4A (Expenses $ 136703440 including grants of $ 0) (Revenue $ 147766298)
692700LEHIGH VALLEY HOSPITAL - SCHUYLKILL (LVH-S), THROUGH THE COMBINED EFFORTS OF ITS HIGHLY QUALIFIED MEDICAL STAFF, EMPLOYEES, AND VOLUNTEERS, OFFERS A BROAD RANGE OF HEALTHCARE SERVICES TO THE RESIDENTS OF SCHUYLKILL COUNTY, PA.INPATIENT HEALTHCARE SERVICES ARE PROVIDED IN MATERNITY, PEDIATRIC, ACUTE AND CRITICAL CARE, ACUTE INPATIENT REHABILITATION UNIT AND BEHAVIORAL HEALTH SERVICES. LVH-S HAD OVER 6,300 ACUTE ADMISSIONS WITH 38,845 DAYS OF INPATIENT CARE. THERE WERE OVER 25,000 EMERGENCY DEPARTMENT VISITS DURING THE YEAR. LVH-S PROVIDES THE ONLY INPATIENT BEHAVIORAL HEALTH SERVICES IN THE COUNTY. IN FY22 WE PROVIDED OVER 17,000 DAYS OF INPATIENT PSYCHIATRIC CARE IN OUR HOSPITAL. THIS SERVICE TO A VERY VULNERABLE, OFTEN UNDER OR UNINSURED POPULATION CONTINUES TO MEET A CRITICAL COMMUNITY NEED. ON AVERAGE 118 PATIENTS PER-DAY USED OUR INPATIENT SERVICES. ADDITIONAL WE SERVE ANOTHER VULNERABLE POPULATION WITH OUR DRUG AND ALCOHOL COUNSELING CENTER. THIS CENTER HAS NEARLY 6,200 PATIENT VISITS PER YEAR AND IS THE ONLY HOSPITAL-BASED PROGRAM IN SCHUYLKILL COUNTY TO PROVIDE MEDICAL ASSISTED THERAPY (MAT) TO PATIENTS.LVH-S PROVIDES A WIDE ARRAY OF DIAGNOSTIC AND TREATMENT PROGRAMS INCLUDING A HOSPITAL-BASED HOME HEALTH DEPARTMENT, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES, OCCUPATIONAL MEDICINE, AS WELL AS CT, MRI, MAMMOGRAPHY, ULTRASOUND, DEXA SCAN, NUCLEAR MEDICINE, AND OTHER IMAGING TECHNOLOGIES. WITH A HIGH INCIDENCE OF DIABETES AND VASCULAR DISEASE WE SERVE OUR COMMUNITY WITH INTERVENTIONAL RADIOLOGY, WOUND CARE AND HYPERBARIC MEDICINE. THE INDUSTRA-MED PROGRAM OF THE MEDICAL CENTER PROVIDED OCCUPATIONAL AND INDUSTRIAL HEALTH SERVICES TO OVER 200 OF THE REGION'S EMPLOYERS. THE OUTPATIENT DEPARTMENTS OF THE HOSPITAL SAW OVER 88,000 PATIENT VISITS.THE MEDICAL CENTER PROVIDES MANY COMMUNITY OUTREACH AND EDUCATIONAL PROGRAMS THROUGHOUT THE YEAR AS WELL AS SCREENINGS, EVENTS, AND HEALTH FAIR PARTICIPATION. THROUGH A PARTNERSHIP WITH A LOCAL AREA ON AGING GROUP (DIAKON), LVH-S PROVIDES FREE FLU SHOTS TO THE VULNERABLE SENIOR CITIZEN POPULATION. WITH THE CHALLENGES OF COVID LVH-S STOOD UP A VACCINATION CLINIC THAT CONTINUES TO RUN EVERY THURSDAY. THIS CLINIC PROVIDED THOUSANDS OF VACCINATIONS AT NO COST TO OUR COMMUNITY. WE ADDITIONALLY, PROVIDE MOBILE VACCINE CLINICS TO SERVE THE ELDERLY/SHUT-IN COMMUNITY MEMBERS THROUGH A PARTNERSHIP WITH THE SCHUYLKILL COUNTY HOUSING AUTHORITY. FINALLY, THROUGH PARTNERSHIP WITH OTHER ORGANIZATIONS (SCHOOLS AND COUNTY FAIR) WE PROVIDED VACCINATIONS AT LOCATIONS MORE CONVENIENT TO OUR COMMUNITY MEMBERS.BEGINNING IN JUNE OF 2022, LVH-S WELCOMED THE INAUGURAL CLASS OF 4 DOCTORS TO OUR RURAL FAMILY MEDICINE PROGRAM. THE PROGRAM IS A THREE-YEAR PROGRAM PROVIDING RESIDENTS TRAINING IN ALL ASPECTS OF PRIMARY CARE.ON SEPTEMBER 16, 2016, LEHIGH VALLEY HEALTH NETWORK (LVHN) AND SCHUYLKILL HEALTH SYSTEM MERGED, WITH LVHN BECOMING THE PARENT ORGANIZATION OF SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET DBA LEHIGH VALLEY HOSPITAL - SCHUYLKILL SOUTH JACKSON STREET; SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET DBA LEHIGH VALLEY HOSPITAL - SCHUYLKILL EAST NORWEGIAN STREET; SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP, INC. DBA LEHIGH VALLEY PHYSICIAN GROUP - SCHUYLKILL; SCHUYLKILL REHABILITATION CENTER, INC. DBA LEHIGH VALLEY HEALTH NETWORK REHABILITATION CENTER - SCHUYLKILL; AND SCHUYLKILL HEALTH SYSTEM DEVELOPMENT CORPORATION DBA LEHIGH VALLEY HEALTH NETWORK DEVELOPMENT CORPORATION - SCHUYLKILL.IN ADDITION, SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET AND SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET MERGED EFFECTIVE JUNE 1, 2018. UNDER THE MERGER, SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET IS THE SURVIVING ORGANIZATION. EFFECTIVE UPON MERGER, SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET CHANGED ITS LEGAL NAME TO LEHIGH VALLEY HOSPITAL - SCHUYLKILL.

LEHIGH VALLEY HOSPITAL - SCHUYLKILL
PART V, SECTION B, LINE 5: FOR THE PURPOSES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LVHN DEFINES THE COMMUNITY IT SERVES AS ALL INDIVIDUALS LIVING WITHIN THE COUNTIES THAT CONTAIN OUR HOSPITAL CAMPUSES. LVHN IS REQUIRED TO PRODUCE A CHNA HEALTH PROFILE FOR EACH OF OUR LICENSED FACILITIES TO ADDRESS THE LOCAL CONTEXT OF THE DIFFERENT COMMUNITIES WE SERVE. THEREFORE, LVHN HAS PRODUCED SEVEN CHNA HEALTH PROFILES FOR OUR LEHIGH VALLEY HOSPITAL (LVH) CAMPUSES: LVH-CARBON (CARBON COUNTY); LVH-DICKSON CITY (LACKAWANNA COUNTY); LVH-HAZLETON (LUZERNE COUNTY); LVH-POCONO (MONROE COUNTY); LVH-CEDAR CREST AND 17TH STREET (LEHIGH COUNTY); MUHLENBERG AND LVH-HECKTOWN OAKS (NORTHAMPTON COUNTY); AND LVH-SCHUYLKILL (SCHUYLKILL COUNTY). LEHIGH AND NORTHAMPTON COUNTY ARE ALSO INCLUSIVE OF OUR COORDINATED HEALTH - ALLENTOWN AND COORDINATED HEALTH - BETHLEHEM CAMPUSES, RESPECTIVELY.WITHIN THE ENTIRE GEOGRAPHIC POPULATION THAT MAKES UP THE COMMUNITIES WE SERVE, WE PLACE A GREATER EMPHASIS ON INCLUDING INDIVIDUALS IN THE COMMUNITY WHO ARE EXPERIENCING HEALTH DISPARITIES TO A GREATER EXTENT OR WHO ARE AT-RISK FOR NEGATIVE HEALTH OUTCOMES BECAUSE OF THE SOCIAL AND ENVIRONMENTAL FACTORS INFLUENCING THEIR HEALTH. IT IS WELL DOCUMENTED THAT THE CLINICAL CARE PROVIDED TO COMMUNITY MEMBERS ONLY ACCOUNTS FOR A SMALL PORTION OF AN INDIVIDUAL'S OVERALL HEALTH. THERE ARE MANY OTHER FACTORS THAT OCCUR OUTSIDE THE DOCTOR'S OFFICE AND HOSPITAL WALLS THAT INFLUENCE HEALTH BEYOND MEDICAL CARE. THEY INCLUDE:- SOCIAL AND ECONOMIC FACTORS, SUCH AS EDUCATION, EMPLOYMENT, AND SOCIAL SUPPORT- PHYSICAL ENVIRONMENT FACTORS, SUCH AS HOUSING, TRANSPORTATION, AND AIR QUALITY- HEALTH BEHAVIORS, SUCH AS SMOKING, DRINKING, DIET, AND EXERCISETHEREFORE, THE CHNA HEALTH PROFILE PROVIDES INFORMATION ABOUT HEALTH CARE AS WELL AS OTHER HEALTH FACTORS FOLLOWED BY HEALTH OUTCOMES. THERE ARE TWO TYPES OF DATA INCLUDED IN THE CHNA HEALTH PROFILES. THE FIRST TYPE IS QUANTITATIVE DATA, OR NUMBERS AND STATISTICS ABOUT THE OVERALL POPULATION IN THE COMMUNITY. THESE STATISTICS COME FROM A VARIETY OF LOCAL, STATE, AND NATIONAL SOURCES INCLUDING THE CENSUS, THE CENTER FOR DISEASE CONTROL, THE DEPARTMENT OF EDUCATION, AND THE CENTERS FOR MEDICAID AND MEDICARE SERVICES. MOST OF THESE DATA POINTS ARE COMPILED TOGETHER THROUGH A PLATFORM CALLED SPARKMAP FROM CARES AT THE UNIVERSITY OF MISSOURI EXTENSION, WHICH LVHN USES AS THE STARTING POINT FOR ITS CHNA HEALTH PROFILES, ADDING OTHER KEY STATE AND LOCAL DATA SOURCES TO THE DATA PROVIDED THROUGH THIS HEALTH REPORT.IN ADDITION, NON-PROFIT HOSPITAL SYSTEMS ARE REQUIRED TO OBTAIN INPUT FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH PUBLIC HEALTH EXPERTISE AND THE VULNERABLE POPULATIONS. LVHN CHOSE TO OBTAIN THIS INPUT THROUGH COMMUNITY CONVERSATIONS AND KEY STAKEHOLDER INTERVIEWS WITH COMMUNITY MEMBERS AND LEADERS. THIS TYPE OF DATA IS REFERRED TO AS QUALITATIVE DATA. FOR EACH CAMPUS, WE PARTNERED WITH AN EXTERNAL COMMUNITY COLLABORATOR WHO HAS EXPERIENCE IN QUALITATIVE DATA COLLECTION TO CONDUCT THESE FOCUS GROUPS AND INTERVIEWS ON LVHN'S BEHALF. THIS PROCESS PROVIDED COMMUNITY MEMBERS WITH AN INDEPENDENT AND OBJECTIVE OPPORTUNITY TO IDENTIFY AND SHARE THEIR PERSONAL EXPERIENCES AND PERSPECTIVE ON THE MOST PRESSING HEALTH NEEDS FACING THEIR COMMUNITY AS WELL AS WHERE THEY WOULD LIKE LVHN TO FOCUS ITS ATTENTION. IN SCHUYLKILL COUNTY, LVH-SCHUYLKILL PARTNERED WITH SCHUYLKILL VISION, A SMALL NON-PROFIT, COMMUNITY ORGANIZING GROUP IN THE COUNTY.THE FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED BETWEEN NOVEMBER 2021 AND JANUARY 2022. IN SCHUYLKILL COUNTY, WHERE OUR SCHUYLKILL CAMPUS IS LOCATED, 24 PARTICIPANTS WERE INVOLVED IN COMMUNITY CONVERSATIONS AND 5 ADDITIONAL KEY STAKEHOLDERS WERE INTERVIEWED.BELOW IS A SUMMARY OF THE ORGANIZATIONS REPRESENTED IN THE COMMUNITY CONVERSATIONS AND INTERVIEWS AS WELL AS A SUMMARY OF THE DEMOGRAPHICS OF THOSE WHO PARTICIPATED. RESIDENTS, INCLUDING THOSE FROM LOW-INCOME POPULATIONS AND OTHER GROUPS OF FOCUS, WERE ALSO INCLUDED IN THE COMMUNITY CONVERSATIONS.ORGANIZATIONS REPRESENTED IN SCHUYLKILL COUNTY:ALVERNIA UNIVERSITY, SCHUYLKILL CAMPUSDOWNTOWN SHENANDOAH, INC.FRACKVILLE FREE PUBLIC LIBRARYPOTTSVILLE FREE PUBLIC LIBRARYSCHUYLKILL COMMUNITY ACTIONSCHUYLKILL COUNTY INTERMEDIATE UNIT 29SCHUYLKILL COUNTY MENTAL HEALTH, DEVELOPMENTAL SERVICES, AND DRUG & ALCOHOL PROGRAMSSCHUYLKILL UNITED WAYPARTICIPANTS IN SCHUYLKILL COUNTY:GENDER: 73% FEMALE, 27% MALEAVERAGE AGE: 55, AGE RANGE: 40-72RACE: 100% WHITE ETHNICITY: 91% NON-HISPANIC, 9% HISPANIC (OF ANY RACE)

