4A (Expenses $ 526993314 including grants of $ 661782) (Revenue $ 679038120)
St. Charles BendSCMC-B PROVIDED SERVICES FOR 16,024 INPATIENTS, 2,236 BIRTHS, 14,128 SURGICAL CASES, 41,686 EMERGENCY ROOM VISITS, AND 136,689 OTHER OUTPATIENT VISITS IN 2021. AS ONE OF THE PACIFIC NORTHWEST'S LEADING REGIONAL HEALTH CARE FACILITIES, ST. CHARLES BEND PROVIDES SERVICES TYPICALLY FOUND IN MARKETS MANY TIMES ITS SIZE. FOR 100 YEARS, ST. CHARLES BEND HAS TAKEN RESPONSIBILITY FOR THE HEALTH AND WELL-BEING OF GENERATIONS OF OREGONIANS, DEVELOPING INTO A LEVEL II REGIONAL TRAUMA CENTER WITH SPECIALIZED PARTNERSHIPS IN HEART, CANCER, ORTHOPEDICS AND NEUROSURGERY.

4B (Expenses $ 96574482 including grants of $ 0) (Revenue $ 61397641)
St. Charles Medical Group (SCMG)SCMG IS A GROUP OF MEDICAL CLINICS OWNED AND OPERATED BY ST. CHARLES HEALTH SYSTEM. THESE CLINICS ARE LOCATED THROUGHOUT THE REGION AND PROVIDE OUTPATIENT SERVICES SUCH AS CANCER CARE, OB/GYN, PULMONARY CARE, SLEEP DISORDER RESOURCES, HEART SERVICES AND PRIMARY CARE. SCMG PROVIDED OVER 152,500 VISITS IN BEND CLINICS, 66,500 VISITS IN REDMOND CLINICS, 9,756 VISITS IN THE SISTERS CLINIC, 33,331 VISITS IN PRINEVILLE CLINICS, 11,046 IN THE MADRAS CLINICS AND 7,045 IN LA PINE CLINICS IN 2021. SCMG ALSO OPERATES THREE IMMEDIATE CARE CLINICS TO PROVIDE LOW-COST URGENT CARE SERVICES TO THE COMMUNITY; THE URGENT CARE CLINICS PROVIDED SERVICES FOR MORE THAN 33,500 PATIENT VISITS IN 2021.

4C (Expenses $ 82026361 including grants of $ 0) (Revenue $ 105765100)
St. Charles RedmondSCMC-R PROVIDED SERVICES FOR 2,200 INPATIENTS, 4,430 SURGICAL CASES, 20,685 EMERGENCY ROOM VISITS, AND 50,291 OTHER OUTPATIENT VISITS IN 2021. AT ST. CHARLES REDMOND, THE PATIENT EXPERIENCE REMAINS AT THE CENTER OF ALL WE DO AND EACH PATIENT IS EMPOWERED TO PLAY AN ACTIVE ROLE IN HIS OR HER OWN CARE AND HEALING. SURGERIES ARE PERFORMED IN FOUR OF OREGON'S NEWEST AND MOST ADVANCED SURGICAL SUITES. PATIENTS AND THEIR FAMILIES ENJOY THE COMFORT OF STATE-OF-THE-ART PATIENT ROOMS. EVERYONE RECEIVES THE LEVEL OF CARE THAT IS EXPECTED OF A LEADING REGIONAL HEALTH CARE FACILITY.

Facility: St Charles Bend - Part V, Section B, Line 5
Methodologyprimary researchThe CHNA was conducted using many forms of data collection and analysis including the following primary research: Surveys: DHM Research conducted telephone interviews of more than 700 residents throughout the communities (Crook, Deschutes and Jefferson Counties), served by a St. Charles facility to determine the health-related priorities of the population residing in Central Oregon. The survey was designed to establish a baseline of importance, priorities and needs around health and wellness, including access, quality and cost. Respondents were contacted from a list of registered voters, which included cell phones. In gathering responses, a variety of quality control measures were employed, including questionnaire pre-testing and validation. Community Input: Community input was gathered via a collaboration between the St. Charles Health System Community Benefit department and Central Oregon Health Council. The CHNA was developed with data, input, and information from a wide variety of health and community-based organizations, stakeholders and community members. The input was gathered from the Central Oregon Health Councils Community Advisory Council, a number of health-related advisory boards and groups, and via numerous community focus groups throughout the region. Individuals (such as traditional health workers/peer support specialists/community health workers) and organizations were asked to share their expertise through a health equity and social determinants of health lens.

Facility: St Charles Madras - Part V, Section B, Line 5
Methodologyprimary researchThe CHNA was conducted using many forms of data collection and analysis including the following primary research: Surveys: DHM Research conducted telephone interviews of more than 700 residents throughout the communities (Crook, Deschutes and Jefferson Counties), served by a St. Charles facility to determine the health-related priorities of the population residing in Central Oregon. The survey was designed to establish a baseline of importance, priorities and needs around health and wellness, including access, quality and cost. Respondents were contacted from a list of registered voters, which included cell phones. In gathering responses, a variety of quality control measures were employed, including questionnaire pre-testing and validation. Community stakeholder interviews: Community input was gathered via a collaboration between the St. Charles Health System Community Benefit department and Central Oregon Health Council. The CHNA was developed with data, input, and information from a wide variety of health and community-based organizations, stakeholders and community members. The input was gathered from the Central Oregon Health Councils Community Advisory Council, a number of health-related advisory boards and groups, and via numerous community focus groups throughout the region. Individuals (such as traditional health workers/peer support specialists/community health workers) and organizations were asked to share their expertise through a health equity and social determinants of health lens.

