVICES IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED WITH NIAGARA FALLS MEMORIAL MEDICAL CENTER (NFMMC), CATHOLIC HEALTH SYSTEM, AND ERIE COUNTY MEDICAL CENTER TO MAKE THIS LIFESAVING CARE READILY ACCESSIBLE TO RESIDENTS THROUGHOUT THE NIAGARA REGION. A NEW CARDIAC CATHETERIZATION LABORATORY OPENED IN 2017 AT THE HEART CENTER OF NIAGARA ON THE NFMMC'S DOWNTOWN NIAGARA FALLS CAMPUS."

PART VI, LINE 5 - CONTINUED
MILLARD FILLMORE SUBURBAN HOSPITAL SERVES THE WESTERN NEW YORK COMMUNITY WITH A COMPREHENSIVE CANCER REHAB PROGRAM. THE HOSPITAL FURTHER PROVIDES CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS AND PARTICIPATES IN COMMUNITY EVENTS INCLUDING NATIONAL PRESCRIPTION DRUG TAKE-BACK DAYS. KALEIDA HEALTH'S DEGRAFF MEDICAL PARK PARTICIPATES IN SEVERAL COMMUNITY EVENTS TO PROVIDE CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS, AND SERVES AS A SITE FOR NATIONAL PRESCRIPTION DRUG TAKE-BACK DAYS. DEGRAFF MEDICAL PARK PROVIDES CANCER REHABILITATION AND RECOVERY SERVICES, CARDIAC REHABILITATION SERVICES, OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPY.KALEIDA HEALTH HOSPITALS ARE RESPONDING TO THE COMMUNITY'S OPIATE PROBLEM THROUGH THE BUFFALO MATTERS BUPRENORPHINE TREATMENT PROGRAM IN THE EMERGENCY DEPARTMENTS WITH IMMEDIATE BUPRENORHINE TREATMENT AND PATIENT REFERRAL TO COMMUNITY TREATMENT AGENCIES. ADDITIONALLY, MEDICATION AND SYRINGE DROP BOXES ARE ON-SITE AT EACH HOSPITAL. KALEIDA HEALTH'S HUMAN RESOURCES DEPARTMENT PARTNERS WITH THE BUFFALO AND ERIE COUNTY WORKFORCE DEVELOPMENT COUNCIL AND THE BUFFALO EDUCATION AND TRAINING CENTER ON DIFFERENT WORKFORCE DEVELOPMENT INITIATIVES AND EVENTS, INCLUDING THOSE TARGETING THE UNDERSERVED. ADDITIONALLY, KALEIDA HEALTH NURSE RECRUITERS PARTNER WITH LOCAL SCHOOLS AND COLLEGES TO ADVANCE RECRUITMENT EFFORTS.INFORMATION REGARDING THE AVAILABILITY OF COMMUNITY HEALTH PROGRAMS, ASSISTANCE WITH HEALTH INSURANCE ENROLLMENT AND FINANCIAL ASSISTANCE PROGRAMS IS PROMOTED TO THE PUBLIC THROUGH MULTIPLE COMMUNITY OUTREACH ACTIVITIES AND EVENTS, ON THE KALEIDA HEALTH WEBSITE WWW.KALEIDAHEALTH.ORG, ON FACEBOOK AND TWITTER; AND AS INCLUDED IN THE 2019-2021 CHNA-CSP. THE CHNA-CSP IS AVAILABLE ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY OR IN PRINT FORMAT UPON REQUEST. WRITTEN COMMENTS ON THE 2019-2021 CHNA-CSP ARE INVITED AND A COMMENT LINK IS PROVIDED NEXT TO THE PLAN FOUND ON THE KALEIDA HEALTH WEBSITE.THE COVID-19 PANDEMIC - ITS IMPACT AND KALEIDA HEALTH'S