LEHIGH VALLEY HOSPITAL - SCHUYLKILL
PART V, SECTION B, LINE 6A: LVHN HAS PRODUCED SEVEN CHNA HEALTH PROFILES FOR OUR LEHIGH VALLEY HOSPITAL (LVH) CAMPUSES: LVH-CARBON (CARBON COUNTY); LVH-DICKSON CITY (LACKAWANNA COUNTY); LVH-HAZLETON (LUZERNE COUNTY); LVH-POCONO (MONROE COUNTY); LVH-CEDAR CREST AND 17TH STREET (LEHIGH COUNTY); MUHLENBERG AND LVH-HECKTOWN OAKS (NORTHAMPTON COUNTY); AND LVH-SCHUYLKILL (SCHUYLKILL COUNTY). LEHIGH AND NORTHAMPTON COUNTY ARE ALSO INCLUSIVE OF OUR COORDINATED HEALTH - ALLENTOWN AND COORDINATED HEALTH - BETHLEHEM CAMPUSES, RESPECTIVELY.WE ADDITIONALLY ASSESSED HEALTH NEEDS WITHIN THE CITY OF ALLENTOWN TO REFLECT THE URBAN COMMUNITY SURROUNDING OUR 17TH STREET CAMPUS IN THE LEHIGH COUNTY REPORT, AND THE LUZERNE COUNTY REPORT INCLUDES INFORMATION ABOUT THE HEALTH NEEDS IN THE CITY OF HAZLETON WHERE IT WAS AVAILABLE. WITHIN THE ENTIRE GEOGRAPHIC POPULATION THAT MAKES UP THE COMMUNITIES WE SERVE, WE PLACE A GREATER EMPHASIS ON INCLUDING INDIVIDUALS IN THE COMMUNITY WHO ARE EXPERIENCING HEALTH DISPARITIES TO A GREATER EXTENT OR WHO ARE AT-RISK FOR NEGATIVE HEALTH OUTCOMES BECAUSE OF THE SOCIAL AND ENVIRONMENTAL FACTORS INFLUENCING THEIR HEALTH.

LEHIGH VALLEY HOSPITAL - SCHUYLKILL
PART V, SECTION B, LINE 6B: ORGANIZATIONS REPRESENTED IN SCHUYLKILL COUNTY:ALVERNIA UNIVERSITY, SCHUYLKILL CAMPUSDOWNTOWN SHENANDOAH, INC.FRACKVILLE FREE PUBLIC LIBRARYPOTTSVILLE FREE PUBLIC LIBRARYSCHUYLKILL COMMUNITY ACTIONSCHUYLKILL COUNTY INTERMEDIATE UNIT 29SCHUYLKILL COUNTY MENTAL HEALTH, DEVELOPMENTAL SERVICES, AND DRUG & ALCOHOL PROGRAMSSCHUYLKILL UNITED WAY

LEHIGH VALLEY HOSPITAL - SCHUYLKILL
PART V, SECTION B, LINE 7D: OUR COMMUNITY HEALTH NEEDS ASSESSMENT IS ALSO AVAILABLE UPON REQUEST.

LEHIGH VALLEY HOSPITAL - SCHUYLKILL
PART V, SECTION B, LINE 11: PRIORITY AREA: ACCESS TO CARE FOR VULNERABLE POPULATIONSLVHN'S 2019 CHNA HIGHLIGHTED VULNERABLE POPULATIONS THAT CONTINUE TO EXPERIENCE BARRIERS TO ACCESS TO CARE INCLUDING: OUR VETERAN POPULATION, WHO MAKE UP APPROXIMATELY 11% OF THE POPULATION IN SCHUYLKILL.MEMBERS OF OUR COMMUNITY WITHOUT HEALTH INSURANCE REPRESENT 8% OF THE TOTAL POPULATION IN SCHUYLKILL. THROUGH THE FOCUS GROUPS DISCUSSIONS, COMMUNITY MEMBERS IN ALL COUNTIES EXPRESSED STRESS AROUND THE INCREASING COST OF HEALTHCARE, CRITICAL MEDICATIONS AND THE STRUGGLE OF BALANCING COST WITH COMPETING BASIC NEEDS. THEY ACKNOWLEDGED THAT THE LACK OF HEALTH INSURANCE OR ABILITY TO PAY FOR MEDICATIONS OFTEN RESULTED IN LIMITING THE USE OF THE HEALTHCARE SYSTEM OR ADDRESSING CHRONIC CONDITIONS. TRANSPORTATION WAS ALSO ACKNOWLEDGED AS ANOTHER BARRIER TO CARE, PARTICULARLY IN THE MORE RURAL SCHUYLKILL AND MONROE COUNTIES. THESE INPUTS FROM THE COMMUNITY ALIGN WITH LVHN'S MISSION OF ADDRESSING THE HEALTH NEEDS FOR ALL MEMBERS OF OUR COMMUNITY AND, THEREFORE, WAS PRIORITIZED WITHIN THE IMPLEMENTATION PLAN AS DISCUSSED BELOW.MEDICATION ASSISTANCETO ADDRESS THE RISING CONCERN ABOUT THE COST OF MEDICATIONS, LVHN'S INTEGRATED CARE COORDINATION TEAM WORKS TO GET PATIENTS DIRECTLY CONNECTED TO PRESCRIPTION DISCOUNT PROGRAMS, THEREBY, REDUCING THE COST BURDEN ON THE PATIENT. PATIENTS FROM 40 LVPG PRACTICES ACROSS ALL 5 COUNTIES RECEIVED THIS SERVICE. THE INTEGRATED CARE COORDINATION TEAM ADDRESSED A TOTAL OF 3,386 CASES TOTALING $5,788,040 IN PRESCRIPTION ASSISTANCE IN FY20. IN FY21, THE TEAM ADDRESSED 3,023 CASES TOTALING $6,161,748. IN FY22, THE TEAM ADDRESSED 2,974 CASES TOTALING $6,824,758. CONNECTION TO HEALTH INSURANCE & FINANCIAL ASSISTANCELEHIGH VALLEY HEALTH NETWORK PROVIDES DIRECT LINKAGES TO RESOURCES AIMED AT ASSISTING UNINSURED PATIENTS IN GETTING INSURANCE COVERAGE, AS WELL AS A ROBUST FINANCIAL ASSISTANCE PROGRAM, CREATING ADDITIONAL ACCESS TO HEALTHCARE FOR VULNERABLE POPULATIONS.THE PATHS PROGRAM AT LVHN HELPS DETERMINE THE ELIGIBILITY FOR INSURANCE FOR UNDERINSURED AND UNINSURED PATIENTS, AS QUICKLY AS POSSIBLE. PATHS REPRESENTATIVES ARE EMBEDDED IN MULTIPLE AREAS IN OUR HOSPITALS, WORKING ALONGSIDE LVHN STAFF. THIS HELPS EXPEDITE THE REFERRAL PROCESS QUICKLY AND EFFICIENTLY AS PATHS COLLEAGUES CAN CONNECT DIRECTLY WITH PATIENTS, AND COUNTY OFFICES TO EXPEDITE PAPERWORK THAT IS REQUIRED AND IF NEEDED FACILITATE IN-PERSON INTERACTIONS. ON AVERAGE, BETWEEN 75% AND 90% OF APPLICATIONS THAT ARE ELIGIBLE ARE APPROVED. IN FY20, THIS RESULTED IN OVER $17 MILLION IN PAYMENTS FROM THE STATE OF PENNSYLVANIA AND SURROUNDING STATES. IN FY21, THE PATHS PROGRAM RESULTED IN OVER $30 MILLION IN PAYMENTS, NEARLY DOUBLING TOTALS FROM THE PREVIOUS FISCAL YEAR. IN FY22, THE PATHS PROGRAM RESULTED IN JUST UNDER $26 MILLION IN PAYMENTS. THE TOTAL NUMBER OF REFERRALS DECREASED FROM LAST YEAR DUE TO PREVIOUS ELIGIBILITY BEING EXTENDED THROUGHOUT THE COVID PANDEMIC.IN ADDITION TO THE PATHS PROGRAM, LVHN PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO ARE NOT ABLE TO COVER THE COST OF THEIR HEALTH CARE. IN FY20, LVH-SCHUYLKILL RECEIVED 960 APPLICATIONS WITH A 7-DAY AVERAGE TO TURN AROUND AN APPLICATION APPROVAL. IN FY21, THERE WERE 204 APPLICATIONS WITH A 50% APPROVAL RATE WITH A 5-DAY TURNAROUND TIME. IN FY22, FOR THE PATIENTS WHO LIVE IN COUNTIES PRIMARILY SERVED BY LVH-SCHUYLKILL, THERE WERE 1,727 APPLICATIONS RECEIVED. THE AVERAGE TURNAROUND TIME FOR APPLICATIONS WAS 4 DAYS, AND THE PERCENT APPROVED WAS 74%. PLEASE