Facility: St Charles Prineville - Part V, Section B, Line 5
The CHNA was conducted using many forms of data collection and analysis including the following primary research: Surveys: DHM Research conducted telephone interviews of more than 700 residents throughout the communities (Crook, Deschutes and Jefferson Counties), served by a St. Charles facility to determine the health-related priorities of the population residing in Central Oregon. The survey was designed to establish a baseline of importance, priorities and needs around health and wellness, including access, quality and cost. Respondents were contacted from a list of registered voters, which included cell phones. In gathering responses, a variety of quality control measures were employed, including questionnaire pre-testing and validation. Community Input: Community input was gathered via a collaboration between the St. Charles Health System Community Benefit department and Central Oregon Health Council. The CHNA was developed with data, input, and information from a wide variety of health and community-based organizations, stakeholders and community members. The input was gathered from the Central Oregon Health Councils Community Advisory Council, a number of health-related advisory boards and groups, and via numerous community focus groups throughout the region. Individuals (such as traditional health workers/peer support specialists/community health workers) and organizations were asked to share their expertise through a health equity and social determinants of health lens.

Facility: St Charles Redmond - Part V, Section B, Line 5
Methodologyprimary researchThe CHNA was conducted using many forms of data collection and analysis including the following primary research:Surveys: DHM Research conducted telephone interviews of more than 700 residents throughout the communities (Crook, Deschutes and Jefferson Counties), served by a St. Charles facility to determine the health-related priorities of the population residing in Central Oregon. The survey was designed to establish a baseline of importance, priorities and needs around health and wellness, including access, quality and cost. Respondents were contacted from a list of registered voters, which included cell phones. In gathering responses, a variety of quality control measures were employed, including questionnaire pre-testing and validation. .Community Input: Community input was gathered via a collaboration between the St. Charles Health System Community Benefit department and Central Oregon Health Council. The CHNA was developed with data, input, and information from a wide variety of health and community-based organizations, stakeholders and community members. The input was gathered from the Central Oregon Health Councils Community Advisory Council, a number of health-related advisory boards and groups, and via numerous community focus groups throughout the region. Individuals (such as traditional health workers/peer support specialists/community health workers) and organizations were asked to share their expertise through a health equity and social determinants of health lens.

Facility: St Charles Bend - Part V, Section B, Line 6a
St. Charles Redmond, St Charles Madras, St Charles Prineville

Facility: St Charles Madras - Part V, Section B, Line 6a
St. Charles Bend, St Charles Redmond, St Charles Prineville

Facility: St Charles Prineville - Part V, Section B, Line 6a
St. Charles Bend, St Charles Redmond, St Charles Madras

Facility: St Charles Redmond - Part V, Section B, Line 6a
St. Charles Bend, St Charles Madras, St Charles Prineville

Facility: St Charles Bend - Part V, Section B, Line 11
The significant health needs that were identified for the St. Charles Bend facility were prioritized as such:1.Stable Housing & Supportsa.Housingb.Housing Supports for High Utilizersc.Homelessness2.Address Poverty & Enhance Self Sufficiency a.Living Wage Jobsb.Homelessnessc.Povertyd.Cost of healthy foods/food insecuritye.High school graduation3.Upstream Prevention: Promotion of Individual Well-Being a.Early Childhood Education & Developmentb.Childcarec.Immunizationsd.Adverse Childhood Experiences (ACEs) (across the lifespan)4.Substance & Alcohol Misuse Prevention & Treatment a.Alcoholb.Tobaccoc.Other Drugsd.Marijuana5.Behavioral Health: Increase Access and Coordination a.Mental Healthb.Behavioral Healthc.Suicided.Emotional Health6.Promote Enhanced Physical Health Across Communities a.Cardiovascular disease (CVD)b.Diabetesc.Obesitya.Preventable DiseasesAfter careful consideration, St. Charles Bend selected alcohol misuse prevention as its priority for the 2020-2022 regional health implementation strategy. The American Academy of Family Physicians defines alcohol misuse as a spectrum of behavior, including risky (excessive) alcohol use, alcohol abuse or alcohol dependence. Risky and excessive alcohol use means drinking more that the amount that results in an increased risk of poor health outcomes. They also mention that in the United States, 58% of men and 46% of women are estimated to have consumed alcohol in the past 30 days. According to the 2018 Oregon Health Authority (OHA) State of Health Assessment there has been a 38% increase in the overall rate of alcohol-related deaths in Oregon since 2001 and in the 2017 Pain in the Nation: The Drug, Alcohol, and Suicide Crises and the Need for a National Resiliency Strategy report it shows that 23% of suicides and 40% of suicide attempts involved alcohol. Oregon also ranks third highest in the country for deaths related to alcohol. Alcohol is a risk factor for injuries, violence, unintended pregnancy and motor vehicle crashes. In Oregon 33% of driving-related deaths involved alcohol, this was according to the OHA report. In Deschutes County 32% of motor vehicle crash deaths involved alcohol and 21% of adults reported they had drank alcohol excessively in the past 30 days. In the 2013 Prevention Status report from the Center for Disease Control and Prevention (CDC) the cost of excessive alcohol use is $2.8 billion, or $1.75 per drink in Oregon. Also in Oregon, in the same report, excessive drinking resulted in 1,302 deaths and 33,933 years of potential life lost each year. In Central Oregon, 37% of people ages 18-34 reported binge drinking at least once in the last 30 days. In the OHA report the word alcohol appears 25 times and in nine of those times it is in relation to the negative impacts it has on the other issues facing our communities. St. Charles Bend representatives feel that alcohol misuse prevention is a health need that is severe in Oregon and Deschutes County and is something that together with our partners, we will make positive changes. Many local organizations are working to address this need and we believe St. Charles can capitalize on the energy that surrounds the subject. St. Charles Health System is using the Robert Wood Johnson Foundation County Health Rankings to measure the success of its 10-year goal of becoming the first, second and third ranked counties in the state of Oregon. Alcohol misuse impacts a lot of the metrics shown in the rankings but it is specifically called out in the Excessive drinking and Alcohol-impaired driving deaths sections. By increasing our efforts to prevent alcohol misuse, we would not only be improving the health of the communities we serve, educating our populations and enhancing our partnerships, we would also be in alignment with the health systems strategic plan and its goals. The following are the significant health needs identified in the St. Charles Bend CHNA that will not be addressed in this implementation strategy: 1.Stable Housing and Supportsa.Housingb.Housing Supports for High Utilizersc.Homelessness 2.Address Poverty and Enhance Self Sufficiency a.Living Wage Jobsb.Homelessnessc.Povertyd.Cost of healthy foods/food insecuritye.High school graduation 3.Upstream Prevention: Promotion of Individual Well-Being a.Early Childhood Education and Developmentb.Childcarec.Immunizationsd.Adverse Childhood Experiences (ACEs) (across the lifespan) 4.Substance Misuse Prevention and Treatment a.Tobaccob.Other Drugsc.Marijuana 5.Behavioral Health: Increase Access and Coordination a.Mental Healthb.Behavioral Healthc.Suicided.Emotional Health 6.Promote Enhanced Physical Health Across Communities a.Cardiovascular disease (CVD)b.Diabetesc.Obesityd.Preventable Diseases In order to achieve real improvement, this plan will only focus on severe issues that the organization has the most ability to impact, has community partners available to collaborate with and needs that will further St. Charles strategic goal of creating the top three healthiest counties in Oregon per the Robert Wood Johnson Foundations County Health Rankings. By selecting one priority, a more focused effort can be made by the caregivers at St. Charles Bend, in collaboration with local partners, to improve the health of those the health system serves. Although the other needs listed above are important, they were not selected for this RHIS. With limited resources available, the St. Charles Bend team felt it was important not to take on too much in order to tackle the selected issue from all angles and have laser-focused energy around improving alcohol misuse prevention efforts in our region. It is important to note that even though the other needs werent selected as priorities, work in these areas will continue. Each of the needs is an area of focus both internally within St. Charles departments and by external partners.