RESPONSETHROUGHOUT 2020-2021, KALEIDA HEALTH MADE PROGRESS IMPLEMENTING THE INTERVENTIONS OUTLINED IN ITS COMMUNITY SERVICE PLAN AND AS ALIGNED WITH THE NYS PREVENTION AGENDA, WHILE ALSO ADDRESSING THE NEEDS OF THE UNDERSERVED. HOWEVER, THE COVID-19 PANDEMIC PRESENTED SOME IMPLEMENTATION CHALLENGES. DURING THE PANDEMIC, KALEIDA HEALTH HOSPITALS EXPERIENCED AN INFLUX OF PATIENTS AFFECTED BY THE CORONAVIRUS IN BOTH INPATIENT AND OUTPATIENT CARE. IT WAS CRITICAL FOR EMPLOYEES TO HAVE APPROPRIATE PPE AND BE PROVIDED THE MOST UP-TO-DATE INFORMATION RELATED TO THE CARE AND TREATMENT OF THE DISEASE. ALL EMPLOYEE AND CORPORATE EFFORTS TO EDUCATE, SCREEN AND TEST EMPLOYEES, PATIENTS AND THE COMMUNITY WAS A TOP PRIORITY AND CONTINUES TO BE SO IN 2022. OUTPATIENT CARE AND ELECTIVE SURGERIES AT KALEIDA HEALTH HOSPITALS WERE CUT BACK IN 2020-2021 DUE TO NYS MANDATES, AND KALEIDA HEALTH OUTPATIENT CLINICS ENLISTED TELEHEALTH PROGRAMS TO HELP MEET PATIENT CARE NEEDS. THROUGHOUT THE PANDEMIC, KALEIDA HEALTH CONTINUED TO IMPLEMENT THE COMMUNITY INTERVENTIONS THAT WERE NOT HAMPERED BY PANDEMIC RESTRICTIONS; AND CONTINUES TO WORK TO RE-ASSESS THE IMPACT OF COVID-19 ON OTHER INTERVENTIONS AND IN THE ADVANCEMENT OF ITS NYS PREVENTION AGENDA PRIORITY AREAS. COVID-19 PRESENTED MANY UNPLANNED COMMUNITY NEEDS, AND KALEIDA HEALTH RESPONDED. THROUGHOUT THE PANDEMIC, KALEIDA HEALTH TRANSFORMED ITS OPERATIONS COMING TOGETHER WITH OTHERS IN THE COMMUNITY IN NOVEL WAYS TO MANAGE THE OVERWHELMING NUMBER OF PATIENTS TO BE TREATED. AS KALEIDA HEALTH PIVOTED TO RESPOND, IT WAS CRITICAL TO EFFECTIVELY COMMUNICATE INTERNALLY WITH OUR STAFF AND PROVIDERS AS WELL AS EXTERNALLY WITH THOSE IN OUR COMMUNITY WHO RELIED ON OUR MEDICAL EXPERTS FOR INFORMATION AND GUIDANCE. KALEIDA HEALTH TEAMS WERE INNOVATIVE AND DECISIVE ON HOW THEY HANDLED CLINICAL CARE, APPLYING A RISK-BASED APPROACH AND ALWAYS REMAINING FOCUSED ON THE WELLNESS AND RESILIENCY OF ITS HEROIC HEALTHCARE WORKERS.KALEIDA HEALTH'S ACCREDITATION PARTNER, DNV HEALTHCARE USA INC. AWARDED KALEIDA HEALTH ITS INAUGURAL 2021 PIVOT AWARD FOR THE COLLECTIVE DEDICATION, INNOVATION AND COLLABORATION OF THE ENTIRE KALEIDA HEALTH FAMILY IN RESPONDING TO COVID-19 CHALLENGES. THE PIVOT AWARD (PROGRESSIVE, INNOVATIVE, VALUABLE, OPPORTUNE, AND TRANSFORMATIVE) IS GIVEN TO A HOSPITAL OR HEALTHCARE SYSTEM THAT QUICKLY IMPLEMENTS NEW WAYS TO MEET PATIENT, COMMUNITY AND STAFF NEEDS. THE NEWLY-CREATED AWARD RECOGNIZES THE EXTRAORDINARY