NOTE THAT IN FY22 REPORTING IMPROVEMENTS WERE MADE IN THE ELECTRONIC HEALTH RECORD RESULTING IN A MORE COMPLETE COUNT OF APPLICATIONS COMPARED TO THE COUNTS FROM THE PREVIOUS YEARS. PRIORITY AREA: HEALTH PROMOTION AND PREVENTIONIN THE 2019 LVHN CHNA FOCUS GROUPS, PARTICIPANTS ASKED FOR A GREATER PRESENCE IN THE COMMUNITY FROM HEALTH CARE SYSTEMS IN THE PLACES WHERE PEOPLE MOST FREQUENTLY LIVE, WORK, AND PLAY. COMMUNITY MEMBERS IN ALL 5 COUNTIES CALLED FOR ADDITIONAL CARE IN THEIR NEIGHBORHOODS, INCLUDING FOLLOW-UPS AT HOME, SERVICES AT SCHOOLS AND SENIOR CENTERS WHERE PEOPLE ARE LOCATED, AND OUTREACH AND EDUCATION ABOUT AVAILABLE RESOURCES. FOCUS GROUP PARTICIPANTS ALSO SAID THEY ARE GENERALLY UNAWARE OF WHEN OR WHERE VARIOUS LVHN SCREENING EVENTS OR SERVICES ARE AVAILABLE. THIS RANKED IN THE TOP THREE HEALTH CARE PRIORITIES THAT COMMUNITY MEMBERS WANTED TO SEE ADDRESSED. AS SUCH, LVHN LEADERSHIP PRIORITIZED THIS AS AN ISSUE THAT HAD SIGNIFICANT MAGNITUDE, CAPACITY, AND ALIGNMENT. THEREFORE, LVHN COMMITTED TO PROMOTE FREE AND LOW-COST SCREENINGS FOR CHRONIC CONDITIONS AND CANCER SCREENINGS IN NEIGHBORHOODS WHERE VULNERABLE POPULATIONS ARE LOCATED IN ORDER TO INCREASE UTILIZATION OF THESE SERVICES AND EARLY DETECTION.THE ZIP CODE WHERE AN INDIVIDUAL RESIDES CAN BE A SIGNIFICANT INFLUENCER OF HEALTH OUTCOMES. IN ORDER TO FOCUS HEALTH PROMOTION AND PREVENTION EFFORTS, LVHN DETERMINED WHICH ZIP CODES REPRESENT THE VULNERABLE POPULATIONS WITHIN EACH OF THE 5 COUNTIES OUR PATIENTS RESIDE. THIS WAS DEFINED BY A METRIC OF 15% OR MORE OF THE POPULATION LIVING BELOW THE POVERTY LINE AND HAS LESS THAN A HIGH SCHOOL EDUCATION. IN ADDITION, LVHN SERVES A SUBSTANTIAL MEDICAID POPULATION IN THESE ZIP CODES. THE FOLLOWING AREAS HAVE BEEN IDENTIFIED: SCHUYLKILL (LVH-S) - 17976, 17948, 18237IN FY20 THROUGH FY22 ACROSS THE REGION, LVHN WAS ABLE TO PROMOTE HEALTH OR PROVIDE HEALTHCARE SCREENINGS IN THE FOLLOWING WAYS:PREVENTATIVE HEALTH SCREENINGS & SERVICESLVHN ALSO HAD A VARIETY OF SCREENING OPPORTUNITIES, INCLUDING FOR BREAST CANCER. IN FY20, A TOTAL OF 1,865 MAMMOGRAMS WERE COMPLETED THROUGH LVHN'S MAMMOGRAM COACH. THE BREAKDOWN BY COUNTY IS PROVIDED BELOW, WITH 2% OF THE MAMMOGRAMS PROVIDED IN SCHUYLKILL COUNTY ON THE MAMMOGRAM COACH FOR PATIENTS FROM THE TARGET ZIP CODES. IN FY21, A TOTAL OF 1,840 MAMMOGRAMS WERE COMPLETED THROUGH LVHN'S MAMMOGRAM COACH. THE BREAKDOWN FOR SCHUYLKILL COUNTY IS PROVIDED BELOW WITH 183 MAMMOGRAMS WERE COMPLETED IN SCHUYLKILL COUNTY, 4% OF WHICH WERE FOR PATIENTS FROM THE TARGET ZIP CODES. IN FY22, THERE WERE A TOTAL OF 2,075 MAMMOGRAMS COMPLETED THROUGH LVHN'S MAMMOGRAM COACH; 3% WERE FOR PATIENTS FROM THE TARGET ZIP CODES. IN FY20 141 SCREENINGS WERE PERFORMED, WITH 21 FOLLOW-UP IMAGES TAKEN, AND 1 CANCER FOUND. IN FY21 183 SCREENINGS WERE PERFORMED, WITH 25 FOLLOW-UP IMAGES TAKEN, AND 1 CANCER FOUND. IN FY22 167 SCREENINGS WERE PERFORMED, WITH 24 FOLLOW-UP IMAGES TAKEN, AND 1 CANCER FOUND. HEALTH PROMOTION & HEALTH FAIRSAT LVH-SCHUYLKILL, VIA LVHN'S SUPPORT OF SCHUYLKILL COUNTY VISION, DOZENS OF FREE COMMUNITY HEALTH PROMOTION EVENTS AND ONLINE SESSIONS WERE HELD IN FY20 & 21. IN FY20, ALMOST 2,200 COMMUNITY MEMBERS WERE ENGAGED IN THE FIRST HALF OF THE FISCAL YEAR THROUGH FREE COMMUNITY HEALTH PROMOTION EVENTS. THESE EVENTS WERE PAUSED DURING THE PANDEMIC AND RESUMED IN FY21, WITH 13 EVENTS HELD THROUGHOUT THE YEAR. THESE INCLUDED:-EVENTS CENTERED AROUND WALKING AS A PHYSICAL ACTIVITY, INCLUDING WALKWORKS ROUTES IN MAHANOY CITY AND SHENANDOAH, WALK ROUTE SAFETY AUDITS IN SCHUYLKILL HAVEN, AND AN EVENING WALKING GROUP IN ASHLAND. -VIRTUAL SCAVENGER HUNTS AND CHALLENGES WITH NUTRITION AND PHYSICAL ACTIVITY MISSIONS.-A HOLIDAY CHALLENGE RUN IN COOPERATION WITH THE NORTH CAROLINA DIVISION OF PUBLIC HEALTH. -SEASONAL ACTIVITIES INCLUDING A WINTER SELF-CARE WEBINAR AND SUMMER GET OUTDOORS BACKPACK PROGRAM -A HEALTH EQUITY TOUR WITH THE YMCA, INCLUDING INFORMATION ON WALKING, WALKING ROUTES, OUTDOOR MAPS, AND THE IMPORTANCE OF MOVEMENT.IN FY22, SCHUYLKILL COUNTY VISION EXPANDED THEIR COMMUNITY EVENTS TO 21 EVENTS, WITH AT LEAST ONE PER MONTH. HIGHLIGHTS OF THESE EVENTS INCLUDE THE FOLLOWING.-IN JULY 2021, SCHUYLKILL VISION PROMOTED THE HEALTHY SCHUYLKILL SUMMER GET OUTDOORS BACKPACK PROGRAM. THE BACKPACKS INCLUDE INFORMATION ON WALKING, MAPS, NUTRITIOUS SNACKS, AND GADGETS TO GET KIDS OUTDOORS.-IN SEPTEMBER 2021, NATIVE PLANTS TALK WAS HELD IN HAVEN GARDEN. A NATURE EDUCATOR TALKED TO PARTICIPANTS ABOUT NATIVE PLANTS, HOW TO IDENTIFY THEM WHILE OUTDOORS, AND STEPS TO TAKE TO PROTECT OUR OUTDOORS.-IN OCTOBER 2021, SCHUYLKILL VISION DISTRIBUTED WALKING MAPS AND NUTRITION INFORMATION TO COMMUNITY MEMBERS AT MAHANOY AREA COMMUNITY DAY.-IN NOVEMBER AND DECEMBER 2021, SCHUYLKILL VISION AGAIN RAN THE HOLIDAY CHALLENGE IN COOPERATION WITH THE NORTH CAROLINA DIVISION OF PUBLIC HEALTH.-IN DECEMBER 2021, SCHUYLKILL HAVEN CHRISTMAS STROLL VIRTUAL SCAVENGER HUNT WAS HELD WHERE PARTICIPANTS WALKING AROUND SCHUYLKILL HAVEN AND COMPLETING CHALLENGES THAT HAD THEM DANCING AND EXERCISING.-IN MARCH 2022, HEALTHY SCHUYLKILL SESSIONS HELD THE FRILUFTSLIV (FREE AIR LIFE) WALK.-IN APRIL 2022, THERE WAS THE MOVE MORE MONTH CHALLENGE.-IN JUNE 2022, SCHUYLKILL VISION COORDINATED THE ACHIEVE (AFTER SCHOOL PROGRAM) HEALTH FAIR.

LEHIGH VALLEY HOSPITAL - SCHUYLKILL
PART V, SECTION B, LINE 18E: COLLECTION ACTIVITIES ARE LIMITED TO HOSPITAL SENDING FOUR STATEMENTS REQUESTING PAYMENT. THE STATEMENTS INCLUDE INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, SOLICITING THE PATIENT'S PARTICIPATION IN THE FINANCIAL ASSISTANCE PROGRAM.

PART V, SECTION B, LINE 11 (CONTINUATION A)
"PRIORITY AREA: INCLUSION AND DIVERSITYCOMMUNITY MEMBERS EXPRESSED FEEDBACK REGARDING ISSUES OF INCLUSION AND DIVERSITY AMONG LVHN'S STAFF AND SERVICES. PATIENTS AND COMMUNITY MEMBERS STRESSED THE NEED FOR LIVE INTERPRETATION SERVICES, TO ALLOW THEM TO INTERACT WITH THEIR PROVIDERS IN THEIR NATIVE LANGUAGE AND A WARM RECEPTION IN A CULTURALLY APPROPRIATE MANNER. THE TABLE SHOWS THAT THE HISPANIC POPULATION IS 3% OF THE TOTAL POPULATION, HIGHLIGHTING THE NEED FOR COMPREHENSIVE LANGUAGE SUPPORT AND CULTURAL AWARENESS ACROSS THE NETWORK. THE COMMUNITY MENTIONED THESE ISSUES MULTIPLE TIMES IN FOCUS GROUPS. LVHN LEADERSHIP AGREED, RANKING INCLUSION AND DIVERSITY RELATED ISSUES AS ONE THAT WOULD HAVE A MODERATE IMPACT ON OVERALL HEALTH, BUT IT ALIGNED WITH OVERALL ORGANIZATIONAL GOALS AND WAS AN INITIATIVE WE HAVE THE CAPACITY TO ADDRESS. SCHUYLKILL COUNTY IS INHABITED BY 146,000 PEOPLE WITH THE FOLLOWING BREAKDOWN; 94.2% WHITE, 2.8% BLACK, 0.5% ASIAN, 1.1% OTHER, 1.4% MULTIPLE, 3.4% HISPANIC, AND 96.6% NON-HISPANIC.LVHN WILL FOCUS ON TWO IMPORTANT STRATEGIES. FIRST, LVHN WILL INCREASE ACCESS TO LANGUAGE INTERPRETATION AT ALL HEALTH CARE SERVICE SITES, BUILDING ON THE ALREADY STRONG SET OF SERVICES AVAILABLE. SECOND, LVHN WILL CUSTOMIZE ROBUST COLLEAGUE EDUCATION AROUND CULTURAL AWARENESS AND INCLUSION AND DIVERSITY TO ENSURE ALL PATIENTS RECEIVE A WARM WELCOME, PARTICULARLY POPULATIONS WITH SPECIAL NEEDS AT EACH OF OUR CAMPUSES. INTERPRETER SERVICESAT EVERY LVHN CAMPUS, INTERPRETER SERVICES ARE PROVIDED TO ENSURE THAT PATIENTS ARE ABLE TO COMMUNICATE WITH CLINICIANS AND STAFF IN THEIR PREFERRED LANGUAGE. LVHN PROVIDES A COMBINATION OF LIVE INTERPRETATION WITH THE PATIENT, PHONE INTERPRETATION, AND VIDEO INTERPRETATION VIA IPAD. THIS MIXED MEDIA APPROACH OFFERS THE FASTEST RESPONSE BASED ON PATIENT NEEDS. IN FY20, 15 TRAINED MEDICAL INTERPRETER STAFF PROVIDED 602,682 MINUTES OF INTERPRETATION ACROSS ALL LVHN SITES.IN FY21, 22 TRAINED MEDICAL INTERPRETER STAFF PROVIDED 701,340 MINUTES OF INTERPRETATION DURING NEARLY 41,000 UNIQUE ENCOUNTERS ACROSS ALL LVHN SITES. AS THE COVID-19 PANDEMIC CONTINUES, VIRTUAL INTERPRETATION IS A VITAL SERVICE FOR PATIENTS.CULTURAL AWARENESS AND STAFF EDUCATIONTHE CHIEF DIVERSITY, EQUITY AND INCLUSION LIAISON OFFERS A WIDE RANGE OF EDUCATION AND TRAINING FOR LVHN STAFF, RANGING FROM GENERAL CULTURAL AWARENESS COVERED AT ""CONNECTIONS"" (THE ORIENTATION PROGRAM FOR ALL NEW LVHN EMPLOYEES) TO AUDIENCE-SPECIFIC CONTENT INCLUSIVE LEADERSHIP, UNCONSCIOUS BIAS, RESPONDING TO MICROAGGRESSIONS, AND CROSS-CULTURAL CARE. IN FY20, OVER 60 TRAININGS WERE HELD WITH JUST OVER 4,000 EMPLOYEES ATTENDING. IN FY21, NEARLY 50 TRAININGS WERE HELD WITH JUST OVER 4,000 EMPLOYEES ATTENDING IN TOTAL. IN FY22, 37 TRAININGS WERE HELD FOR 2,641 EMPLOYEES IN ATTENDANCE. ADDITIONAL DIVERSITY, EQUITY AND INCLUSION EDUCATIONAL CONTENT AND RESOURCES ARE ALSO AVAILABLE TO COLLEAGUES VIA A NEW DEI INTRANET SITE THAT LAUNCHED IN FEBRUARY 2022.WITH LVHN LEADERSHIP'S INCREASED STRATEGIC FOCUS ON DIVERSITY AND INCLUSION IN THE NETWORK, IT WAS IMPORTANT TO INCREASE RESOURCES IN SUPPORT OF THIS IMPORTANT WORK. ON MARCH 8, 2021, A DIVERSITY EQUITY AND INCLUSION (DEI) PROJECT MANAGER COLLEAGUE WAS BROUGHT ON STAFF. THIS IMPORTANT ROLE SUPPORTS NETWORK INITIATIVES INCLUDING THE ACTIONS AGAINST RACISM AND ADVANCING EQUITY COUNCIL, CULTURAL AWARENESS LEADERSHIP COUNCIL AND THE LGBTQ PATIENT AND FAMILY CARE EXPERIENCE PROJECT TEAM.PRIORITY AREA: SOCIAL DETERMINANTS OF HEALTHSOCIAL DETERMINANTS OF HEALTH ARE AT THE HEART OF COMMUNITY HEALTH WORK AT LVHN. DURING THE PRIMARY DATA COLLECTION PROCESS, LVHN RECEIVED COMMUNITY FEEDBACK THAT CONFIRMED THE IMPORTANCE OF ADDRESSING SOCIAL DETERMINANTS BOTH DIRECTLY AND THROUGH PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS. EXAMPLES OF SOCIAL DETERMINANTS THAT REQUIRE MULTIPLE AGENCIES AND ORGANIZATIONS WORKING TOGETHER IN A COORDINATED MANNER ARE HOUSING AND FOOD INSECURITY. BOTH WERE HIGHLIGHTED DURING COMMUNITY FOCUS GROUPS. IN ALL COUNTIES LVHN SERVES:-AN AVERAGE OF 20% OF THE POPULATIONS ARE AT RISK FOR FOOD INSECURITY. -AT LEAST A QUARTER OF THE POPULATION SPENDS MORE THAN 30% OF THEIR INCOME ON HOUSING.LVHN CHNA EXECUTIVE TEAMS RECOGNIZED THE MAGNITUDE OF HOUSING AND FOOD INSECURITY ISSUES, BUT ALSO WERE LESS CERTAIN ABOUT HEALTHCARE'S ABILITY TO HAVE AN IMPACT IN THIS AREA, PARTICULARLY BECAUSE THESE ARE NOT ISSUES THAT HEALTHCARE CAN ADDRESS ALONE. THE IMPORTANCE OF PARTNERSHIPS IN THIS AREA IS HIGHLIGHTED IN LVHN'S CHNA IMPLEMENTATION PLAN. BELOW ARE BOTH INTERNAL AND CROSS-SECTOR PARTNERSHIP EFFORTS ADDRESSING THESE ISSUES IN OUR COMMUNITIES.FOOD ACCESS THE FIRST STRATEGY TO ADDRESS SOCIAL DETERMINANTS OF HEALTH OUTLINED IN THE IMPLEMENTATION PLAN IS IMPROVE ACCESS TO HEALTHY FOOD AND REDUCE OBESITY RATES IN OUR COMMUNITIES, THROUGH IN-SCHOOL EDUCATION, PROMOTION OF HEALTHY LIFESTYLES AND COMMUNITIES, AND SUPPORT OF MOBILE MARKET FOOD DISTRIBUTION. WELLER HEALTH EDUCATION AT LEHIGH VALLEY REILLY CHILDREN'S HOSPITAL PARTNERS WITH OVER 25 SCHOOL DISTRICTS ACROSS THE HEALTH NETWORK'S EIGHT-COUNTY SERVICE AREA TO PROVIDE INTERACTIVE RESEARCH-BASED PROGRAMS THAT HELP PREVENT CHRONIC DISEASE AND IMPROVE CHILDREN'S OVERALL HEALTH, SAFETY, AND WELL-BEING. ALL PROGRAMS ARE PRESENTED BY SPECIALLY TRAINED HEALTH EDUCATORS WHO ARE EXPERTS AT CONNECTING WITH YOUNG PEOPLE AND TRANSLATING COMPLEX INFORMATION INTO EASY-TO-UNDERSTAND CONCEPTS. LVHN IS THE ONLY HEALTH SYSTEM IN THE REGION OFFERING THIS TYPE OF PREVENTIVE HEALTH EDUCATION FOR CHILDREN AND FAMILIES.WITH THE GENEROUS SUPPORT OF THE CARL E. AND EMILY I. WELLER FOUNDATION, CORPORATE AND FOUNDATION FUNDERS, AND IN-KIND SUPPORT FROM THE LEHIGH VALLEY REILLY CHILDREN'S HOSPITAL, PROGRAMS ARE PRESENTED FREE TO ALL SCHOOL DISTRICTS. OVER 80% OF THE STUDENTS SERVED ARE ECONOMICALLY DISADVANTAGED. IN FY20, BETWEEN SEPTEMBER 2019 AND MARCH 2020 (BEFORE THE SCHOOLS CLOSED DUE TO COVID-19), WELLER SERVED OVER 27,000 STUDENTS FROM 72 SCHOOLS IN 25 SCHOOL DISTRICTS IN SIX COUNTIES. IN FY21, WELLER REACHED 30,000 STUDENTS THROUGH A VARIETY OF IN-PERSON, VIRTUAL AND ASYNCHRONOUS LEARNING OPPORTUNITIES DESIGNED TO MEET THE VARYING NEEDS OF STUDENTS AND SCHOOL DISTRICTS ACROSS OUR REGION. NUTRITION AND EXERCISE ACCOUNTED FOR 6% OF THE PROGRAMMING PROVIDED IN THE SCHOOLS. IN ADDITION TO DELIVERING CLASSROOM PROGRAMS EITHER IN-PERSON OR VIA REMOTE LEARNING PLATFORMS, WELLER'S TEAM HAS CREATED A VIDEO LIBRARY WITH NEARLY 40 ASYNCHRONOUS LESSONS THAT RANGE FROM DEALING WITH PANDEMIC-INDUCED STRESS, ANXIETY AND FATIGUE, TO SCHOOL DISTRICT CURRICULUM-BASED CONTENT ON MENTAL HEALTH, SUBSTANCE USE DISORDER PREVENTION, HEALTHY RELATIONSHIPS, AND NUTRITION AND FITNESS. THE PROGRAMS ARE PROVIDED AT NO COST TO THE SCHOOLS AND LVHN IS THE ONLY HEALTH SYSTEM IN THE REGION OFFERING THIS TYPE OF PREVENTIVE HEALTH EDUCATION FOR CHILDREN AND FAMILIES.IN FY22, WELLER REACHED 21,688 STUDENTS THROUGH IN-PERSON AND SYNCHRONOUS VIRTUAL LEARNING OPPORTUNITIES DESIGNED TO MEET THE VARYING NEEDS OF STUDENTS AND SCHOOL DISTRICTS ACROSS OUR REGION. NUTRITION AND EXERCISE ACCOUNTED FOR 8% OF THE PROGRAMMING PROVIDED IN THE SCHOOLS. LVH-SCHUYLKILL ALSO PARTNERS WITH SCHUYLKILL COUNTY VISION ON THE HEALTHY SCHUYLKILL COMMUNITIES INITIATIVE, AN EFFORT TO PROMOTE NUTRITION AND EXERCISE, HEALTHY LIFESTYLE, AND ACCESS TO HEALTHY FOODS. SCHUYLKILL COUNTY VISION HAS SET UP 4 GARDENS THROUGHOUT THE COUNTY (SCHUYLKILL HAVEN, MAHANOY). IN ADDITION, BETWEEN JULY AND SEPT 2019 SCHUYLKILL COUNTY VISION HELD 8 COMMUNITY ENGAGEMENT EVENTS FOCUSED ON HEALTHY FOOD AND NUTRITION, REACHING 142 COMMUNITY MEMBERS. EXAMPLES OF THESE HEALTHY LIFESTYLE EVENTS INCLUDE SCHUYLKILL ON THE MOVE, MATTER OF BALANCE, AND SUMMER CAMP YOGA. DUE TO COVID-19, THESE EFFORTS COULD NOT CONTINUE DURING THE REMAINDER OF FY20. IN FY21, TWO COMMUNITY GARDENS WERE OPEN DURING THE GROWING SEASON IN MAHANOY CITY AND SCHUYLKILL HAVEN. THIS YEAR, VISION ALSO TACKLED AN UNFINISHED PROJECT AT SCHUYLKILL HAVEN GARDEN BY INSTALLING FENCING AROUND THE GARDEN. THIS WAS IN PARTNERSHIP WITH SCHUYLKILL RIVER TRAIL (SRT) TO REPLACE FENCING ALONG THE TRAIL, AND VISION COLLECTED OLD FENCE AND REFURBISHED WITH A FRESH COAT OF PAINT TO INSTALL AT SCHUYLKILL HAVEN GARDEN. BETWEEN BOTH GARDENS, OVER 20 COMMUNITY MEMBERS MAINTAINED THE PLOTS. SCHUYLKILL HAVEN GARDEN ALSO INCLUDED A COMMUNITY PLOT WHICH WAS MAINTAINED BY A VISION SEASONAL STAFF MEMBER AND ALL PRODUCE DONATED TO LOCAL FOOD PANTRY OR THE EVANS DELIVERY COMPANY FOR AN EMPLOYEE CSA PROJECT."

PART V, SECTION B, LINE 11 (CONTINUATION B)
"UNFORTUNATELY, COMMUNITY EVENTS WERE POSTPONED OR POORLY ATTENDED IN FY21 DUE TO THE PANDEMIC. HOWEVER, VISION UTILIZED A VIRTUAL SCAVENGER HUNT APP TO CONDUCT COMMUNITY HUNTS. PARTICIPANTS COMPLETED MISSIONS THAT GOT THEM MOVING AND EXPLORING THEIR COMMUNITIES, SHOWING THEIR MYPLATE MEALS AND OTHER FRUITS AND VEGGIES MISSIONS, AND ANSWERING QUESTIONS ABOUT THE IMPORTANCE OF HEALTHY EATING AND INCREASED PHYSICAL ACTIVITY.IN FY22, SCHUYLKILL COUNTY VISION WAS ABLE TO RESUME SOME OF THE COMMUNITY EVENTS AS THE PANDEMIC BECAME LESS OF A LIMITING FACTOR. HIGHLIGHTS OF OUR FOOD-RELATED WORK ARE INCLUDED THE BELOW. IN A NUMBER OF EVENTS, INFORMATION ON BOTH NUTRITION AND EXERCISE WAS INCLUDED.-SHENANDOAH AND POTTSVILLE MOBILE MARKETS. ASSISTED HELPING HARVEST FOOD PANTRY DISTRIBUTE FOOD TO FAMILIES IN NEED AND AT MOBILE MARKETS AND SAT ON THEIR YOUTH ADVISORY BOARD.-SUMMER FUN VIRTUAL SCAVENGER HUNT WITH NUTRITION AND PHYSICAL ACTIVITY MISSIONS. 85 MISSIONS THAT HAD PARTICIPANTS EXPLORING SCHUYLKILL COUNTY, VISITING USDA'S MYPLATE WEBSITE FOR HEALTHY EATING IDEAS, INCORPORATING FRUITS AND VEGETABLES INTO MEALS, AND MORE.-SUMMER WIND DOWN VIRTUAL SCAVENGER HUNT WITH NUTRITION AND PHYSICAL ACTIVITY MISSIONS.-HAVEN GARDEN SESSIONS: THE HOME VEGETABLE GARDEN. PENN STATE EXTENSION STAFF AVAILABLE ON COMMUNITY GARDEN SITE TO EDUCATE PARTICIPANTS ABOUT HOME VEGETABLE GARDENING AND ANSWER QUESTIONS.-SCHUYLKILL HAVEN BOROUGH DAY. DISTRIBUTED INFORMATION ABOUT HEALTHY EATING AND PHYSICAL ACTIVITY AT COMMUNITY EVENT.-DIAKON SENIOR EXPO. DISTRIBUTED INFORMATION ON INCREASING PHYSICAL ACTIVITY AND HEALTHY EATING TO EXPO PARTICIPANTS.-HEALTHY SCHUYLKILL SESSIONS: MAKING 2022 ALL ABOUT YOU. AN ONLINE LEARNING OPPORTUNITY TO PROMOTE SELF-CARE AND STRESS THE IMPORTANCE OF EATING HEALTHY, EXERCISING, AND GETTING PROPER SLEEP.-HOLIDAY HOOPLA VIRTUAL SCAVENGER HUNT WITH NUTRITION AND PHYSICAL ACTIVITY MISSIONS.PRIORITY AREA: BEHAVIORAL HEALTHONE CONSISTENT AREA OF NEED VOICED BY THE COMMUNITY, IN BOTH THE 2016 AND 2019 LVHN CHNAS, WAS THE NEED TO BETTER ADDRESS BEHAVIORAL HEALTH AND MENTAL WELL-BEING IN THE COMMUNITY. ACCORDING TO THE ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS, MEMBERS OF THE COMMUNITY EXPERIENCE MORE THAN 4 ""UNHEALTHY"" MENTAL HEALTH DAYS PER MONTH, ECHOING THE DIRECT FEEDBACK FROM FOCUS GROUPS. THIS NEED WAS DISCUSSED IN ALL FIVE COUNTIES AND THEREFORE WAS MADE A CROSS-CUTTING PRIORITY AREA FOR THE IMPLEMENTATION PLAN. WITHIN THE BEHAVIORAL HEALTH PRIORITY AREA, THERE ARE 3 AREAS OF FOCUS: MENTAL HEALTH, SUBSTANCE ABUSE, AND SUICIDE PREVENTION. WHILE PUBLIC DATA AROUND SUBSTANCE USE DISORDER IS LACKING, IT WAS A CLEAR CONCERN EXPRESSED COMMUNITY MEMBERS WHO PARTICIPATED IN FOCUS GROUPS AND INTERVIEWS. LVHN LEADERSHIP BELIEVES THIS IS A HIGH IMPACT AREA OF WORK, BUT WE NEED TO INCREASE CAPACITY IN ORDER TO ADDRESS THESE NEEDS ADEQUATELY. THE SECTIONS BELOW OUTLINE THE APPROACHES BEING IMPLEMENTED IN EACH OF THESE FOCUS AREAS TO ADDRESS THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITIES LVHN SERVES.MENTAL HEALTHPREVENTION AND EDUCATIONTHE FIRST STRATEGY TO ADDRESS THE MENTAL HEALTH NEEDS OF THE COMMUNITY IS DECREASE THE STIGMA AND INCREASE SKILLS OF PROFESSIONALS AND COMMUNITY MEMBERS TO RECOGNIZE MENTAL HEALTH CONCERNS AND PROMOTE MENTAL WELLNESS. IN ADDITION, LVHN WILL PARTICIPATE IN AND PARTNER AROUND COMMUNITY-BASED TRAUMA-INFORMED CARE COLLABORATIVE TO CREATE MORE TRAUMA-INFORMED COMMUNITIES. LVHN HAS MADE A CONCERTED EFFORT TO DEVELOP SUPPORTS FOR THE PREGNANT AND PARENTING POPULATION IN OUR REGION. IN THE LEHIGH VALLEY, THE CONNECTIONS CLINIC IS A PROGRAM FOR PREGNANT AND/OR POSTPARTUM SUBSTANCE USE DISORDER INCLUDING OPIOIDS AND IS A COLLABORATION BETWEEN OBSTETRICS AND PEDIATRICS (SEE SUBSTANCE ABUSE SECTION FOR ADDITIONAL DETAILS). IN FY20, THE LVH-SCHUYLKILL CAMPUS RECEIVED AND BEGAN IMPLEMENTING A PREGNANCY SUPPORT SERVICES GRANT. THROUGH THIS GRANT, THE LAKESIDE GLOBAL INSTITUTE TRAUMA 101 (OVERVIEW OF TRAUMA INFORMED CARE), 102 (BASIC SKILLS OF TRAUMA-INFORMED CARE) AND 103 (RECOGNIZING VICARIOUS & SECONDARY TRAUMA IN CAREGIVERS) TRAININGS WERE PROVIDED FOR LVHN EMPLOYEES WITHIN THE WOMEN AND CHILDREN'S SERVICE LINE AND WITH THE CONNECTIONS CLINIC. THESE TRAININGS WERE HELD OVER THE COURSE OF 3 CONSECUTIVE WEEKS DURING THE MONTH OF JUNE AND WERE ATTENDED BY 32 INDIVIDUALS WITH APPROXIMATELY 45% OF ATTENDEES COMPLETING ALL 3 SESSIONS. THE GRANT IS ALSO CREATING A SERVICE SIMILAR TO THE CONNECTION CLINIC FROM LVH-LV AT THE LVH-S CAMPUS, BUT SPECIFICALLY FOR OPIOID USE DISORDER. IT IS A COLLABORATION BETWEEN LVH-S MENTAL HEALTH SERVICES AND OBSTETRICS AND GYNECOLOGY. TO DATE, 45 WOMEN IN THE SCHUYLKILL AREA HAVE BEEN REFERRED FOR SERVICES AND 5 OF THEM HAVE BEEN ADMITTED TO DRUG AND ALCOHOL SERVICES. AS A PART OF THIS MODEL, LVH-S IS ALSO PROVIDING TELE-PSYCH SERVICES AT THE ST. CLAIR PRACTICE (SEE TELE-PSYCH SECTION BELOW). THIS WORK CONTINUED IN FY21 THOUGH TRACKING MECHANISMS ARE BEING CHANGED TO BETTER REFLECT THE WORK. BETTER DATA WILL BE AVAILABLE IN THE FUTURE.LVH-SCHUYLKILL IS ALSO PARTNERING WITH SCHUYLKILL COUNTY'S VISION, WHO RECEIVED PENNSYLVANIA COMMISSION ON CRIME AND DELINQUENCY (PCCD) FUNDING, TO CREATE A RESILIENCY CENTER IN SCHUYLKILL COUNTY, NOW CALLED FAMILIES GROW TOGETHER. THIS RAN THROUGH NOVEMBER 2020. IN NOVEMBER 2020, THE 3RD ANNUAL SCHUYLKILL TRAUMA DAY WAS HELD VIRTUALLY. THE DAY PROVIDED A SERIES OF WORKSHOPS, ON TOPICS SUCH AS TRAUMA 101, STIGMA, AND VETERAN'S CARE AND SERVICES.ADDITIONAL TRAUMA TRAININGS WERE HELD IN PERSON AND VIRTUAL IN SCHOOLS AND COMMUNITY SETTINGS.- FEBRUARY 2021: GAUDENZIA TREATMENT FACILITY STAFF WITH 11 ATTENDEES- APRIL 2021: CSBBH, CHILD AND FAMILY SUPPORT SERVICES/COUNTY EMPLOYEES, PATHWAYS, MINERSVILLE JR/SR HIGH SCHOOL STAFF, SCHOOL GUIDANCE COUNSELORS GROUP WITH 91 ATTENDEES- MAY 2021: MINERSVILLE ELEMENTARY SCHOOL STAFF, MINERSVILLE JR/SR HIGH SCHOOL (ADVANCE TRAINING) WITH 56 TOTAL ATTENDEES- JUNE 2021: CLINICAL OUTCOMES GROUP, INC. WITH 27 ATTENDEESREFERRAL COORDINATIONTHE SECOND STRATEGY TO ADDRESS THE MENTAL HEALTH NEEDS OF THE COMMUNITY IS A CENTRALIZED REFERRAL PROCESS TO OUTPATIENT BEHAVIORAL HEALTH SERVICES. IN FY19, LVHN RECEIVED OVER 9,000 REFERRALS FOR BEHAVIORAL HEALTH SERVICES AND WERE ABLE TO SERVE 1 IN 8. IN ORDER TO IMPROVE TREATMENT AND REFERRAL WORKFLOWS FOR PATIENTS, LVHN CREATED A BEHAVIORAL HEALTH REFERRAL SPECIALIST ROLE. THIS ROLE PROVIDES SUPPORT TO PROVIDERS, PRACTICES AND PATIENTS SEEKING ACCESS TO MENTAL HEALTH AND/OR SUBSTANCE ABUSE SERVICES. SUPPORT BY THIS ROLE IS PROVIDED ON THREE LEVELS: 1. INFORMATION DISSEMINATION AND EDUCATION: PRACTICES RECEIVE RESOURCE INFORMATION TO ENABLE THEM TO MAKE BEHAVIORAL HEALTH AND SUBSTANCE ABUSE REFERRALS FROM THE BEHAVIORAL HEALTH RESOURCES SHAREPOINT DATABASE WITH INFORMATION THAT IS ALWAYS CURRENT AND ACCURATE. IN ADDITION, THE BEHAVIORAL HEALTH REFERRAL SPECIALIST HAS BEEN PROVIDING EDUCATION ON HOW TO EFFECTIVELY REFER A PATIENT FOR MENTAL HEALTH AND/OR SUBSTANCE ABUSE SERVICES TO THE FOLLOWING: PEDIATRIC PRIMARY CARE, ADULT SPECIALTY PROGRAMS, INPATIENT CASE MANAGEMENT, LVHN LEADERSHIP AND ADDITIONAL OUTSIDE PROGRAMS AND SERVICES.2. CONSULTATION TO PROVIDERS SEEKING SERVICES FOR THEIR PATIENTS WHEN THEY ARE UNABLE TO DO SO UTILIZING THE BEHAVIORAL HEALTH RESOURCES SHAREPOINT AND PAST REFERRAL EDUCATION. 3. DIRECT PATIENT CONTACT TO PROVIDE SUPPORT AND RESOURCES IF THE FIRST TWO LEVELS OF SERVICE FAIL TO SUPPORT THE PATIENT. IN FY19, THERE WERE 620 REQUESTS FOR ASSISTANCE FROM THE BEHAVIORAL HEALTH REFERRAL SPECIALIST. IN FY20, DUE TO THE HIGH DEMAND, A NEW PROCESS WAS IMPLEMENTED TO HAVE THE BEHAVIORAL HEALTH REFERRAL SPECIALIST MANAGE ALL OUTPATIENT PSYCHIATRY REFERRALS FOR LVHN AFFILIATED PRACTICES. THIS NEW PROCESS WAS MADE TO IMPROVE THE REFERRAL EXPERIENCE FOR THE AFFILIATED PRACTICE PROVIDERS WHILE BETTER ASSISTING PATIENTS WITH CONNECTING TO BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES. THE BEHAVIORAL HEALTH SPECIALIST HAS BECOME A TEAM OF 5.5 FTE DEDICATED TO MANAGING ALL REFERRALS TO AMBULATORY PSYCHIATRY PRACTICES, WHICH IS NOW CALLED CENTRALIZED INTAKE. THIS SERVICE OFFICIALLY WENT LIVE ON MAY 4, 2020, AND THEY RECEIVE REFERRALS FROM OUTPATIENT PRACTICES FROM ALL LVHN CAMPUSES. IN FY21, CENTRALIZED INTAKE RECEIVED 10,179 REFERRALS. OF THE 10,179 REFERRALS, 6,240 (61%) WERE SCHEDULED WITH LVHN PSYCHIATRY PRACTICES OR PROVIDED WITH A LIST OF EXTERNAL PROVIDERS WITH THE OPTION TO CALL BACK FOR ADDITIONAL ASSISTANCE IF UNABLE TO CONNECT WITH A PROVIDER. IN FY22, CENTRALIZED INTAKE RECEIVED 10,922 REFERRALS. OF THE 10,922 REFERRALS, 7,440 (68%) WERE SCHEDULED WITH LVHN PSYCHIATRY PRACTICES OR PROVIDED WITH A LIST OF EXTERNAL PROVIDERS WITH THE OPTION TO CALL BACK FOR ADDITIONAL ASSISTANCE IF UNABLE TO CONNECT WITH A PROVIDER."

PART V, SECTION B, LINE 11 (CONTINUATION C)
"INNOVATIONTHE THIRD STRATEGY LVHN HAS COMMITTED TO IN ORDER TO ADDRESS THE MENTAL HEALTH NEEDS OF THE COMMUNITY IS INNOVATION THROUGH THE USE OF TECHNOLOGY TO PROVIDE TELE-PSYCHIATRY, TELE-THERAPY, AN APP DEPLOYMENT, AND ECONSULTS. THE DEVELOPMENT AND IMPLEMENTATION OF TELE-PSYCHIATRY AND THERAPY SERVICES WAS UNDERWAY AT THE START OF FY20. WITH THE ONSET OF THE COVID-19 PANDEMIC, THE SCALE AND REACH OF THESE SERVICES INCREASED RAPIDLY AND DRAMATICALLY. OUTPATIENT BEHAVIORAL HEALTH VIRTUAL VISITS INCREASED FROM 2% BEFORE COVID-19 TO 98% SOON AFTER THE START OF THE PANDEMIC. IN FY21 THE DEPARTMENT OF PSYCHIATRY COMPLETED NEARLY 45,000 VIRTUAL VISITS.IN ADDITION, TELE-CONSULTS WERE PROVIDED FOR PRIMARY CARE PROVIDERS. A PSYCHIATRIC OUTPATIENT CONSULTATION REFERRAL ORDER WAS ESTABLISHED IN FY20 TO FACILITATE A BRIEF PSYCHIATRIC INTERVENTION BY A PSYCHIATRIST OR APC WITH THE GOAL OF EVALUATING AND PROVIDING TREATMENT RECOMMENDATIONS WHICH MAY INCLUDE THE PRESCRIBING OF PSYCHOTROPIC MEDICATIONS, AND THEN RETURNING THE PATIENT BACK TO THEM FOR ON-GOING CARE. IN FY21, 618 TELE-PRIMARY CARE CONSULTS AND 268 ECONSULTS WERE COMPLETED, UP FROM 80 AND 208, RESPECTIVELY IN FY20. SOME OF THESE REFERRALS WERE COMPLETED FOR LVH-S PATIENTS. IN FY22, 591 TELE-PRIMARY CARE CONSULTS AND 254 ECONSULTS WERE COMPLETED.SUBSTANCE ABUSELVHN HAS ADOPTED A 4-PRONGED APPROACH TO ADDRESSING THE SUBSTANCE ABUSE EPIDEMIC IN THE COMMUNITIES WE SERVE:1. STIGMA REDUCTION BY PROVIDING EDUCATION AND PROMOTIONAL MATERIALS TO THE COMMUNITY TO REDUCE THE STIGMA ASSOCIATED WITH SUBSTANCE USE DISORDER AND ADDICTION.2. OPIOID STEWARDSHIP BY PROVIDING EDUCATION TO FRONT-LINE STAFF (E.G., PROVIDERS, NURSES) TO MINIMIZE OPIOID PRESCRIBING, PROMOTE SAFETY MEASURES TO MINIMIZE ADDICTION TO OPIOIDS, AND INCREASE AWARENESS OF TOOLS AVAILABLE.3. LINKAGE TO TREATMENT BY REDUCING THE BARRIERS BETWEEN A PATIENT WHO IS STRUGGLING WITH SUBSTANCE ABUSE OR ADDICTION AND THEIR ACCESS TO TREATMENT OPTIONS.4. HARM REDUCTION BY REDUCING THE LIKELIHOOD THAT HARM WILL COME TO THOSE WHO ARE STRUGGLING WITH ADDICTION.ADDITIONAL DETAILS ABOUT EFFORTS FOR EACH OF THE ELEMENTS OF LVHN'S 4-PRONGED APPROACH IS OUTLINED BELOW. COLLEAGUES FROM THE LEHIGH VALLEY SCHUYLKILL COUNSELING CENTER (LVH-SCHUYLKILL) ARE ALSO PARTICIPATING IN SCHUYLKILL COUNTY REACH (RECOVERY EDUCATION ADVOCACY COMMUNITY HEALTH). THE COLLABORATIVE WAS FORMED IN SEPTEMBER 2017 TO ADDRESS THE RISE OF OPIOID OVERDOSES IN SCHUYLKILL COUNTY. THE GOALS OF THE STRATEGIC PLAN ALIGN WITH LVHN'S OVERALL STRATEGY FOR ADDRESSING SUBSTANCE ABUSE CONCERNS IN THE COMMUNITY. DURING THEIR MOST RECENT STRATEGIC PLANNING SESSION, COALITION MEMBERS IDENTIFIED FIVE PRIORITIES TO GUIDE THEIR EFFORTS OVER THE FIRST THREE YEARS (JULY 2019-2022) OF COALITION WORK:GOAL 1: EDUCATE INDIVIDUALS AND FAMILIES ABOUT ADDICTION AND OVERDOSE TO PREVENT INITIATION OF SUBSTANCE USE AMONG SCHUYLKILL COUNTY RESIDENTS.GOAL 2: ENSURE THAT ALL INDIVIDUALS HAVE THE OPPORTUNITY FOR SUCCESSFUL RECOVERY AND BUILD SUPPORTIVE COMMUNITIES.GOAL 3: ELIMINATE BARRIERS TO INCREASE ACCESS AND UTILIZATION OF SUBSTANCE USE DISORDER (SUD/OPIOID USE DISORDER (OUD) TREATMENT PROGRAMS.GOAL 4: ELIMINATE STIGMA IN SCHUYLKILL COUNTY.GOAL 5: COORDINATE EFFORTS BETWEEN LAW ENFORCEMENT, THE LEGAL SYSTEM, AND TREATMENT.STIGMA REDUCTIONTHROUGHOUT FY20 AND FY22, LVHN LEADERS AND COLLEAGUES HOSTED AND PRESENTED AT COMMUNITY EVENTS TO REDUCE THE STIGMA SURROUND SUBSTANCE USE DISORDERS AND PROMOTE THE RESOURCES AVAILABLE TO ADDRESS THIS COMMUNITY CONCERN. IN FY20:-IN SEPTEMBER 2019, PENN STATE-SCHUYLKILL AND LVH-SCHUYLKILL SPONSORED AND HOSTED AN OPIOID SYMPOSIUM ENTITLED ""OPIOIDS: THE CRISIS NEXT DOOR. THE FACTS, THE SIGNS, THE RESOURCES"". THERE WERE 150 PEOPLE IN ATTENDANCE AT THIS EVENT.-IN DECEMBER 2019, LVH-SCHUYLKILL HELD A SENIOR OPIOID EDUCATION EVENT AT THE ROSEWOOD SENIOR CENTER WHERE THE BEHAVIORAL HEALTH TEAM PRESENTED ""HOW SUBSTANCE USE DISORDER AFFECTS OLDER ADULTS AND LED A DISCUSSION. THIS EVENT INCLUDED 100 PEOPLE IN ATTENDANCE, INCLUDING SUD TREATMENT PROVIDERS, NURSING FACILITY STAFF, AND COMMUNITY MEMBERS.-EDUCATION WAS HELD IN 5 SCHOOL DISTRICTS IN SCHUYLKILL COUNTY (LVH-SCHUYLKILL) REGARDING THE NEGATIVE EFFECTS OF VAPING A PARTICULAR COMMUNITY CONCERN IN SCHUYLKILL COUNTY. IN FY20, THE YOUTH ADVISORY BOARD CREATED A VIDEO THAT WAS SHOWN IN THE SCHOOLS ALONG WITH A DISCUSSION. -IN OCTOBER 2019, LEHIGH VALLEY COUNSELING SERVICES PRESENTED ABOUT VAPING AND THEIR PARTNERSHIP WITH LOCAL DRUG AND ALCOHOL AND STUDENT GROUPS REGARDING THE VIDEO. THE VIDEO WAS SHOWN TO THE 12 ATTENDEES OF THE EVENT. -IN NOVEMBER 2019, PENN STATE AND LVH-SCHUYLKILL HELD A LUNCH PRESENTATION ABOUT THE DANGERS OF VAPING FOR 30 FACULTY AND STUDENTS. -IN JANUARY 2020, THE COUNSELING CENTER HELD A DISCUSSION ABOUT THE VAPING VIDEO WITH THE SEPA WELLNESS COALITION OF SOUTHEASTERN PENNSYLVANIA; 20 PEOPLE ATTENDED THIS EVENT. IN FY21:-JUNE 2021-LVH-SCHUYLKILL EMERGENCY MEDICINE MEETING WITH 20 ATTENDEES REGARDING SUBSTANCE USE DISORDERS AND SERVICES OFFERED AT OUR PROGRAM. LVH-SCHUYLKILL BOARD OF ASSOCIATES MEETING REGARDING SUBSTANCE USE DISORDERS AND SERVICES OFFERED BY OUR PROGRAM WITH APPROXIMATELY 10 ATTENDEES.-JULY 2021 - OPIOID OVERDOSE AWARENESS WALK AND FESTIVAL IN TAMAQUA, PA WITH APPROXIMATELY 200 ATTENDEES. LVH-SCHUYLKILL DIRECTOR OF COUNSELING SERVICES WAS THE KEYNOTE SPEAKER.-OCTOBER 2021 - SCHUYLKILL COUNTY RECOVERY WALK PROGRAM WITH RECOVERY INFORMATION AVAILABLE TO 200+ ATTENDEES, INCLUDING STIGMA REDUCTION MATERIALS.ALL PRESENTATIONS CONTAINED REFERENCES AND MATERIALS DESIGNED TO STRENGTHENED PROFESSIONAL AND COMMUNITY PARTNERSHIP'S, COORDINATED LINKAGE TO TREATMENT, AND REDUCED STIGMA.ALSO IN FY21, THE LVH-SCHUYLKILL COUNSELING CENTER CONTINUED TO BE ACTIVE IN THE SCHUYLKILL COUNTY COALITION KNOWN AS REACH (RECOVERY, EDUCATION, ADVOCACY, COMMUNITY HEALTH) BY ATTENDING MONTHLY MEETINGS. THE MISSION STATEMENT OF THIS INITIATIVE IS TO WORK COLLABORATIVELY ACROSS ALL AGENCIES TO ELIMINATE SUBSTANCE MISUSE AND OVERDOSE FATS IN SCHUYLKILL COUNTY.IN FY22, CERTIFIED RECOVERY SUPPORT AND CASE COORDINATION SERVICES EXPANDED THE CONTINUUM OF CARE OFFERED TO PATIENTS AT LVH-SCHUYLKILL. IN ADDITION, LVHN PARTICIPATED IN COMMUNITY EVENTS, AS WELL AS PROFESSIONAL PRESENTATIONS, INCLUDING SAFER STREETS, OUT OF DARKNESS WALK, SCHUYLKILL COUNTY RECOVERY WALK, AND PRESENTATION TO DEPARTMENT OF EMERGENCY MEDICINE AND LVH-S BOARD OF ASSOCIATES. IN ADDITION, A WEBINAR WAS HELD IN JULY 2021 BY LVHN SCHUYLKILL COUNSELING CENTER ENTITLES MARIJUANA, MEDICAL CANNABIS, AND SYNTHETIC CANNABINOIDS. OPIOID STEWARDSHIPIN ADDITION TO PRESENTING AND HOSTING DISCUSSION IN THE COMMUNITY, LVHN COLLEAGUES ENGAGED IN SIGNIFICANT EDUCATION TO 340 PROVIDERS AND HEALTHCARE WORKERS TO EMPOWER PROVIDERS AS KNOWLEDGEABLE STEWARDS OF THE SIGNS AND IMPACTS OF SUBSTANCE USE DISORDER. IN ADDITION, IN FY21, THE FOLLOWING TACTICS WERE DEPLOYED:-A 2-HOUR LEARNING MODULE WAS DEVELOPED AND DISSEMINATED TO ALL LVHN PROVIDERS DURING FY21 TO ENSURE ADEQUATE EDUCATION AROUND OPIOID STEWARDSHIP AND LINKAGE TO TREATMENT, AND TO FULFILL LICENSING REQUIREMENTS FOR THE PA STATE MEDICAL BOARD.-THE MULTIDISCIPLINARY OPIOID REVIEW COMMITTEE WAS IMPLEMENTED TO REVIEW OPIOID STEWARDSHIP CASES OF CONCERN AND TO PROVIDE OUTREACH AND EDUCATION TO PROVIDERS.-REVISIONS WERE MADE TO THE STANDARDIZED DISCHARGE OPIOID WEANING PROTOCOLS FOR THE EMERGENCY DEPARTMENT (ED) AND INPATIENT SETTINGS TO INCREASE MEDICATION OPTIONS AND DURATION OF WEANING PROTOCOLS. -NON-OPIOID PAIN MODALITY INITIATIVES WERE IMPLEMENTED INCLUDING: O ED BACK PAIN PROTOCOL IN COLLABORATION WITH PT O DEVELOPMENT OF A NON-OPIOID PAIN MANAGEMENT ORDER SET WITH PT/OT INTERVENTIONS O IMPLEMENTATION OF AN OT-LED AROMATHERAPY FOR PAIN PROTOCOL WITHIN THE ED OBSERVATION UNIT -CLINICIANS ACROSS MULTIPLE DISCIPLINES WERE TRAINED IN NON-OPIOID PAIN MANAGEMENT MODALITIES INCLUDING EMPOWERED RELIEF AND EXPLAIN PAIN."

PART V, SECTION B, LINE 11 (CONTINUATION D)
"BUILDING ON THE WORK OF PAST YEARS, THE FOLLOWING ACTIVITIES WERE COMPLETED IN FY22: -THE MULTIDISCIPLINARY OPIOID REVIEW COMMITTEE FURTHER EVOLVED TO REVIEW OPIOID STEWARDSHIP CASES OF CONCERN AND TO PROVIDE OUTREACH AND EDUCATION TO PROVIDERS.-ALTERNATIVES TO OPIOID (ALTO) PAIN MODALITY INITIATIVES CONTINUED INCLUDING: O ONGOING IMPLEMENTATION OF AN OT-LED AROMATHERAPY FOR PAIN PROTOCOL WITHIN THE ED OBSERVATION UNIT O IMPLEMENTATION OF AN OMM & ACUPUNCTURE REFERRAL PROCESS WITHIN LVPG PRIMARY CARE, O DOEHM US TEAM PROVIDED FASCIA ILIACA NERVE BLOCK TRAINING - OFFERED TO FACULTY AND RESIDENTS DURING 2 SESSIONS IN 2021-2022. -FLEMING FUNDS AND COMMUNITY HEALTH CHAIR FUNDS WERE USED TO TRAIN CLINICIANS ACROSS MULTIPLE DISCIPLINES IN NON-OPIOID PAIN MANAGEMENT MODALITIES INCLUDING EMPOWERED RELIEF AND EXPLAIN PAIN, AS WELL AS MOTIVATIONAL INTERVIEWING AND PEER SUPPORT TRAINING.-RELEASED A REVISED OPIOID PRESCRIBING DASHBOARD WHICH BETTER ADDRESSED TRACKING OF COMPLIANCE WITH OPIOID TREATMENT AGREEMENTS. -IN APRIL 2022, ELECTRONIC SIGNATURES FOR OPIOID TREATMENT AGREEMENTS HAD GO-LIVE. HARM REDUCTION-TAKE-HOME NALOXONE WAS PROVIDED AT NO COST TO PATIENTS FROM ALL NETWORK EMERGENCY DEPARTMENTS (ED) AS WELL AS LEHIGH VALLEY PHARMACY SERVICES LOCATIONS WHERE A PATIENT WITH A NALOXONE PRESCRIPTION IS UNINSURED OR UNDER-INSURED.-LVHN MARKETING AND PUBLIC AFFAIRS, IN COLLABORATION WITH LEHIGH COUNTY, HAS FUNDED THE PURCHASE OF 4,000 MEDICATION DISPOSAL KITS WHICH WILL BE DISTRIBUTED TO PATIENTS AT RISK AT BOTH HOSPITAL PHARMACIES, AND AT LOCAL COMMUNITY EVENTS ACROSS THE NETWORK.SUICIDE PREVENTIONLVHN IS COMMITTED TO ADDRESSING IS SUICIDE PREVENTION IN THE COMMUNITIES WE SERVE. THE GOAL IS TO PROVIDE EDUCATION, INCREASE AWARENESS, AND DECREASE STIGMA BY COLLABORATING WITH THE COMMUNITY TO PREVENT SUICIDE. IN LEHIGH, NORTHAMPTON, AND SCHUYLKILL COUNTIES, SUICIDE PREVENTION TASK FORCES HAVE BEEN ESTABLISHED WITH ACTIVE PARTICIPATION FROM LVHN THROUGHOUT FY20.IN SCHUYLKILL COUNTY, THE SCHUYLKILL COUNTY TASK FORCE IS LED BY SCHUYLKILL COUNTY VISION. THIS TASK FORCE HAS ADDRESSED THE HIGH SUICIDE RATE IN THE COUNTY THROUGH PUBLIC EDUCATION FORUMS, CONFERENCES, CREATING A SPEAKERS' BUREAU, AND DISTRIBUTING ""DO SOMETHING"" CARDS. THESE CARDS INCLUDE INFORMATION ABOUT RISK FACTORS, SIGNS OF SUICIDE, AS WELL AS COUNTY RESOURCES AVAILABLE FOR ASSISTANCE. THE TASK FORCE HAS ALSO SPONSORED TRAINING OVER THE PAST TWO YEARS RELATED TO RECOGNIZING THE SIGNS OF SUICIDE IN SCHOOLS AND BULLYING PREVENTION. IN MARCH 2021, THE SCHUYLKILL COUNTY MH/DS OFFICE HIRED A NEW STAFF PERSON WHO BECAME THE CHAIR OF THE SUICIDE PREVENTION TASK FORCE OF SCHUYLKILL COUNTY, RETURNING THE TASK FORCE TO A FISCAL SPONSORSHIP OF SCHUYLKILL COUNTY'S VISION. THE TASK FORCE IS NOW LED BY THE SCHUYLKILL COUNTY MH/DS OFFICE AND HAS APPROXIMATELY 50 MEMBERS WITH 10-15 ATTENDING MONTHLY MEETINGS ON A REGULAR BASIS. A SUICIDE PREVENTION TRAINING, QUESTION-PERSUADE-RESPOND (QPR), CONTINUES TO BE MADE AVAILABLE IN SCHUYLKILL COUNTY TO THE PUBLIC FREE OF CHARGE. THE TASK FORCE PROVIDES GUN LOCKS FROM THE VA TO GUN STORES TO PROMOTE KEEPING THE AMMUNITION SEPARATELY LOCKED FROM THE GUNS IN ORDER TO DECREASE THE LIKELIHOOD OF SUICIDES BY FIREARM. THE TASK FORCE HAS ALSO STARTED TO PARTNER WITH THE SCHUYLKILL COUNTY DRUG AND ALCOHOL PROGRAMS AND LOCAL FOOD PANTRIES TO MAKE DRUG PRESCRIPTION LOCK BOXES AND DISPOSAL BAGS AVAILABLE. THE MATERIALS ARE DISTRIBUTED AT NARCAN DISTRIBUTION AND MOBILE MARKET EVENTS AROUND THE COUNTY."

PART I, LINE 6A:
THE COMMUNITY BENEFIT REPORT IS ISSUED BY LEHIGH VALLEY HEALTH NETWORK, EIN #22-2458317, THE SOLE CORPORATE MEMBER OF LEHIGH VALLEY HOSPITAL - SCHUYLKILL.

PART I, LINE 7:
THE COSTING METHODOLOGY IS COST TO CHARGE RATIO FOR PROGRAMS WITH GROSS CHARGES AND DIRECT COSTS FOR PROGRAMS WITHOUT GROSS CHARGES.

PART I, LINE 7G:
THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED.

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A) IS $6,746,315.

PART III, LINE 2:
PATIENT ACCOUNTS WRITTEN OFF AS BAD DEBT ARE IDENTIFIED. THE COST TO PROVIDE CARE TO THESE PATIENTS IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES WRITTEN OFF AS BAD DEBT BY THE COST TO CHARGE RATIO.

PART III, LINE 3:
THIS AMOUNT IS THE COST TO PROVIDE CARE TO UNINSURED PATIENTS THAT DO NOT PARTICIPATE IN THE PROCESS TO DETERMINE IF THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE COST IS DETERMINED USING COST TO CHARGE RATIOS. THE RATIONALE FOR INCLUDING THE COST TO PROVIDE CARE TO UNINSURED PATIENTS THAT DO NOT PARTICIPATE IN THE FINANCIAL ASSISTANCE PROCESS IS THE HOSPITAL'S EXPERIENCE WITH UNINSURED PATIENTS THAT DO PARTICIPATE IN THE FINANCIAL ASSISTANCE PROGRAM. WHEN THE HOSPITAL EVALUATES UNINSURED PATIENTS FOR FINANCIAL ASSISTANCE, THE MOST COMMON FINDING IS THAT UNINSURED PATIENTS HAVE INCOME LESS THAN 400% OF THE FEDERAL POVERTY GUIDELINE AND QUALIFY FOR FINANCIAL ASSISTANCE. THE HOSPITAL BELIEVES THAT UNINSURED PEOPLE WHO CHOOSE NOT TO PARTICIPATE IN THE FINANCIAL ASSISTANCE PROCESS AND HAVE THEIR ACCOUNTS WRITTEN OFF AS BAD DEBT, HAVE INCOME THAT WOULD QUALIFY FOR THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM.

PART III, LINE 4:
THE ORGANIZATION ESTIMATES AN IMPLICIT PRICE CONCESSION RELATED TO UNINSURED ACCOUNTS, NET OF THE AGB (AMOUNTS GENERALLY BILLED) DISCOUNT, TO RECORD THE NET SELF-PAY ACCOUNTS RECEIVABLE AT THE ESTIMATED AMOUNTS THE ORGANIZATION EXPECTS TO COLLECT. COINSURANCES AND DEDUCTIBLES WITHIN THE THIRD-PARTY PAYER AGREEMENTS ARE THE PATIENT'S RESPONSIBILITY SO THE ORGANIZATION INCLUDES THESE AMOUNTS IN THE SELF-PAY ACCOUNTS RECEIVABLE AND CONSIDERS THESE AMOUNTS IN ITS DETERMINATION OF THE PROVISION FOR UNCOLLECTIBLE DEBTS BASED ON HISTORICAL COLLECTION EXPERIENCE. FOR THE YEARS ENDED JUNE 30, 2022, AND 2021, RESPECTIVELY, LVH-SCHUYLKILL RECORDED A PROVISION FOR IMPLICIT PRICE CONCESSIONS OF $6,566,868 AND $5,116,022 AS A DIRECT REDUCTION TO PATIENT SERVICES REVENUES.IN INSTANCES WHERE THE ORGANIZATION BELIEVES A PATIENT HAS THE ABILITY TO PAY FOR SERVICES AND, AFTER APPROPRIATE COLLECTION EFFORTS, PAYMENT IS NOT MADE, THE UNPAID PORTION OF THE ACCOUNT BALANCE IS WRITTEN-OFF TO THE PROVISION FOR BAD DEBTS. AMOUNTS RECORDED AS PROVISION FOR BAD DEBTS DO NOT INCLUDE CHARITY CARE.

PART III, LINE 8:
THE SOURCE OF THE MEDICARE ALLOWABLE COSTS RELATING TO REVENUE RECEIVED FROM MEDICARE IS THE FY2022 MEDICARE COST REPORT. THE ENTIRE SHORTFALL ON LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE REVENUE AND EXPENSES ARE BOTH DETERMINED USING MEDICARE PRINCIPLES.

PART III, LINE 9B:
FINANCIAL COUNSELING STAFF WILL DETERMINE WHETHER PATIENTS MEET ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE. ACCOUNTS THAT DO NOT MEET THE ELIGIBLILTY REQUIREMENTS WILL BE REFERRED TO AN EXTERNAL RECEIVABLES FOLLOW UP AGENCY, AND IF NOT PAID, REFERRED TO A COLLECTION AGENCY AND SUBSEQUENTLY TRANSFERRED TO BAD DEBT STATUS IF THE ACCOUNTS REMAIN UNPAID.

PART VI, LINE 2:
AS PART OF THE AFFORDABLE CARE ACT, STARTING IN 2013, ALL NON-PROFIT HOSPITALS AND HEALTH CARE SYSTEMS ARE REQUIRED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS. THE CHNA REPORT EXAMINES THE FACTORS THAT IMPACT THE HEALTH AND WELLNESS OF ALL THE PEOPLE IN A PARTICULAR GEOGRAPHIC AREA. BEYOND ITS REGULATORY FUNCTION, THE CHNA IS AN IMPORTANT OVERVIEW OF THE CURRENT STATE OF HEALTH IN OUR REGION AND IDENTIFIES POTENTIAL AREAS OF CONCERN WHICH INFORMS LEHIGH VALLEY HEALTH NETWORK'S (LVHN) POPULATION HEALTH MANAGEMENT EFFORTS. LVHN'S CHNA INCLUDES A HEALTH PROFILE, A REPORT THAT LOOKS AT ALL THE FACTORS THAT GO INTO MAKING PEOPLE IN A PARTICULAR AREA HEALTHY. THIS INCLUDES SOCIAL AND ENVIRONMENTAL FACTORS LIKE EMPLOYMENT, EDUCATION AND AIR QUALITY, INDIVIDUAL BEHAVIORS LIKE SMOKING OR HEALTHY EATING, AND THE QUALITY AND AVAILABILITY OF HEALTH CARE IN THEIR AREA. THIS INTRODUCTION PROVIDES AN OVERVIEW OF THE 2022 CHNA HEALTH PROFILE AND LVHN'S CHNA PROCESS. THE 2022 HEALTH PROFILE COMBINES DATA AND INFORMATION FROM LOCAL, STATE, AND NATIONAL SOURCES ABOUT DISEASE, THE ENVIRONMENT, SOCIAL FACTORS, AND INDIVIDUAL BEHAVIORS, WITH IDEAS, STORIES, AND EXPERIENCES FROM COMMUNITY MEMBERS AND LEADERS FROM THROUGHOUT THE COUNTIES SERVED BY LVHN. THE SECOND COMPONENT OF THE LVHN'S CHNA INCLUDES AN IMPLEMENTATION PLAN, WHICH OUTLINES OUR PLAN TO ADDRESS THE NEEDS IDENTIFIED IN THE HEALTH PROFILE OVER THE COURSE OF THE NEXT THREE YEARS. THE 2022 CHNA HEALTH PROFILES AND IMPLEMENTATION PLAN ARE PROVIDED AT WWW.LVHN.ORG/CHNA.THE 2022 LVHN CHNA HEALTH PROFILE IS BROKEN OUT INTO THE FOLLOWING SECTIONS: DEMOGRAPHICS, INCOME AND ECONOMICS, EDUCATION, HOUSING AND FAMILIES, OTHER SOCIAL AND ECONOMIC FACTORS, PHYSICAL ENVIRONMENT, CLINICAL CARE AND PREVENTION, HEALTH BEHAVIORS, HEALTH OUTCOMES, AND SPECIAL TOPICS - COVID-19. TO INCREASE THE READABILITY OF THE REPORT, THE COMMUNITY WILL FIND TWO TYPES OF CALL-OUT BOXES THROUGHOUT THE CHNA HEALTH PROFILES. THE FIRST TYPE SUMMARIZES SOME OF THE DATA PRESENTED ON THAT PAGE, PROVIDING EASY-TO-READ, SUMMARY STATEMENTS OF IMPORTANT DATA ABOUT THE COMMUNITY. THE SECOND TYPE PROVIDES INFORMATION FROM THE INTERVIEWS AND COMMUNITY CONVERSATIONS. THESE REPORTS HAVE BEEN REVIEWED AND APPROVED BY LVHN'S BOARD OF TRUSTEES AS WELL AS THE COMMUNITY RELATIONS COMMITTEE OF THE BOARD.VISIT WWW.LVHN.ORG/CHNA TO VIEW THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENTLY CONDUCTED CHNA AND HOW WE ARE ADDRESSING THOSE NEEDS.

PART VI, LINE 3:
EACH PATIENT IS REGISTERED INTO THE HOSPITAL COMPUTER SYSTEM WHEN THEY ARRIVE FOR SERVICES. AS PART OF THE REGISTRATION, INFORMATION IS OBTAINED ON ANY HEALTH INSURANCE THEY HAVE. INDIVIDUALS WITHOUT HEALTH INSURANCE ARE INFORMED AT THAT TIME OF THE MEDICAL CENTER'S CHARITY CARE POLICY. PATIENTS ARE GIVEN INFORMATION ON CONTACTING STAFF WITHIN THE HOSPITAL PATIENT ACCOUNTING DEPARTMENT TO DISCUSS APPLYING FOR THE HOSPITAL CHARITY CARE PROGRAM. SPECIFIC STAFF HAVE BEEN TRAINED AND ARE RESPONSIBLE FOR ADMINISTERING THE CHARITY CARE PROGRAM FOR THE HOSPITAL. HOSPITAL STAFF CONTACT PATIENTS WITHOUT INSURANCE AND EXPLAIN THE POLICY AND THE INFORMATION NEEDED TO APPLY. HOSPITAL STAFF WILL ALSO ASSIST PATIENTS IN APPLYING FOR MEDICAL ASSISTANCE. THEY WILL ALSO ASSIST PATIENTS IN COMPLETING THE APPLICATION AND GATHERING THE NECESSARY FINANCIAL DOCUMENTS.THE HOSPITAL ALSO POSTS INFORMATION WITHIN THE ADMISSION AND EMERGENCY ROOM AREAS INFORMING PATIENTS THAT THERE IS A CHARITY CARE POLICY AVAILABLE. ALL REGISTRATION PERSONNEL ARE TRAINED ON THE POLICY SO THAT THEY ARE ABLE TO INFORM PATIENTS WHEN THEY ARE REGISTERED.OTHER HOSPITAL STAFF MEMBERS THAT MAY COME IN CONTACT WITH PATIENTS ARE ALSO EDUCATED REGARDING THE CHARITY CARE POLICY. THIS WOULD INCLUDE SOCIAL WORKERS, CARE MANAGERS, NURSING STAFF, AND ALL DEPARTMENT DIRECTORS. THE CHARITY CARE POLICY IS AVAILABLE ON THE HOSPITAL INTRANET WHICH IS ACCESSIBLE BY ALL EMPLOYEES. THE HOSPITAL IS ALSO IN THE PROCESS OF PLACING THE POLICY ON THE HOSPITAL WEBSITE.ALL PATIENT ACCOUNTING, CASHIERING, AND COLLECTION STAFF ARE ALSO EDUCATED ON THE CHARITY CARE POLICY AND CAN ASSIST PATIENTS IN APPLYING FOR CHARITY CARE. ALSO ALL THIRD PARTY ORGANIZATIONS THAT WORK ON BEHALF OF THE MEDICAL CENTER IN PERFORMING COLLECTIONS HAVE BEEN EDUCATED ON THE CHARITY CARE POLICY AND CAN ADVISE PATIENTS ON APPLYING FOR THIS BENEFIT.

PART VI, LINE 4:
THE PRIMARY SERVICE AREA OF LVH-SCHUYLKILL IS SCHUYLKILL COUNTY. U.S. CENSUS BUREAU DATA FOR THE 2020 CENSUS INDICATES THE PRIMARY SERVICE AREA POPULATION WAS APPROXIMATELY 143,049. DURING THE CALENDAR YEAR 2021, 96.7% OF THE DISCHARGES FROM LVH-SCHUYLKILL WERE RESIDENTS OF THE PRIMARY SERVICE AREA. ACCORDING TO THE 2021 U.S. CENSUS BUREAU ACS, THE PRIMARY SERVICE AREA'S ESTIMATED POPULATION IN 2021 IS 143,264. THE 2020 POPULATION OF THE SECONDARY SERVICE AREA WAS APPROXIMATELY 1,189,749, OVER AN EXTENSIVE GEOGRAPHIC AREA WITH A SMALL PATIENT DISTRIBUTION (FOUR COUNTIES). DURING THE CALENDAR YEAR 2021, ABOUT 2.5% OF THE DISCHARGES FROM LVH-SCHUYLKILL WERE RESIDENTS OF THE SECONDARY SERVICE AREA. THE 2021 U.S. CENSUS ACS POPULATION ESTIMATE OF THE SECONDARY SERVICE AREA IS 1,205,152. DURING THE CALENDAR YEAR 2021, 0.8% OF THE DISCHARGES FROM LVH-SCHUYLKILL WERE RESIDENTS OUTSIDE THE PRIMARY AND SECONDARY SERVICE AREAS. BASED ON PROPRIETARY DATA ESTIMATES (SCANUS), THE PRIMARY SERVICE AREA CURRENT POPULATION PROJECTION WILL DECREASE BY APPROXIMATELY -2.4% BY 2027.

PART VI, LINE 5:
THE BOARD OF LVH-S IS COMPRISED OF SIXTEEN INDIVIDUALS, FOURTEEN OF WHOM ARE FROM THE SCHUYLKILL COUNTY COMMUNITY WHO ARE NOT EMPLOYED BY THE HOSPITAL. THEY ARE INVOLVED IN EDUCATION, SOCIAL SERVICES, GERIATRIC SERVICES, MATERNAL/CHILD SERVICES, PRIMARY MEDICAL CARE, CRIMINAL JUSTICE, SMALL BUSINESS AND MANUFACTURING. ALL PHYSICIANS ARE ENCOURAGED TO APPLY FOR MEDICAL STAFF PRIVILEGES FOR THE MEDICAL CENTER.LVH-S ALSO WORKS WITH VARIOUS COMMUNITY ORGANIZATIONS TO HELP IDENTIFY COMMUNITY NEEDS AND WORK TOGETHER TO MEET THOSE NEEDS. THE MEDICAL CENTER HAS INPATIENT ADOLESCENT AND ADULT BEHAVIORAL HEALTH SERVICES AVAILABLE TO THE RESIDENTS OF SCHUYLKILL COUNTY. THIS ALLOWS COUNTY RESIDENTS TO OBTAIN NECESSARY INPATIENT CARE WITHIN THE COUNTY WITHOUT REQUIRING FAMILIES TO TRAVEL OUTSIDE OF THE COUNTY. THE MEDICAL CENTER ALSO HAS A CERTIFIED DIABETES EDUCATOR AVAILABLE TO CONSULT WITH PATIENTS AND ALSO WITH PHYSICIANS WHEN THEY HAVE A PATIENT THAT IS NEWLY DIAGNOSED WITH DIABETES. THE MEDICAL CENTER IS THE ONLY FACILITY IN THE COUNTY WITH A MATERNITY DEPARTMENT AND NEWBORN NURSERY. THIS ALLOWS COUNTY RESIDENTS TO REMAIN IN THE COUNTY FOR MATERNITY CARE. MORE THAN 50% OF THE BIRTHS EACH YEAR ARE MEDICAID.THE EMERGENCY DEPARTMENT OF LVH-S IS A 24-HOUR EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE MEDICAL CENTER PARTICIPATES IN MANY INSURANCE PROGRAMS SUCH AS MEDICARE, MEDICAID, CHAMPUS, AND VA. THE MEDICAL CENTER ALSO HAS A CHARITY CARE POLICY THAT PROVIDES ASSISTANCE TO ELIGIBLE INDIVIDUALS IN PROVIDING FREE OR DISCOUNTED CARE BASED ON THEIR ABILITY TO PAY AND THE FEDERAL POVERTY GUIDELINES.LVH-S ALSO PROVIDES OPPORTUNITIES TO STUDENTS IN HEALTHCARE FIELDS TO GAIN EXPERIENCE WORKING IN THE HEALTH CARE ENVIRONMENT SUCH AS NURSING STUDENTS (RN AND LPN), PHARMACY STUDENTS, PHYSICIAN ASSISTANT STUDENTS, PHYSICAL THERAPY STUDENTS, RADIOLOGY TECHNICIANS AND MEDICAL ASSISTANTS. THE MEDICAL CENTER ALSO PROVIDES A VOLUNTEER PROGRAM FOR JUNIOR HIGH AND HIGH SCHOOL STUDENTS TO BECOME FAMILIAR WITH THE MEDICAL SERVICES OFFERED AND THE EDUCATIONAL OPPORTUNITIES AVAILABLE WITHIN THE HEALTHCARE ENVIRONMENT.THE HOSPITAL ALSO SPONSORS AND PARTICIPATES IN HEALTH FAIRS AT COMMUNITY EVENTS SUCH AS THE COUNTY FAIR, EVENTS AT THE LOCAL MALL, HEALTH SCREENINGS, BLOOD PRESSURE SCREENINGS AND CLINICS, VETERANS BREAKFAST EVENT, MEALS ON WHEELS, SKIN CANCER SCREENINGS, MAMMOGRAPHY SCREENINGS, SUPPORT GROUPS, AND LOCAL AMERICAN CANCER SOCIETY RELAY FOR LIFE.ANY EXCESS FUNDS THAT ARE GENERATED FROM THE OPERATIONS ARE INVESTED BACK INTO THE MEDICAL CENTER BY PURCHASING THE NECESSARY CAPITAL EQUIPMENT, FUNDING CAPITAL IMPROVEMENT PROJECTS, FUNDING NEW SERVICES, IMPROVING AND EXPANDING EXISTING SERVICES, AND ANY OTHER GENERAL IMPROVEMENTS TO PATIENT CARE.