Facility: St Charles Madras - Part V, Section B, Line 11
The significant health needs selected for the St. Charles Madras facility were prioritized as such:1.Stable Housing & Supports a.Housingb.Housing Supports for High Utilizersc.Homelessness 2.Address Poverty & Enhance Self Sufficiency a.Living Wage Jobsb.Homelessnessc.Povertyd.Cost of healthy foods/food insecuritye.High school graduation 3.Substance & Alcohol Misuse Prevention & Treatment a.Alcoholb.Tobaccoc.Other Drugsd.Marijuana 4.Upstream Prevention: Promotion of Individual Well-Being a.Early Childhood Education & Developmentb.Childcarec.Immunizationsd.ACEs (across the lifespan) 5.Behavioral Health: Increase Access and Coordination a.Mental Healthb.Behavioral Healthc.Suicided.Emotional Health 6.Promote Enhanced Physical Health Across Communities a.CVDb.Diabetesc.Obesityd.Preventable DiseasesAfter careful consideration, St. Charles Madras selected alcohol misuse prevention as its priority for the 2020-2022 regional health implementation strategy. The American Academy of Family Physicians defines alcohol misuse as a spectrum of behavior, including risky (excessive) alcohol use, alcohol abuse or alcohol dependence. Risky and excessive alcohol use means drinking more that the amount that results in an increased risk of poor health outcomes. They also mention that in the United States, 58% of men and 46% of women are estimated to have consumed alcohol in the past 30 days. According to the 2018 Oregon Health Authority (OHA) State of Health Assessment there has been a 38% increase in the overall rate of alcohol-related deaths in Oregon since 2001. In the 2017 Pain in the Nation: The Drug, Alcohol, and Suicide Crises and the Need for a National Resiliency Strategy report it shows that 23% of suicides and 40% of suicide attempts involved alcohol. Oregon also ranks third highest in the country for deaths related to alcohol. Alcohol is a risk factor for injuries, violence, unintended pregnancy and motor vehicle crashes. In Oregon 33% of driving-related deaths involved alcohol, this was according to the OHA report. In Jefferson County 19% of motor vehicle crash deaths involved alcohol and 17% of adults reported drinking alcohol excessively in the past 30 days. In the 2013 Prevention Status report from the Center of Disease Control and Prevention (CDC) the cost of excessive alcohol use is $2.8 billion, or $1.75 per drink in Oregon. Also in Oregon, in the same report, excessive drinking resulted in 1,302 deaths and 33,933 years of potential life lost each year. In Central Oregon, 37% of people ages 18-34 reported binge drinking at least once in the last 30 days. In the OHA report the word alcohol appears 25 times and in nine of those times it is in relation to the negative impacts it has on the other issues facing our communities. St. Charles Madras representatives feel that alcohol misuse prevention is a health need that is severe in Oregon and Jefferson County and that together with our partners, we will make positive changes. Many local organizations are working to address this need and we believe St. Charles can capitalize on the energy that surrounds the subject. St. Charles Health System is using the Robert Wood Johnson Foundation County Health Rankings to measure the success of its 10-year goal of becoming the first, second and third ranked counties in the state of Oregon. Alcohol misuse impacts a lot of the metrics shown in the rankings but it is specifically called out in the Excessive drinking and Alcohol-impaired driving deaths sections. By increasing our efforts to prevent alcohol misuse, we would not only be improving the health of the communities we serve, educating our populations and enhancing our partnerships, we would also be in alignment with the health systems strategic plan and its goals. The following are the significant health needs identified in the St. Charles Madras CHNA that will not be addressed in this implementation strategy: 1.Stable Housing and Supports a.Housingb.Housing Supports for High Utilizersc.Homelessness 2.Address Poverty and Enhance Self Sufficiency a.Living Wage Jobsb.Homelessnessc.Povertyd.Cost of healthy foods/food insecuritye.High school graduation 3.Substance Misuse Prevention and Treatment a.Tobaccob.Other Drugsc.Marijuana 4.Upstream Prevention: Promotion of Individual Well-Being a.Early Childhood Education and Developmentb.Childcarec.Immunizationsd.Adverse Childhood Experiences (ACEs) (across the lifespan) 5.Behavioral Health: Increase Access and Coordination a.Mental Healthb.Behavioral Healthc.Suicided.Emotional Health 6.Promote Enhanced Physical Health Across Communities a.Cardiovascular disease (CVD)b.Diabetesc.Obesityd.Preventable Diseases In order to achieve real improvement, it was determined that this plan would only focus on severe issues that the organization felt it had the most ability to impact, had community partners available to collaborate with and needs that would further its strategic goal of creating the top three healthiest counties in Oregon per the Robert Wood Johnson Foundations County Health Rankings. By selecting one priority, a more focused effort can be made by the caregivers at St. Charles Madras, in collaboration with local partners, to improve the health of those the health system serves. Although the other needs listed above are important, they were not selected for this RHIS. With limited resources available, the St. Charles Madras team felt it was important not to take on too much in order to tackle the selected issue from all angles and have laser-focused energy around improving alcohol misuse prevention efforts in our region. It is important to note that even though the other needs werent selected as priorities, work in these areas will continue. Each of the needs is an area of focus both internally within St. Charles departments and by external partners.

Facility: St Charles Prineville - Part V, Section B, Line 11
The significant health needs selected for the St. Charles Prineville facility were prioritized as such:1.Stable Housing and Supports a.Housingb.Housing Supports for High Utilizersc.Homelessness 2.Address Poverty and Enhance Self Sufficiency a.Living Wage Jobsb.Homelessnessc.Povertyd.Cost of healthy foods/food insecuritye.High school graduation 3.Behavioral Health: Increase Access and Coordination a.Mental Healthb.Behavioral Healthc.Suicided.Emotional Health 4.Promote Enhanced Physical Health Across Communities a.Cardiovascular disease (CVD)b.Diabetesc.Obesityd.Preventable Diseases 5.Substance and Alcohol Misuse Prevention and Treatment a.Alcoholb.Tobaccoc.Other Drugsd.Marijuana 6.Upstream Prevention: Promotion of Individual Well-Being a.Early Childhood Education and Developmentb.Childcarec.Immunizationsd.Adverse Childhood Experiences (ACEs) (across the lifespan)After careful consideration, St. Charles Prineville selected alcohol misuse prevention as its priority for the 2020-2022 regional health implementation strategy. The American Academy of Family Physicians defines alcohol misuse as a spectrum of behavior, including risky (excessive) alcohol use, alcohol abuse or alcohol dependence. Risky and excessive alcohol use means drinking more that the amount that results in an increased risk of poor health outcomes. They also mention that in the United States, 58% of men and 46% of women are estimated to have consumed alcohol in the past 30 days.[1] According to the 2018 Oregon Health Authority (OHA) State of Health Assessment there has been a 38% increase in the overall rate of alcohol-related deaths in Oregon since 2001. In the 2017 Pain in the Nation: The Drug, Alcohol, and Suicide Crises and the Need for a National Resiliency Strategy report it shows that 23% of suicides and 40% of suicide attempts involved alcohol. Oregon also ranks third highest in the country for deaths related to alcohol.[2] Alcohol is a risk factor for injuries, violence, unintended pregnancy and motor vehicle crashes. In Oregon 33% of driving-related deaths involved alcohol, this was according to the OHA report.[3] In Crook County 58% of motor vehicle crash deaths involved alcohol and 17% of adults reported drinking excessively in the past 30 days.[4] In the 2013 Prevention Status report from the Center of Disease Control and Prevention (CDC) the cost of excessive alcohol use is $2.8 billion, or $1.75 per drink in Oregon. Also in Oregon, in the same report, excessive drinking resulted in 1,302 deaths and 33,933 years of potential life lost each year. In Central Oregon, 37% of people ages 18-34 reported binge drinking at least once in the last 30 days.[5] In the OHA report the word alcohol appears 25 times and in nine of those times it is in relation to the negative impacts it has on the other issues facing our communities.St. Charles Prineville representatives feel that alcohol misuse prevention is a health need that is severe in Oregon and Crook County and that together with our partners, we will make positive changes. Many local organizations are working to address this need and we believe St. Charles can capitalize on the energy that surrounds the subject. St. Charles Health System is using the Robert Wood Johnson Foundation County Health Rankings to measure the success of its 10-year goal of becoming the first, second and third ranked healthiest counties in the state of Oregon. Alcohol misuse impacts a lot of the metrics shown in the rankings but it is specifically called out in the Excessive drinking and Alcohol-impaired driving deaths sections. By increasing our efforts to prevent alcohol misuse, we would not only be improving the health of the communities we serve, educating our populations and enhancing our partnerships, we would also be in alignment with the health systems strategic plan and its goals. The following are the significant health needs identified in the St. Charles Prineville CHNA that will not be addressed in this implementation strategy: 1.Stable Housing and Supports a.Housingb.Housing Supports for High Utilizersc.Homelessness 2.Address Poverty and Enhance Self Sufficiency a.Living Wage Jobsb.Homelessnessc.Povertyd.Cost of healthy foods/food insecuritye.High school graduation 3.Behavioral Health: Increase Access and Coordination a.Mental Healthb.Behavioral Healthc.Suicided.Emotional Health 4.Promote Enhanced Physical Health Across Communities a.Cardiovascular disease (CVD)b.Diabetesc.Obesityd.Preventable Diseases 5.Substance Misuse Prevention and Treatment a.Tobaccob.Other Drugsc.Marijuana 6.Upstream Prevention: Promotion of Individual Well-Being a.Early Childhood Education and Developmentb.Childcarec.Immunizationsd.Adverse Childhood Experiences (ACEs) (across the lifespan) In order to achieve real improvement, it was determined that this plan would only focus on severe issues that the organization felt it had the most ability to impact, had community partners available to collaborate with and needs that would further its strategic goal of becoming the top three healthiest counties in Oregon per the Robert Wood Johnson Foundations County Health Rankings. By selecting one priority, a more focused effort can be made by the caregivers at St. Charles Prineville, in collaboration with local partners, to improve the health of those the health system serves. Although the other needs listed above are important, they were not selected for this RHIS. With limited resources available, the St. Charles Prineville team felt it was important not to take on too much in order to tackle the selected issue from all angles and have laser-focused energy around improving alcohol misuse prevention efforts in our region. It is important to note that even though the other needs werent selected as priorities, work in these areas will continue. Each of the needs is an area of focus both internally within St. Charles departments and by external partners.

Facility: St Charles Redmond - Part V, Section B, Line 11
The significant health needs selected for the St. Charles Redmond facility were prioritized as such:1.Stable Housing and Supports a.Housingb.Housing Supports for High Utilizersc.Homelessness 2.Address Poverty and Enhance Self Sufficiency a.Living Wage Jobsb.Homelessnessc.Povertyd.Cost of healthy foods/food insecuritye.High school graduation 3.Substance and Alcohol Misuse Prevention and Treatment a.Alcoholb.Tobaccoc.Other Drugsd.Marijuana 4.Upstream Prevention: Promotion of Individual Well-Being a.Early Childhood Education and Developmentb.Childcarec.Immunizationsd.Adverse Childhood Experiences (ACEs) (across the lifespan) 5.Behavioral Health: Increase Access and Coordination a.Mental Healthb.Behavioral Healthc.Suicided.Emotional Health 6.Promote Enhanced Physical Health Across Communities a.Cardiovascular disease (CVD)b.Diabetesc.Obesityd.Preventable DiseasesAfter careful consideration, St. Charles Redmond selected alcohol misuse prevention as its priority for the 2020-2022 regional health implementation strategy. The American Academy of Family Physicians defines alcohol misuse as a spectrum of behavior, including risky (excessive) alcohol use, alcohol abuse or alcohol dependence. Risky and excessive alcohol use means drinking more that the amount that results in an increased risk of poor health outcomes. They also mention that in the United States, 58% of men and 46% of women are estimated to have consumed alcohol in the past 30 days. According to the 2018 Oregon Health Authority (OHA) State of Health Assessment there has been a 38% increase in the overall rate of alcohol-related deaths in Oregon since 2001. In the 2017 Pain in the Nation: The Drug, Alcohol, and Suicide Crises and the Need for a National Resiliency Strategy report it shows that 23% of suicides and 40% of suicide attempts involved alcohol. Oregon also ranks third highest in the country for deaths related to alcohol. Alcohol is a risk factor for injuries, violence, unintended pregnancy and motor vehicle crashes. In Oregon 33% of driving-related deaths involved alcohol, this was according to the OHA report. In Deschutes County 32% of motor vehicle crash deaths involved alcohol and 21% of adults had drank excessively in the past 30 days. In the 2013 Prevention Status report from the Center of Disease Control and Prevention (CDC) the cost of excessive alcohol use is $2.8 billion, or $1.75 per drink in Oregon. Also in Oregon, in the same report, excessive drinking resulted in 1,302 deaths and 33,933 years of potential life lost each year. In Central Oregon, 37% of people ages 18-34 reported binge drinking at least once in the last 30 days. In the OHA report the word alcohol appears 25 times and in nine of those times it is in relation to the negative impacts it has on the other issues facing our communities. St. Charles Redmond representatives feel that alcohol misuse prevention is a health need that is severe in Oregon and Deschutes County and is something that together with our partners, we will make positive changes. Many local organizations are working to address this need and we believe St. Charles can capitalize on the energy that surrounds the subject. St. Charles Health System is using the Robert Wood Johnson Foundation County Health Rankings to measure the success of its 10-year goal of becoming the first, second and third ranked healthiest counties in the state of Oregon. Alcohol misuse impacts a lot of the metrics shown in the rankings but it is specifically called out in the Excessive drinking and Alcohol-impaired driving deaths sections. By increasing our efforts to prevent alcohol misuse, we would not only be improving the health of the communities we serve, educating our populations and enhancing our partnerships, we would also be in alignment with the health systems strategic plan and its goals. The following are the significant health needs identified in the St. Charles Redmond CHNA that will not be addressed in this implementation strategy: 1.Stable Housing and Supports a.Housingb.Housing Supports for High Utilizersc.Homelessness 2.Address Poverty and Enhance Self Sufficiency a.Living Wage Jobsb.Homelessnessc.Povertyd.Cost of healthy foods/food insecuritye.High school graduation 3.Substance Misuse Prevention and Treatment a.Tobaccob.Other Drugsc.Marijuana 4.Upstream Prevention: Promotion of Individual Well-Being a.Early Childhood Education and Developmentb.Childcarec.Immunizationsd.Adverse Childhood Experiences (ACEs) (across the lifespan) 5.Behavioral Health: Increase Access and Coordination a.Mental Healthb.Behavioral Healthc.Suicided.Emotional Health 6.Promote Enhanced Physical Health Across Communities a.Cardiovascular disease (CVD)b.Diabetesc.Obesityd.Preventable Diseases In order to achieve real improvement, it was determined that this plan would only focus on severe issues that the organization felt it had the most ability to impact, had community partners available to collaborate with and needs that would further its strategic goal of creating the top three healthiest counties in Oregon per the Robert Wood Johnson Foundations County Health Rankings. By selecting one priority, a more focused effort can be made by the caregivers at St. Charles Redmond, in collaboration with local partners, to improve the health of those the health system serves. Although the other needs listed above are important, they were not selected for this RHIS. With limited resources available, the St. Charles Redmond team felt it was important not to take on too much in order to tackle the selected issue from all angles and have laser-focused energy around improving alcohol misuse prevention efforts in our region. It is important to note that even though the other needs werent selected as priorities, work in these areas will continue. Each of the needs is an area of focus both internally within St. Charles departments and by external partners.

Facility: St Charles Bend - Part V, Section B, Line 16j
A REFERENCE TO THE FINANCIAL ASSISTANCE PROGRAM WAS INCLUDED ON BILLING STATEMENTS AS WELL AS VOICE MESSAGING ON CUSTOMER SERVICE PHONE LINES & PROMPTS.

Facility: St Charles Madras - Part V, Section B, Line 16j
A REFERENCE TO THE FINANCIAL ASSISTANCE PROGRAM WAS INCLUDED ON BILLING STATEMENTS AS WELL AS VOICE MESSAGING ON CUSTOMER SERVICE PHONE LINES & PROMPTS.

Facility: St Charles Prineville - Part V, Section B, Line 16j
A REFERENCE TO THE FINANCIAL ASSISTANCE PROGRAM WAS INCLUDED ON BILLING STATEMENTS AS WELL AS VOICE MESSAGING ON CUSTOMER SERVICE PHONE LINES & PROMPTS.

Facility: St Charles Redmond - Part V, Section B, Line 16j
A REFERENCE TO THE FINANCIAL ASSISTANCE PROGRAM WAS INCLUDED ON BILLING STATEMENTS AS WELL AS VOICE MESSAGING ON CUSTOMER SERVICE PHONE LINES & PROMPTS.

Part I, Line 7 - Explanation of Costing Methodology
The costing methodology used was derived from SCHS's financial systems, which address all hospital-based patient segments and other services provided. A cost-to-charge ratio from the financial systems was used to calculate the cost of Financial Assistance in line 7a. Numbers reported in column (b) in lines 7a and 7b refer to the number of patient encounters.

Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense
When SCHS provides care to patients, it does not require collateral; however, itmaintains an estimated allowance for doubtful accounts. The primary collection risksrelate to uninsured patient accounts and patient accounts for which the primaryinsurance payor has paid, but patient responsibility amounts (generally deductiblesand copayments) remain outstanding. The reserves against accounts receivable is estimated based primarily upon SCHS historical collection experience, the age of the patient's account, management's estimate of the patient's economic ability to pay, and the effectiveness of collection efforts. Patient accounts receivable balances are routinely reviewed in conjunction with historical collection rates and other economic conditions that might ultimately affect the collectability of patientaccounts when considering the adequacy of the amounts recorded as net patient revenues. Actual write offs have historically been within management'sexpectations.

Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit
SCHS currently has no reasonable way to track or estimate the amount of bad debt expense attributable to charity care, and accordingly this line has been left blank.

Part III, Line 4 - Bad Debt Expense
"See page 14, footnote 4 ""Net Patient Service Revenue"", in the attached Audited Financial Statements."

Part III, Line 8 - Explanation Of Shortfall As Community Benefit
As a response to efforts to improve the health and quality of life of people living in the community, SCHS provided approximately $70 million in unreimbursed services to patients enrolled in traditional Medicare programs. SCHS believes that the Medicare shortfall should be treated as a community benefit since it has a clear mission to serving and improving the health status of the elderly. If SCHS should cease to exist, this shortfall would have to be absorbed by another health care provider. Costs are from the Medicare Cost Report, but none of these costs are being claimed as a community benefit in Part I, line 7.SCHS had a total medicare shortfall of approximately $160M which differs from the shortfall of $70M reported in Part III Section B because Part III Section B includes only those costs allowed in the Medicare Cost Report which excludes the Medicare Advantage shortfall.

Part III, Line 9b - Provisions On Collection Practices For Qualified Patients
Collection policies are the same for all patients. Every effort is made to identify patients who may need financial assistance at the earliest point during the patients experience with St. Charles. Patients may be identified as a candidate for financial assistance at any time before, during or after services are delivered. If at any point during the collection process documentation or information is received that indicates the patient may be eligible for our financial assistance program, the account is reviewed by our financial assistance team for eligibility. Prior to sending an account to collections, patient accounts are reviewed for Federal Poverty Level(FPL). If FPL is 200% or below, a Financial Assistance policy & Financial Assistance application are mailed to the guarantor. If the guarantor fails to complete and return the application, or fails to pay the account in full, or fails to set up a payment plan within 45-days of mailing the policy application, the accounts are assigned to a bad debt agency.

Part VI, Line 2 - Needs Assessment
St. Charles Health System (SCHS) assesses the needs of each of our communities in many different ways other than the facility community health needs assessments. SCHS partners with many organizations from around the community. We collaborated with the Central Oregon Health Council (COHC) to establish a local community data website. The data is provide by Healthy Communities Institute (HCI) and COHC staff manages the website. The website will have dashboards of each community and population risk profiling data that is continuously updated and accessible to the community. This information helps SCHS to keep a finger on the pulse of each population's many health indicators, helping us to continually assess each community's needs, positive changes and/or opportunities for improvement. This information can be found at http://www.centraloregonhealthdata.org. Each year St. Charles also produces the St. Charles Health System Annual Report. This report is comprised of a summary of each of the following: Community BenefitTotalsFinancial OverviewDays cash on handOperating marginExcess marginOperating ExpensesFull time employee countEach health system facility (St. Charles Bend, St. Charles Redmond, St. Charles Prineville and St. Charles Madras) BirthsDischargesIn-patient casesOut-patient casesEmergency visitsSt. Charles Medical GroupPatient visits for each clinicsThe 2021 Annual Report is posted online on the St. Charles Health System website at https://www.stcharleshealthcare.org/about-us/st-charles-annual-report. This report and the primary data collected for its creation let us know what the trends are for different hospital stays, conditions and out-patient visits, helping to decide what services we offer and where the needs are. St. Charles also plays a significant role in local, regional and State groups in order to stay abreast of the newest information, trends, health data and best practices. SCHS has representation on the Central Oregon Health Council (COHC), the governance entity over the region's Coordinated Care Organization, PacificSource Community Solutions, County Commissions, patients, community members & local medical clinics. BY PARTICIPATING ON THIS COUNCIL, ST. CHARLES IS ABLE TO WORK WITH THE EXPERTS IN EACH OF THE THREE COUNTIES TO HEAR FIRSTHAND HOW EACH COMMUNITY IS DOING AND WHAT THEIR HEALTH NEEDS ARE. ST. CHARLES ALSO SITS ON DIFFERENT COMMITTEES FOR THE OREGON ASSOCIATION FOR HOSPITALS AND HEALTH SYSTEMS (OAHHS) AND LOCAL NON-PROFITS. BEING PART OF THESE GROUPS HELPS ST. CHARLES TO BETTER UNDERSTAND THE NEEDS OF OUR COMMUNITIES WHILE ALSO LEARNING HOW TO BETTER COLLECT, TRACK, REPORT AND IMPROVE UPON COLLECTED INFORMATION.

Part VI, Line 4 - Community Building Activities
Our community building activities focused on workforce development activities which support the community by offering the expertise and resources of our hospital systems caregivers for the betterment of the community. Specifically these programs address community-wide workforce issues, potentially providing health care workers to promote the health of the community.

Part VI, Line 7 - States Filing of Community Benefit Report
OR

Part VI - Additional Information
URL of most recently adopted implementation strategy: https://www.stcharleshealthcare.org/community-health/community-health-needs-assessmentWebsite where FAP was widely available:https://www.stcharleshealthcare.org/patients/billing-and-insurance/patient-financial-assistance

Part VI, Line 3 - Patient Education of Eligibility for Assistance
The Financial assistance program policy is posted on the SCHS website.Financial Counselors and registration staff in our facilities & primary care clinics offer financial assistance to patients, both upon request and when patients are uninsured.SCHS works to identify patients who may qualify for coverage through the following government programs (uninsured patients seen in our Emergency departments & those admitted to all of our facilities are automatically referred to a Financial Counseling Patient Advocate): CobraCrime Victims AssistanceEmergency Medicaid for Aliens Medicaid for pregnant women and children Medicaid, Medicare Supplemental Security Income (SSI)Temporary Aid for Needy Families (TANF) VeteransOur Financial Counseling Patient Advocate will work with these individuals through the process of qualifying for coverage or denial of coverage from all applicable government programs.Patients working with the Financial Counseling Patient Advocate have their accounts put on hold from collections. Patients will be referred to the SCHS Financial Assistance Department for follow-up.

Part VI, Line 4 - Community Information
Deschutes County: (St. Charles Bend and St. Charles Redmond) Information taken from United States Census Bureau(https://www.census.gov/quickfacts/fact/table/deschutescountyoregon) unless otherwise noted:URBANLAND AREA IN SQUARE MILES (2010): 3,018POPULATION (2020 ESTIMATE): 198,253POPULATION (2020): UNDER 5 YEARS: 5% UNDER 18 YEARS: 19.8% 65 YEARS AND OVER: 20.5% FEMALE: 50.5%HOUSEHOLDS (2016-2020): 77,040PERSONS PER HOUSEHOLD (2016-2020): 2.47MEDIAN HOUSEHOLD INCOME (2016-2020): $68,937PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2016-2020): 8.1%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2016-2020): 93.8%POPULATION BY RACE (2020): WHITE ALONE, NOT HISPANIC: 94.1% HISPANIC OR LATINO: 8.3% TWO OR MORE RACES: 2.8% AMERICAN INDIAN AND ALASKA NATIVE ALONE: 1.1% ASIAN ALONE: 1.3% BLACK OR AFRICAN AMERICAN ALONE: .6% NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER: 0.2%HEALTH CARE PROVIDER ASSETS IN DESCHUTES COUNTY (OUTSIDE OF ST. CHARLES BEND AND REDMOND): MOSAIC MEDICAL CLINIC, (BEND AND REDMOND) (FQHC) LYNCH COMMUNITY CLINIC (SCHOOL-BASED HEALTH CENTER PARTNERSHIP BETWEEN MOSAIC MEDICAL, REDMOND SCHOOL DISTRICT AND DESCHUTES COUNTY) ENSWORTH COMMUNITY SCHOOL-BASED HEALTH CENTER (PARTNERSHIP BETWEEN MOSAIC MEDICAL, BEND-LAPINE SCHOOL DISTRICT AND DESCHUTES COUNTY) BEND MEMORIAL CLINIC, (BEND, REDMOND AND SISTERS) HIGH LAKES HEALTH CARE (BEND, REDMOND AND SISTERS).CROOK COUNTY: (ST. CHARLES PRINEVILLE) INFORMATION TAKEN FROM UNITED STATES CENSUS BUREAU (https://www.census.gov/quickfacts/fact/table/crookcountyoregon) UNLESS OTHERWISE NOTED:RURALMEDICALLY UNDERSERVED AREA (MUA)LAND AREA IN SQUARE MILES (2010): 2.979POPULATION (2021 ESTIMATE): 24,738POPULATION (2021): UNDER 5 YEARS: 5.6% UNDER 18 YEARS: 19.8% 65 YEARS AND OVER: 25.2% FEMALE: 50.4%HOUSEHOLDS (2016-2020): 11,501PERSONS PER HOUSEHOLD (2016-2020): 2.36MEDIAN HOUSEHOLD INCOME (2016-2020): $59,000PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2016-2020): 10.3%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2016-2020): 89.3%POPULATION BY RACE (2020): WHITE ALONE, NOT HISPANIC: 94.7% HISPANIC OR LATINO: 7.6% TWO OR MORE RACES: 2.3% AMERICAN INDIAN AND ALASKA NATIVE ALONE: 1.7% ASIAN ALONE: 0.7% BLACK OR AFRICAN AMERICAN ALONE: 0.5% NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER: 0.1%HEALTH CARE PROVIDER ASSETS IN CROOK COUNTY (OUTSIDE OF ST. CHARLES PRINEVILLE): MOSAIC MEDICAL (FQHC)CROOK KIDS CLINIC (SCHOOL-BASED HEALTH CENTER PARTNERSHIP BETWEEN MOSAIC MEDICAL AND CROOK COUNTY SCHOOL DISTRICT).JEFFERSON COUNTY: (ST. CHARLES MADRAS) INFORMATION TAKEN FROM UNITED STATES CENSUS BUREAU (https://www.census.gov/quickfacts/fact/table/jeffersoncountyoregon)UNLESS OTHERWISE NOTED: RURALMEDICALLY UNDERSERVED AREA (MUA)LAND AREA IN SQUARE MILES (2019): 1,781POPULATION (2020 ESTIMATE): 25,068POPULATION (2020): UNDER 5 YEARS: 6.3% UNDER 18 YEARS: 23.3% 65 YEARS AND OVER: 19.8% FEMALE: 48.3%HOUSEHOLDS (2016-2020): 8,395PERSONS PER HOUSEHOLD (2016-2020): 2.72MEDIAN HOUSEHOLD INCOME (2015-2019): $53,277PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2016-2020): 12.5%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2015-2019): 88.3%POPULATION BY RACE (2020): WHITE ALONE, NOT HISPANIC: 75.9% HISPANIC OR LATINO: 19.9% TWO OR MORE RACES: 3.4% AMERICAN INDIAN AND ALASKA NATIVE ALONE: 18.3% ASIAN ALONE: .9% BLACK OR AFRICAN AMERICAN ALONE: 1.2% NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER: 0.2%HEALTH CARE PROVIDER ASSETS IN JEFFERSON COUNTY (OUTSIDE OF ST. CHARLES MADRAS): MOSAIC MEDICAL (FQHC)CONFEDERATED TRIBES OF WARM SPRINGS MADRAS MEDICAL GROUP

Part VI, Line 5 - Promotion of Community Health
SCHS provides services without charge, or at amounts less than its established rates, to patients who meet the criteria of its charity care policy. SCHS criteria for the determination of charity care include the patientsor other responsible partys annual household income, number of people in the home and amount claimed on taxes, credit history, existing medical debt obligations and other indicators of the patient's ability to pay. Generally, those individuals with an annual household income at or less than 300% of the Federal Poverty Guidelines (the Guidelines) qualify for charity care under SCHS policy. In addition, SCHS provides discounts on a sliding scale to those individuals with an annual household income of between 300% and 400% of the Guidelines. Since SCHS does not pursue collection of amounts determined to qualify as charity care, those amounts are not reported as net patient service revenue.BECAUSE MADRAS PRINEVILLE AND LA PINE ARE LOCATED IN MEDICALLY UNDERSERVED AREAS(MUAS), THE RESOURCES USED FOR PROVIDER RECRUITMENT IN THOSE COMMUNITIES ARE COUNTED AS COMMUNITY BENEFIT. ST. CHARLES ALSO ALLOWS NURSING STUDENTS, HIGH SCHOOL STUDENTS AND OTHER PROVIDERS TO PARTAKE IN JOB-SHADOWING WITH OUR PAID CAREGIVERS TO HELP THEM COMPLETE THEIR COURSE WORK AND/OR EARN CREDITS, WITHOUT RESTRICTIONS RELATED TO FUTURE EMPLOYMENT. THE ST. CHARLES HEALTH SYSTEM BOARD OF DIRECTORS IS COMPRISED OF MEMBERS FROM MULTIPLE COMMUNITIES SERVED BY THE SYSTEMBEND, PRINEVILLE, SISTERS,ETC.ALLOWING FOR DIVERSE VIEWS AND LEADERSHIP RELATED TO PROMOTING THE HEALTH OF THE COMMUNITY. VARIOUS COMMUNITY CLASSES ARE OFFERED AT EACH CAMPUS, INCLUDING CHILDBIRTH EDUCATION AND BREASTFEEDING EDUCATION, HEALTH HEART EDUCATION, ETC. IN ORDER TO CONTINUE TO PROMOTE HEALTH IN THE COMMUNITY AND ELIMINATE BARRIERS,SCHOLARSHIPS ARE AVAILABLE FOR THOSE WHO ARE UNABLE TO PAY BUT WOULD STILL LIKE TO PARTICIPATE IN ANY OF THESE CLASSES. DUE TO COVID-19, WE SHIFTED RESOURCES AND ASSETS TO COLLABORATING WITH OUR LOCAL PARTNERS TO HELP TACKLE THE ISSUES THAT HAVE ARISED BECAUSE OF THE PANDEMIC. BEING THE ONLY HEALTH CARE SYSTEM IN CENTRAL OREGON, MANY NON-PROFIT COMMUNITYORGANIZATIONS COME TO ST. CHARLES NEEDING FUNDS AND OTHER DONATIONS, SUCH AS IN-KIND SUPPORT. DURING 2021 ST. CHARLES FACILITY CAREGIVERS PROVIDED HUNDREDS OF HOURS OF IN-KIND SUPPORT TO THESE ORGANIZATIONS WHO SHARE IN ST. CHARLES VISION OF CREATING AMERICAS HEALTHIEST COMMUNITY, TOGETHER. IN-KIND SUPPORT ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO MEMBERSHIP ON NON-PROFIT COMMUNITY ORGANIZATION BOARDS, BELOW FAIRMARKET VALUE RENT FEES, FREE CLEANING AND LANDSCAPING SERVICES AND HOURS SPENT COORDINATING EVENTS PROMOTING HEALTH IMPROVEMENT FOR VULNERABLE AND LOW-INCOME COMMUNITY MEMBERS.