EFFORTS HOSPITALS PUT IN PLACE IN RESPONDING TO THE CHALLENGES CREATED BY THE COVID-19 PANDEMIC.DNV HIGHLIGHTED SEVERAL OF KALEIDA HEALTH'S NOTEWORTHY COLLABORATIVE COMMUNITY EFFORTS, INCLUDING:-TRANSFORMED THE FORMER SEARS AUTOMOTIVE BUILDING AT THE WALDEN GALLERIA INTO A DRIVE-THRU COVID-19 TESTING FACILITY, - CREATED A RELATIONSHIP WITH A LOCAL COMMUNITY 503B COMPOUNDING PHARMACY (PINE PHARMACY) TO PRODUCE SACCHARIN SOLUTION NEEDED FOR FIT TESTING PROCESS,-WORKED WITH THE UNIVERSITY AT BUFFALO (UB) TO DEVELOP PREDICTIVE ANALYTICS ON THE WESTERN NEW YORK COVID-19 POSITIVE TEST RATES TO PREPARE LEADERSHIP FOR COVID-19 INPATIENT SURGES, - WITH PARTNERS AT UB, 26 CLINICAL TRIALS WERE PERFORMED AT KALEIDA HEALTH, RESULTING IN 28 PUBLICATIONS. BECAUSE OF OUR CLINICAL TRIALS, WE HAD EARLY ACCESS TO POTENTIAL THERAPEUTIC TREATMENTS FOR PATIENTS WITHIN OUR REGION, -COLLABORATED WITH MANY COMMUNITY, GOVERNMENT AND FAITH-BASED PARTNER ORGANIZATIONS TO CREATE INNOVATIVE VIRTUAL COMMUNITY OUTREACH EVENTS, INCLUDING A VIRTUAL EDUCATION SERIES WITH THE BUFFALO NAACP, WHICH FEATURED KALEIDA HEALTH'S MEDICAL EXPERTS WHO SHARED INFORMATION ABOUT COVID-19 DISEASE, TRANSMISSION, PREVENTION, TREATMENT OPTIONS, TESTING OPPORTUNITIES AND VACCINE SAFETY AND AVAILABILITY, -LED NATIONAL GUIDELINE EFFORTS TO ESTABLISH TREATMENT GUIDELINES FOR EMERGENT ACUTE STROKE PATIENTS IN THE SETTING OF COVID, -LEAD TESTING EFFORTS IN THE COMMUNITY DURING THE FIRST WAVE, PROVIDING TESTING FOR FIRST RESPONDERS AND ESSENTIAL SERVICE PERSONNEL TO SUPPORT THE COMMUNITY; WITH INNOVATIONS INTERNALLY FROM THE KALEIDA HEALTH IT TEAM TO CREATE EFFICIENCIES AND EASE OF SCHEDULING, - VISITING NURSING ASSOCIATION OF WNY TRAINED OTHER HEALTH SYSTEMS AND NURSING HOME TEAMS TO DELIVER MONOCLONAL ANTIBODY TREATMENT FOR NURSING HOME PATIENTS, -SUPPORTED OTHER HEALTHCARE ORGANIZATIONS WITH MUCH-NEEDED PPE, PARTICULARLY FACE MASKS AT THE BEGINNING OF THE PANDEMIC,-DEVELOPED AN EMOTIONAL SUPPORT TASK FORCE WITH A TEAM OF SOCIAL WORKERS, PSYCHOLOGISTS, AND PSYCHIATRISTS TO SUPPORT MENTAL HEALTH NEEDS OF STAFF ACROSS GREAT LAKES HEALTH SYSTEM OF WNY.PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEMKALEIDA HEALTH IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WHOSE MEMBERS INCLUDE: THE UPPER ALLEGHENY HEALTH SYSTEM, KALEIDA HEALTH FOUNDATION, VISITING NURSING ASSOCIATION OF WNY, INC., VNA HOMECARE SERVICE, INC., AND OISHEI CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION.