4A (Expenses $ 235179452 including grants of $ 38102239) (Revenue $ 330921622)
SEE SCHEDULE H

PART V, SECTION B, LINE 5
"INPUT FOR COMMUNITY HEALTH NEEDS ASSESSMENT:PENN STATE HEALTH IS COMMITTED TO UNDERSTANDING AND ADDRESSING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. IN ORDER TO BEST DO THAT, THE HEALTH SYSTEM COMPLETED ITS 2021 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CHNA PROCESS THE 2021 CHNA USED BOTH PRIMARY AND SECONDARY METHODS TO SOLICIT COMMUNITY INPUT AND COMPARE HEALTH TRENDS AND DISPARITIES ACROSS THE SIX-COUNTY SERVICE AREA. THE CHNA TIMELINE COMPLIED WITH IRS TAX CODE 501(R) REQUIREMENTS TO CONDUCT A CHNA EVERY THREE YEARS, AS SET FORTH BY THE AFFORDABLE CARE ACT. SPECIFIC CHNA STEPS INCLUDED:-KICKOFF MEETING TO ANNOUNCE THE START OF THE CHNA PROCESS AND HOST ALL INTERNAL COMMUNITY-MINDED STAFF MEMBERS. THEY PROVIDED INPUT ON COMMUNITY PARTNERS TO ENGAGE BASED ON HIGH-NEED AREAS, AS DEFINED BY COMMUNITY NEED INDEX (CNI) SCORES-MONTHLY LEADERSHIP MEETINGS, INCLUDING ALL HOSPITALS, TO REVIEW PROGRESS AND PROVIDE FEEDBACK-A KEY INFORMANT SURVEY WITH 317 COMMUNITY LEADERS AND STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING EXPERTS IN PUBLIC HEALTH AND INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS-A COMMUNITY MEMBER SURVEY (CMS) COMPLETED BY 2,778 INDIVIDUALS, WITH 2,532 RESPONSES ABLE TO BE USED BASED UPON COUNTY OF RESIDENCE AND AGE-AN ANALYSIS OF EXISTING SECONDARY DATA SOURCES, INCLUDING PUBLIC HEALTH STATISTICS, DEMOGRAPHIC AND SOCIAL MEASURES AND HEALTH CARE UTILIZATION-TWO PARTNER FORUMS, WITH REPRESENTATIVES FROM DIVERSE COMMUNITY-BASED AND PUBLIC HEALTH ORGANIZATIONS, TO GATHER INSIGHT ON COMMUNITY HEALTH NEEDS AND FOSTER COLLABORATION TOWARD COMMUNITY HEALTH IMPROVEMENT - THE FIRST FORUM HOSTED 112 PARTICIPANTS AND THE SECOND 103 PARTICIPANTS-REVIEW OF THE CURRENT CHNA IMPLEMENTATION PLAN AND AVAILABLE RESOURCES-PRIORITIZATION OF IDENTIFIED COMMUNITY HEALTH NEEDS TO DETERMINE THE MOST PRESSING ISSUES ON WHICH TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS KEY INFORMANT SURVEY A KEY INFORMANT SURVEY WAS CONDUCTED ELECTRONICALLY TO SOLICIT INFORMATION ABOUT COMMUNITY HEALTH NEEDS. A TOTAL OF 317 INDIVIDUALS RESPONDED TO THE SURVEY, INCLUDING HEALTH AND SOCIAL SERVICE PROVIDERS; COMMUNITY AND STATEWIDE PUBLIC HEALTH EXPERTS; CIVIC, RELIGIOUS AND SOCIAL LEADERS; COMMUNITY PLANNERS, POLICYMAKERS AND ELECTED OFFICIALS; AND OTHERS REPRESENTING DIVERSE POPULATIONS, INCLUDING MINORITY, LOW-INCOME, LGBTQ+ AND OTHER UNDERSERVED OR VULNERABLE POPULATIONS. THE SURVEY WAS AVAILABLE IN ENGLISH AND SPANISH AND INCLUDED A DISABILITY AND LANGUAGE ACCOMMODATION STATEMENT. IT WAS OPEN FOR A LONGER PERIOD OF TIME COMPARED TO PAST CHNA CYCLES, FROM NOVEMBER 2020 TO MARCH 2021, DUE TO THE COVID-19 PANDEMIC. QR CODES AND LINKS TO THE SURVEY WERE SHARED MULTIPLE TIMES VIA EMAIL, AS WELL AS AT VIRTUAL MEETINGS AND PROFESSIONAL EDUCATION SESSIONS. KEY INFORMANTS WERE ASKED A SERIES OF QUESTIONS ABOUT THEIR PERCEPTIONS OF COMMUNITY HEALTH, INCLUDING HEALTH DRIVERS, BARRIERS TO CARE, COMMUNITY INFRASTRUCTURE AND RECOMMENDATIONS FOR COMMUNITY HEALTH IMPROVEMENT. RESPONDENTS REPRESENTED EXCELLENT GEOGRAPHIC BALANCE ACROSS THE SIX COUNTY AREA, AS FOLLOWS: BERKS COUNTY (124, 39.1%), CUMBERLAND COUNTY (123, 38.8%), DAUPHIN COUNTY (167, 52.7%), LANCASTER COUNTY (97, 30.6%), LEBANON COUNTY (97, 30.6%), PERRY COUNTY (100, 31.6%) AND OTHER (67, 21.1%). RESPONDENTS WERE ABLE TO SELECT MULTIPLE COUNTIES, SO THE NUMBER OF INDIVIDUAL RESPONDENTS AND PERCENTAGES DO NOT ADD UP TO 317 AND 100%, RESPECTIVELY. ABOUT 40% OF RESPONDENTS PROVIDED SERVICES TO ALL RESIDENTS. OF THOSE ORGANIZATIONS THAT FOCUSED PRIMARILY ON A SPECIAL POPULATION, MOST SERVED LOW-INCOME/POOR (35%), FAMILIES (27%) OR CHILDREN/YOUTH (27%). ""OTHER"" POPULATIONS SERVED, AS INDICATED BY 5% OF RESPONDENTS, INCLUDED ARABIC, NEPALESE, VETERANS, PREGNANT WOMEN, SINGLE PARENTS, COLLEGE STUDENTS AND INDIVIDUALS AFFECTED BY SPECIFIC ISSUES, INCLUDING HIV/AIDS, MENTAL HEALTH, INTELLECTUAL DISABILITIES, EPILEPSY OR SUBSTANCE USE.COMMUNITY MEMBER SURVEYA COMMUNITY MEMBER SURVEY WAS CONDUCTED WITH RESIDENTS ACROSS THE SIX-COUNTY COMMUNITY TO GATHER INSIGHTS INTO HEALTH STATUS, RISK BEHAVIORS, BARRIERS TO ACCESSING HEALTH SERVICES AND THE HEALTH AND SOCIAL NEEDS OF VULNERABLE COMMUNITY MEMBERS. THE SURVEY WAS CONDUCTED WITH ADULTS AGE 18 OR OVER AND INCLUDED LOW-INCOME, UNDERSERVED OR MINORITY POPULATIONS. DUE TO THE COVID-19 PANDEMIC LIMITING IN-PERSON OPPORTUNITIES, THE SURVEY WAS CONDUCTED OVER A LONGER PERIOD, FROM SEPTEMBER 2020 TO APRIL 2021, THAN PAST CHNA CYCLES. ELECTRONIC AND PAPER VERSIONS OF THE SURVEY WERE AVAILABLE IN ENGLISH AND SPANISH, AND THEY INCLUDED A DISABILITY AND LANGUAGE ACCOMMODATION STATEMENT. PAPER SURVEYS WERE COLLECTED AT 29 COMMUNITY PARTNER PHYSICAL LOCATIONS, PRIMARILY FOCUSED ON UNDERSERVED COMMUNITIES. ADVERTISING CARDS, INCLUDING QR CODES AND LINKS, WERE SHARED AT COMMUNITY EVENTS WHERE IN-PERSON SURVEYING COULD NOT BE ACCOMMODATED DUE TO COVID-19. PAPER AND VIRTUAL ADVERTISING MATERIALS WERE SHARED EXTENSIVELY BY OUR COMMUNITY PARTNERS VIA THEIR VIRTUAL EVENTS AND EDUCATIONAL SESSIONS, WITH SUPPORT GROUPS, IN COMMUNITY AND PROFESSIONAL NEWSLETTERS, WITH FORMER PATIENT/CLIENT EMAIL LISTS, VIA PRESS RELEASE CYCLES, FROM SEPTEMBER 2020 TO APRIL 2021, AND THROUGH SOCIAL MEDIA ARTICLES. THE SURVEY WAS NOT INTENDED TO BE A REPRESENTATIVE SAMPLE OF THE GREATER COMMUNITY, BUT RATHER PROVIDE GENERAL INSIGHTS INTO RESPONDENTS' PERCEPTIONS AND HEALTH STATUS. THE SURVEY DATA WERE ANALYZED BY COUNTY AND RACE/ETHNICITY. (NOTE: RACIAL/ETHNIC DATA WAS NOT ANALYZED FOR GROUPS WITH FEWER THAN 10 RESPONDENTS.) A TOTAL OF 2,778 INDIVIDUALS COMPLETED THE SURVEY ACROSS THE SIX-COUNTY SERVICE AREA, AND 2,532 RESPONSES WERE ABLE TO BE USED BASED UPON COUNTY OF RESIDENCE AND AGE. THE LARGEST PERCENTAGES OF RESPONDENTS RESIDED IN DAUPHIN COUNTY (43%) AND BERKS COUNTY (19%), WHICH ARE THE HOME COUNTIES OF THE MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER, PENNSYLVANIA PSYCHIATRIC INSTITUTE AND PENN STATE HEALTH REHABILITATION HOSPITAL. THE LARGEST PERCENTAGES OF RESPONDENTS WERE FEMALE (67.5%) AND WHITE (87.4%). NINE PERCENT OF RESPONDENTS IDENTIFIED AS HISPANIC OR LATINO AND 5% OF RESPONDENTS IDENTIFIED AS BLACK OR AFRICAN AMERICAN. THE MOST REPRESENTED AGE GROUPS WERE 65 TO 74 (23.4%) AND 55 TO 64 (22.6%). APPROXIMATELY 19% OF RESPONDENTS REPORTED A HOUSEHOLD INCOME OF $34,999 OR LESS. ABOUT 2.8% DID NOT COMPLETE HIGH SCHOOL, WHILE 15.6% GRADUATED HIGH SCHOOL OR EARNED A GED. SEVENTY-SEVEN PERCENT OF RESPONDENTS HAVE SOME COLLEGE EXPERIENCE, INCLUDING EARNING AN ASSOCIATE, BACHELOR'S OR MASTER'S DEGREE. ABOUT HALF OF THE RESPONDENTS WERE EMPLOYED, WHILE THE OTHER HALF WAS NOT WORKING DUE TO BEING RETIRED (32.7%), UNEMPLOYED (4.4%), UNABLE TO WORK (4.1%) OR FOR OTHER REASONS. DEMOGRAPHIC DATA FOR ALL SURVEY RESPONDENTS CAN BE FOUND IN THE FULL REPORT AT HTTPS://WWW.PENNSTATEHEALTH.ORG/COMMUNITY.COMMUNITY MEMBERS WERE ASKED TO PROVIDE THEIR FEEDBACK ON PREVIOUS CHNAS CONDUCTED BY PENN STATE HEALTH AS PART OF THE KEY INFORMANT SURVEY, AS WELL AS DURING THE COMMUNITY PARTNER FORUMS. THE OPPORTUNITY TO PROVIDE FEEDBACK IS ALSO AVAILABLE TO THE GENERAL PUBLIC ON AN ONGOING BASIS VIA A LINK POSTED ON PENNSTATEHEALTH.ORG/COMMUNITY. OVERALL, THE FEEDBACK WAS POSITIVE, WITH MANY COMMENTS INDICATING THAT RESPONDENTS FELT PENN STATE HEALTH HAS BEEN DOING AN EXCELLENT JOB WITH FACILITATING COLLABORATION, FOSTERING PARTNERSHIPS AND DOCUMENTING AND SHARING FINDINGS. SOME RESPONDENTS EXPRESSED A DESIRE FOR PENN STATE HEALTH TO HAVE A STRONGER PRESENCE IN VARIOUS GEOGRAPHICAL LOCATIONS AND TO UTILIZE ITS INFLUENCE TO HAVE AN IMPACT ON SYSTEMIC FACTORS THAT INFLUENCE HEALTH. A FULL LIST OF COMMENTS RECEIVED IS INCLUDED IN APPENDIX C OF THE FULL REPORT."

PART V, SECTION B, LINE 6A / 6B
OTHER HOSPITAL FACILITIES INCLUDED IN NEEDS ASSESSMENT: FOR THIS 2021, FOURTH ASSESSMENT CYCLE, PENN STATE HEALTH FORMED A COLLECTIVE WORKGROUP THAT INCLUDED THE FOLLOWING HOSPITALS:-PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER-PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER-PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER-PENN STATE HEALTH HAMPDEN MEDICAL CENTER-PENNSYLVANIA PSYCHIATRIC INSTITUTE-PENN STATE HEALTH REHABILITATION HOSPITALIT ALSO INCLUDED KEY COMMUNITY STAKEHOLDERS TO IDENTIFY AND ADDRESS THE NEEDS OF RESIDENTS LIVING IN THE SIX COUNTY COMMUNITY. BECAUSE PENN STATE HEALTH LANCASTER MEDICAL CENTER WAS UNDER CONSTRUCTION DURING THIS ASSESSMENT, THIS COMMUNITY WAS ALSO INCLUDED. THE DEPARTMENT OF PUBLIC HEALTH SCIENCES AT PENN STATE COLLEGE OF MEDICINE COORDINATED THE CHNA EFFORTS. APPENDIX B OF THE FULL REPORT AVAILABLE AT HTTPS://WWW.PENNSTATEHEALTH.ORG/COMMUNITY CONTAINS A LIST OF COMMUNITY PARTNER ORGANIZATIONS THAT PARTICIPATED IN ANY ASPECT OF THE ASSESSMENT PROCESS. PLEASE NOTE THIS LIST MAY NOT BE ALL-INCLUSIVE SINCE PARTICIPANTS COULD REMAIN ANONYMOUS.

PART V, SECTION B, LINE 11
THREE PRIORITIZED COMMUNITY HEALTH NEEDSTHE 2021 CHNA GATHERED COMMUNITY INPUT AND COMPARED HEALTH TRENDS AND DISPARITIES ACROSS THE SIX-COUNTY SERVICE AREA. BASED ON THIS WORK, OUR HOSPITALS, IN COLLABORATION WITH OUR COMMUNITY PARTNERS, WILL FOCUS SYSTEM-WIDE HEALTH IMPROVEMENT EFFORTS OVER THE THREE-YEAR CYCLE FROM JULY 1, 2022, TO JUNE 30, 2025 ON THE IDENTIFIED PRIORITY AREAS OF 1) MENTAL HEALTH 2) HEALTH EQUITY AND 3) WELLNESS AND DISEASE PREVENTION. ALL PRIORITIES IDENTIFIED THROUGH THE CHNA WILL BE ADDRESSED. MENTAL HEALTH INCLUDES A FOCUS ON COMMUNITY GROUPS, SUCH AS THE LGBTQ+ COMMUNITY, PEOPLE OF COLOR AND YOUTH. SUBSTANCE USE DISORDER WILL ALSO BE ADDRESSED UNDER THIS PRIORITY. HEALTH EQUITY COVERS CONCERNS THAT INCLUDE ACCESS TO CARE, ELDER ISSUES WITH ACCESS, SOCIAL DETERMINANTS OF HEALTH, RACISM, DIVERSITY, TRANSPORTATION AND HOUSING. WELLNESS AND DISEASE PREVENTION ENCOMPASSES FOOD ACCESS AND NUTRITION, SUBSTANCE USE PREVENTION, CHRONIC DISEASE PREVENTION, HEALTH EDUCATION AND PHYSICAL ACTIVITY. THESE PRIORITIES ARE INTERRELATED, AND ONE CANNOT BE ADDRESSED WITHOUT THE OTHER.IMPLEMENTATION PLAN TO DEVELOP OUR IMPLEMENTATION PLAN, INTERNAL EMPLOYEES AND COMMUNITY PARTNERS ATTENDED A KICKOFF MEETING, WHERE CHNA FINDINGS AND PARTNER FORUM RECOMMENDATIONS WERE SHARED. PARTICIPANTS ORGANIZED INTO THE FOLLOWING TASK FORCES TO BEST DEVELOP OUR PLAN: 1) MENTAL HEALTH; 2) HEALTH EQUITY; 3) CHRONIC DISEASE AND RISK FACTOR PREVENTION; 4) NUTRITION AND FOOD ACCESS; AND 5) PHYSICAL ACTIVITY. THESE TASK FORCES MET FROM NOVEMBER 2021 TO FEBRUARY 2022 TO DISCUSS KEY FINDINGS FROM THE CHNA; EXPLORE UNDERSERVED COMMUNITIES THROUGH REVIEW OF COMMUNITY NEED INDEX (CNI) SCORES, LIFE EXPECTANCY MEASURES AND OTHER KEY SOCIAL DETERMINANTS OF HEALTH; FIND ADDITIONAL COMMUNITY PARTNER RESOURCES; AND DEVELOP A PLAN. THE PLAN INCLUDES KEY PROGRAM DESCRIPTIONS, GOALS AND OBJECTIVES TO BE MET OVER THE NEXT THREE YEARS.DUE TO THE OVERLAPPING NATURE OF OUR PRIORITIES, ALL FIVE TASK FORCES PROPOSED SIMILAR PROGRAMS TO EXPAND COMMUNICATION AND PROMOTE EXISTING RESOURCES. ALL HAVE AGREED TO CONTINUE TO MEET AND ENGAGE NEW PARTNERS OVER THE THREE YEARS OF THIS PLAN TO ENCOURAGE DIALOGUE AMONG THEMSELVES AND CONTINUE TO STREAMLINE AND STRENGTHEN EACH OTHER'S COMMUNITY EFFORTS. ADDITIONALLY, EACH TASK FORCE PLANS TO COMPILE AN INVENTORY OF COMMUNITY RESOURCES THAT ARE CURRENTLY AVAILABLE TO NOT ONLY INCREASE AWARENESS AMONG THE GROUP BUT ALSO TO ADVERTISE TO COMMUNITY MEMBERS. NOT KNOWING WHAT RESOURCES ARE AVAILABLE AND HOW TO ACCESS THEM WAS A CLEAR MESSAGE HEARD DURING OUR CHNA PROCESS. THROUGH KEY PARTNERSHIPS WITH ORGANIZATIONS LISTED AT THE END OF THIS IMPLEMENTATION PLAN DOCUMENT, THE PLAN IS TO MAKE THESE RESOURCES MORE WELL-KNOWN - THROUGH THE PROGRAM PA 211: GET CONNECTED (PA 211), FOR EXAMPLE, A FREE AND CONFIDENTIAL SERVICE THAT HELPS PEOPLE FIND THE LOCAL RESOURCES THEY NEED 24/7. OUR PROJECTS FOCUS HEAVILY ON COMMUNITY EDUCATION, ANOTHER MESSAGE WE HEARD THROUGH OUR CHNA PROCESS. IN ADDITION, MANY OF OUR PROJECTS WILL SERVE MORE THAN ONE OF OUR IDENTIFIED COMMUNITY NEEDS. FOR EXAMPLE, INCREASING OUR OUTREACH AND PROGRAMMING TO MORE FOOD PANTRIES ACROSS OUR SERVICE AREA FURTHERS OUR WORK IN THE AREAS OF HEALTH EQUITY, WELLNESS AND DISEASE PREVENTION AND NUTRITION AND FOOD ACCESS. WITHIN EACH PRIORITY AREA, WE WILL BE FOCUSING OUR EFFORTS ON COMMUNITIES IDENTIFIED WITH THE HIGHEST NEED. THESE MIGHT BE AREAS WITH LARGER MINORITY POPULATIONS, LOWER LIFE EXPECTANCY AND OTHER HIGH-RISK GROUPS. THE FOLLOWING ACTIONS WILL ADDRESS OUR PRIORITIZED HEALTH NEEDS OVER THE NEXT THREE YEARS, AS WELL AS THE SPECIFIC HOSPITAL ADDRESSING EACH NEED. ALL NEEDS WILL BE ADDRESSED IN THIS PLAN. STRATEGIES INCLUDED ARE EVIDENCE-BASED, OR STRATEGIES THAT WILL BE EVALUATED, TO ENSURE THE MOST EFFECTIVE USE OF COMMUNITY AND HOSPITAL RESOURCES. ALL OUTCOMES WILL BE TRACKED AND ANY NECESSARY ADJUSTMENTS TO THIS PLAN WILL BE SHARED IN ANNUAL REPORTS THAT WILL BE COMMUNICATED PUBLICLY ON OUR WEBSITES.PRIORITY 1) MENTAL HEALTH RESPONSIBLE PARTY: PENNSYLVANIA PSYCHIATRIC INSTITUTE, PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER AND PENN STATE HEALTH HAMPDEN MEDICAL CENTERGOAL: IMPROVE MENTAL HEALTH THROUGH PREVENTION, INTERVENTION AND SUPPORT. OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS:-REDUCE THE NUMBER OF POOR MENTAL HEALTH DAYS REPORTED BY ADULTS IN THE PAST 30 DAYS.-DECREASE THE PERCENTAGE OF CHILDREN REPORTING FEELING SAD OR DEPRESSED MOST DAYS IN THE PAST YEAR. -DECREASE THE NUMBER OF DRUG OVERDOSE DEATHS PER 100,000 POPULATION.PROGRAM 1. BEHAVIORAL HEALTH EDUCATION AND PREVENTION - EXPAND AND INCREASE BEHAVIORAL HEALTH TRAINING AND EDUCATION.SHORT TERM OBJECTIVES (YEAR 1)1. OFFER MENTAL HEALTH SIGNS/SYMPTOMS TRAININGS.-5 TO TEACHERS-3 TO LAW ENFORCEMENT-2 TO COMMUNITY HEALTH WORKERS (CHWS)-COLLABORATE WITH THE DAUPHIN COUNTY DISTRICT ATTORNEY'S OFFICE TO OFFER 3 CIT TRAININGS.2. PROVIDE SUBSTANCE USE EDUCATION VIA 15 LECTURES, TRAININGS, WEBINARS OR HEALTH FAIRS.3. DISTRIBUTE NALOXONE, LOCK BOXES AND SAFE DISPOSAL POUCHES AT 2 HEALTH FAIRS IN OUR SERVICE AREA.MEDIUM-TERM OBJECTIVES (YEAR 2)1. OFFER MENTAL HEALTH SIGNS/SYMPTOMS TRAININGS.-USE TRAIN-THE-TRAINER TO EDUCATE 3 CHWS ON OFFERING MENTAL HEALTH SIGNS/SYMPTOMS TRAINING.-OFFER 3 MENTAL HEALTH SIGNS/SYMPTOMS TRAININGS TO STUDENTS IN GRADES 7 AND HIGHER.2. EXPAND SUBSTANCE USE EDUCATION VIA LECTURES, TRAININGS, WEBINARS OR HEALTH FAIRS IN 2 ADDITIONAL COUNTIES AND WITHIN THE BUREAU OF PRISONS.3. DISTRIBUTE NALOXONE, LOCK BOXES AND SAFE DISPOSAL POUCHES AT 2 ADDITIONAL HEALTH FAIRS IN OUR SERVICE AREA.LONG-TERM OBJECTIVES (YEAR 3) 1. OFFER MENTAL HEALTH SIGNS/SYMPTOMS TRAININGS.-BY THE END OF THE 3RD YEAR, OVER 800 INDIVIDUALS WILL HAVE RECEIVED MENTAL HEALTH SIGNS/SYMPTOMS TRAINING.2. PROVIDE SUBSTANCE USE EDUCATION VIA 15 LECTURES, TRAININGS, WEBINARS OR HEALTH FAIRS AMONG 2 ADDITIONAL POPULATIONS (LGBTQ+, RELIGIOUS, PEOPLE OF COLOR, ETC.).3. DISTRIBUTE NALOXONE, LOCK BOXES AND SAFE DISPOSAL POUCHES AT 2 ADDITIONAL HEALTH FAIRS IN OUR SERVICE AREA.PROGRAM 2. BEHAVIORAL HEALTH RESOURCES, SUPPORT AND COLLABORATION - COLLABORATE WITH OTHER ORGANIZATIONS TO DEVELOP AN INVENTORY OF BEHAVIORAL HEALTH RESOURCES AND SUPPORT SYSTEMS.SHORT TERM OBJECTIVES (YEAR 1)1. DEVELOP OPPORTUNITIES TO COLLABORATE-JOIN A COLLABORATIVE ALREADY IN PLACE, SUCH AS THE HEAL PA INITIATIVE.-APPLY FOR PSH COMMUNITY RELATIONS AND ASSOCIATION FOR FACULTY AND FRIENDS GRANTS.-GATHER AND CREATE AN INVENTORY OF MENTAL HEALTH AND SUBSTANCE USE RESOURCES.2. BUILD RELATIONSHIPS WITH 3 SUPERINTENDENTS TO DISCUSS MENTAL HEALTH RESOURCE PROMOTION.3. COLLABORATE WITH PA 211 TO INCREASE AWARENESS OF MENTAL HEALTH RESOURCES.-OBTAIN BASELINE STATISTICS ON PA 211 MENTAL HEALTH RESOURCE USAGE.4. PSH GOVERNMENT RELATIONS WILL MEET WITH PSH LEADERSHIP TO REVIEW AND ASSESS MENTAL HEALTH PRIORITIES AND NEEDS FOR THE NEXT 2 YEARS.5. RECRUIT ADDITIONAL PROVIDERS.-RECRUIT 5 PHYSICIANS FOCUSED ON ADDICTION TO THE AIR PROGRAM.-RECRUIT 2 FELLOWS TO THE ADDICTION MEDICINE FELLOWSHIP AND OBTAIN A BASELINE NUMBER OF PATIENTS SEEN IN CLINICS AT PPI.6. INITIATE 1 SMART RECOVERY SUPPORT GROUP.MEDIUM-TERM OBJECTIVES (YEAR 2)1. MAINTAIN AND EXPAND THE INVENTORY OF MENTAL HEALTH AND SUBSTANCE USE RESOURCES.2. COLLABORATE WITH 3 SCHOOL DISTRICTS TO ADD PA 211 AND 741741 AS RESOURCES IN STUDENTS' AGENDA BOOKS.3. DETERMINE INCREASE IN PA 211 MENTAL HEALTH RESOURCE USE DURING YEAR 1 AND INCREASE BY 10%.4. PSH GOVERNMENT RELATIONS WILL WORK ON ADDRESSING THE MENTAL HEALTH PRIORITY AREAS IDENTIFIED IN YEAR 1.5. INCREASE THE NUMBER OF PATIENTS RECEIVING METHADONE OR BUPRENORPHINE TREATMENT AT PPI CLINICS BY 45%.6. INITIATE 1 SMART RECOVERY FRIENDS AND FAMILY SUPPORT GROUP.LONG-TERM OBJECTIVES (YEAR 3) 1. MAINTAIN AND EXPAND THE INVENTORY OF MENTAL HEALTH AND SUBSTANCE USE RESOURCES.2. CONTINUE COLLABORATING WITH SCHOOL DISTRICTS TO PROMOTE MENTAL HEALTH RESOURCES.3. MEET OR EXCEED TARGET OF 10% INCREASE IN USE OF PA 211 MENTAL HEALTH RESOURCES.4. PSH GOVERNMENT RELATIONS WILL CONTINUE TO WORK ON ADDRESSING THE MENTAL HEALTH PRIORITY AREAS IDENTIFIED IN YEARS 1 AND 2.5. MAINTAIN THE NUMBER OF PATIENTS RECEIVING METHADONE OR BUPRENORPHINE TREATMENT AT PPI CLINICS.6. CONTINUE TO OFFER 2 SMART RECOVERY SUPPORT GROUPS.PRIORITY 2) HEALTH EQUITYRESPONSIBLE PARTY: PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER, PENN STATE HEALTH HAMPDEN MEDICAL CENTER, PENNSYLVANIA PSYCHIATRIC INSTITUTE AND PENN STATE HEALTH REHABILITATION HOSPITAL.

GOALS:
- BRIDGE SYSTEMIC GAPS IN CARE BY EXPANDING COMMUNITY ACCESS AND NAVIGATION POINTS IN COLLABORATION WITH COMMUNITY PARTNERS. - EXPAND LANGUAGE AND PRACTICES THAT ARE SENSITIVE TO ISSUES LIKE SOCIAL DETERMINANTS OF HEALTH, RACISM AND LGBTQ+ DISCRIMINATION BY PROMOTING TRAUMA-INFORMED CARE (TIC). OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS: - REDUCE DISPARITIES IN LIFE EXPECTANCY WITHIN OUR SERVICE AREA. - INCREASE THE PERCENTAGE OF ADULTS WITH A ROUTINE CHECKUP IN THE PAST YEAR. - DECREASE THE AVERAGE SCORES OF THE COMMUNITY NEED INDEX, SOCIAL VULNERABILITY INDEX OR AREA DEPRIVATION INDEX.PROGRAM 1. COMMUNITY ACCESS POINTS - COLLABORATE WITH FORMAL AND INFORMAL COMMUNITY LEADERS TO FIND COMMUNITY ACCESS AND NAVIGATION POINTS TO ENHANCE HEALTH OUTREACH. SHORT TERM OBJECTIVES (YEAR 1)1. COLLABORATE TO CREATE AND MAINTAIN AN INVENTORY OF COMMUNITY HEALTH CARE ACCESS POINTS IN HIGHEST NEED AREAS, FOCUSING ON HEALTH NEEDS SPECIFIC TO COMMUNITY.2. UPLIFT PARTNERSHIP WITH UNITED WAY:- SUPPORT PROMOTION OF PA 211 PROGRAM.- RUN PSH UNITED WAY CAMPAIGN.- HIRE CONTACT TO CARE CHW TO IMPLEMENT CHW PROGRAM FOR PSH IN CUMBERLAND, DAUPHIN AND PERRY COUNTIES.MEDIUM-TERM OBJECTIVES (YEAR 2)1. MAINTAIN AND UPDATE INVENTORY OF COMMUNITY HEALTH CARE ACCESS AND NAVIGATION POINTS, AND INCREASE NUMBER OF COMMUNITY ACCESS POINTS BY 6 LOCATIONS/EVENTS.2. CONTINUE PARTNERSHIP WITH UNITED WAY:- CONTINUE SUPPORTING PROMOTION OF PA 211 PROGRAM.- RUN PSH UNITED WAY CAMPAIGN, INCREASING DONATIONS BY 3%.- DEVELOP PSH CONTACT TO CARE CHW PROGRAM FOR CUMBERLAND, PERRY AND DAUPHIN COUNTIES.LONG-TERM OBJECTIVES (YEAR 3) 1. MAINTAIN AND UPDATE INVENTORY OF COMMUNITY HEALTH CARE ACCESS AND NAVIGATION POINTS, INCREASE NUMBER OF COMMUNITY ACCESS POINTS BY 12 LOCATIONS/EVENTS AND ASSESS THE COMMUNITY IMPACT.2. CONTINUE PARTNERSHIP WITH UNITED WAY:- CONTINUE SUPPORTING PROMOTION OF PA 211.- RUN UNITED WAY CAMPAIGN, INCREASING EMPLOYEE CONTRIBUTIONS BY 3%.- ASSESS UNITED WAY CHW PROGRAM.PROGRAM 2. TRAUMA INFORMED COMMUNITIES - EXPAND TRAUMA-INFORMED AND HEALING-CENTERED PRACTICES ACROSS THE SERVICE AREA. SHORT TERM OBJECTIVES (YEAR 1)1. COLLABORATE TO CREATE AND MAINTAIN AN INVENTORY OF COMMUNITY ORGANIZATIONS ALREADY PROMOTING TRAUMA INFORMED PRACTICES.2. PARTNER WITH COMMUNITY ORGANIZATIONS TO IDENTIFY EXISTING TIC TRAINING OPTIONS FOR PSH STAFF.MEDIUM-TERM OBJECTIVES (YEAR 2)1. INCREASE PSH INVOLVEMENT IN STATEWIDE TRAUMA-INFORMED CARE WORK BY:- SERVING ON THREE TASK FORCES- EXPANDING OCCUPATIONAL THERAPY EDUCATION ON SENSORY NEEDS OF CHILDREN TO 2 COUNTIES2. IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS, OFFER 2 TIC TRAININGS TO PSH STAFF THAT ARE ALSO OPEN TO THE COMMUNITY TO PARTICIPATE.LONG-TERM OBJECTIVES (YEAR 3) 1. BEGIN TO EDUCATE AT THE STATE LEVEL ON HOW TO IMPLEMENT TRAUMA-INFORMED PROCESSES. 2. IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS, OFFER 2 TIC TRAININGS TO PSH STAFF THAT ARE ALSO OPEN TO THE COMMUNITY TO PARTICIPATE.PRIORITY 3) WELLNESS AND DISEASE PREVENTIONELEMENT 1. CHRONIC DISEASE AND RISK FACTOR PREVENTIONRESPONSIBLE PARTY: PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER, PENN STATE HEALTH HAMPDEN MEDICAL CENTER AND PENN STATE HEALTH REHABILITATION HOSPITALGOAL: IMPROVE CHRONIC DISEASE PREVENTION BY PROVIDING SCREENINGS AND EDUCATIONAL SESSIONS IN IDENTIFIED HIGH-NEED COMMUNITIES. OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS - INCREASE THE NUMBER OF HEALTH SCREENINGS PROVIDED IN HIGH-NEED COMMUNITY LOCATIONS THAT RESULT IN EDUCATION AND/OR REFERRALS FOR FOLLOW-UP CARE. - PARTICIPANTS SHOW IMPROVED KNOWLEDGE OF CHRONIC DISEASE RISK FACTOR PREVENTION AFTER EDUCATIONAL SESSIONS. - INCREASE THE PERCENTAGE OF FEMALE MEDICARE ENROLLEES AGES 65 TO 74 WHO RECEIVED AN ANNUAL MAMMOGRAPHY SCREENING.PROGRAM 1. COLLABORATE TO INCREASE OPPORTUNITIES FOR CHRONIC DISEASE EDUCATION AND SCREENINGS, WITH A FOCUS ON UNDERSERVED COMMUNITIES AS IDENTIFIED BY CHNA AND COMMITTEE INPUT.SHORT TERM OBJECTIVES (YEAR 1)1. COLLABORATE ON PROVIDING EDUCATION AND SCREENINGS AT 4 LARGE OPPORTUNITIES.- FORM AND HOLD REGULAR TASK FORCE MEETINGS TO ENHANCE COMMUNICATION BETWEEN PSH HOSPITALS AND COMMUNITY PARTNERS ACROSS THE 6-COUNTY REGION.- DEVELOP AND PROMOTE AN INVENTORY OF EVENTS, ACTIVITIES AND PROGRAMS ALREADY BEING OFFERED IN UNDERSERVED COMMUNITIES.- IDENTIFY GAPS AND DEVELOP ONE NEW OPPORTUNITY WHERE NEEDED.MEDIUM-TERM OBJECTIVES (YEAR 2)1. COLLABORATE ON PROVIDING EDUCATION AND SCREENINGS AT 6 LARGE OPPORTUNITIES.- SUMMARIZE AND EVALUATE COMMUNITY OPPORTUNITIES ATTENDED IN YEAR 1 TO DETERMINE BEST FIT FOR MEETING HIGH-NEED COMMUNITIES.LONG-TERM OBJECTIVES (YEAR 3) 1. COLLABORATE ON PROVIDING EDUCATION AND SCREENINGS AT 8 LARGE OPPORTUNITIES.- SUMMARIZE AND EVALUATE COMMUNITY OPPORTUNITIES ATTENDED IN YEAR 2 TO DETERMINE BEST FIT FOR MEETING HIGH-NEED COMMUNITIES.PROGRAM 2. EVALUATE EDUCATIONAL PROGRAMS TO DEMONSTRATE IMPROVED UNDERSTANDING OF CHRONIC DISEASE RISK FACTOR PREVENTION.SHORT TERM OBJECTIVES (YEAR 1)1. CREATE AN EVALUATION SURVEY TO IMPLEMENT AT EACH EDUCATIONAL PROGRAM.MEDIUM-TERM OBJECTIVES (YEAR 2)1. COLLABORATE WITH COMMUNITY PARTNERS TO OFFER 6 EDUCATIONAL SESSIONS, AND MEASURE IMPROVED UNDERSTANDING OF CHRONIC DISEASE RISK FACTOR PREVENTION.LONG-TERM OBJECTIVES (YEAR 3) 1. COLLABORATE WITH COMMUNITY PARTNERS TO OFFER 8 EDUCATIONAL SESSIONS, AND MEASURE IMPROVED UNDERSTANDING OF CHRONIC DISEASE RISK FACTOR PREVENTION.ELEMENT 2. NUTRITION AND FOOD ACCESSRESPONSIBLE PARTY: PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER AND PENN STATE HEALTH HAMPDEN MEDICAL CENTERGOAL: ADDRESS ISSUES RELATED TO OBESITY AND FOOD INSECURITY BY PROMOTING ACCESS TO AND CONSUMPTION OF HEALTHFUL DIETS, AND DETERMINE THE IMPACT OF NUTRITION EDUCATION AND IMPROVED ACCESS. OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS: - REDUCE OBESITY RATES IN BERKS, LEBANON AND DAUPHIN COUNTIES. - REDUCE THE PERCENTAGE OF RESIDENTS WITH LOW ACCESS TO FOOD IN BERKS, LEBANON AND DAUPHIN COUNTIES. - INCREASE THE REACH OF NUTRITION EDUCATION AND FOOD ACCESS TO RESIDENTS OF BERKS, CUMBERLAND, DAUPHIN, LANCASTER, LEBANON AND PERRY COUNTIES.PROGRAM 1. FOOD BUCKS / VEGGIE RX EXPANSION - EXPAND REACH OF NUTRITION AND FOOD ACCESS PROGRAMS.SHORT TERM OBJECTIVES (YEAR 1)1. BEGIN PROGRAM PLANNING AND DEVELOPMENT OF VEGGIE RX INTO LEBANON.- IDENTIFY KEY PARTNERS AND REQUIRED RESOURCES.- DETERMINE GOALS, OBJECTIVES AND MEASURABLE OUTCOMES.- DETERMINE REFERRAL PROCESS AND ELIGIBILITY.- CREATE NEEDS ASSESSMENT OF COMMUNITY PARTICIPANTS.2. ENGAGE AT LEAST 10,000 PARTICIPANTS ACROSS ALL NUTRITION AND FOOD ACCESS PROGRAMS (FOOD BOX INITIATIVE, COMMUNITY GARDEN, FARMERS MARKETS, WELLNESS ON WHEELS, FARM STAND, VEGGIE RX AND DOWNTOWN HEALTHY FOOD PANTRY).3. DEVELOP A PRE-/POST EVALUATION PLAN FOR NUTRITION EDUCATION FOR CURRENT VEGGIE RX PROGRAM.MEDIUM-TERM OBJECTIVES (YEAR 2)1. START NEW SITE LOCATION IN LEBANON.- ENROLLMENT OF 30 INDIVIDUALS AT NEW SITE LOCATION.- DETERMINE PROCESS-EVALUATION METHODS.- MONITOR PROGRESS TOWARD THE PROGRAM'S GOALS.2. ENGAGE AT LEAST 12,000 PARTICIPANTS ACROSS ALL NUTRITION AND FOOD ACCESS PROGRAMS (FOOD BOX INITIATIVE, COMMUNITY GARDEN, FARMERS MARKETS, WELLNESS ON WHEELS, FARM STAND, VEGGIE RX AND DOWNTOWN HEALTHY FOOD PANTRY).3. IMPLEMENT THE PRE-/POST-EVALUATION OF EDUCATIONAL OFFERINGS FOR PARTICIPANTS.LONG-TERM OBJECTIVES (YEAR 3) 1. ENROLL 40 INDIVIDUALS IN THE PROGRAM.- UTILIZE AN EVALUATION TOOL.- EXPAND THE NETWORK OF FOOD RETAIL PARTNERS.2. ENGAGE AT LEAST 14,000 PARTICIPANTS ACROSS ALL NUTRITION AND FOOD ACCESS PROGRAMS (FOOD BOX INITIATIVE, COMMUNITY GARDEN, FARMERS MARKETS, WELLNESS ON WHEELS, FARM STAND, VEGGIE RX AND DOWNTOWN HEALTHY FOOD PANTRY).3. EVALUATE THE PRE-/POST-DATA FOR NUTRITION EDUCATION.PROGRAM 2. REGIONAL COLLABORATIVE AND STANDARDIZED NUTRITION AND FOOD ACCESS RESOURCE GUIDE - DEVELOP A REGIONAL 6-COUNTY COLLABORATIVE TO INCREASE COMMUNICATION AND DEVELOP A NUTRITION/FOOD ACCESS RESOURCE GUIDE. SHORT TERM OBJECTIVES (YEAR 1)1. ESTABLISH A MEETING SCHEDULE FOR THE COLLABORATIVE AND IDENTIFY PARTNERS TO INCLUDE.2. IDENTIFY PROGRAMS THAT WILL BE INCLUDED IN THE RESOURCE GUIDE.- CATEGORIZE THE RESOURCE GUIDE BASED ON NEED AND COUNTY.- FINALIZE METHODS OF DISSEMINATION AND DISTRIBUTE THE RESOURCE GUIDE THROUGH AT LEAST 5 OUTLETS.MEDIUM-TERM OBJECTIVES (YEAR 2)1. MAINTAIN THE MEETING SCHEDULE FOR THE COLLABORATIVE.2. MAINTAIN AND DISTRIBUTE THE RESOURCE GUIDE THROUGH AT LEAST 10 COMMUNITY OPPORTUNITIES IN UNDERSERVED COMMUNITIES.

LONG-TERM OBJECTIVES (YEAR 3)
1. MAINTAIN THE MEETING SCHEDULE FOR THE COLLABORATIVE.- DEVELOP AND IMPLEMENT A POST-SURVEY TO ASSESS THE EFFECTIVENESS OF THE COLLABORATIVE.2. MAINTAIN AND DISTRIBUTE THE RESOURCE GUIDE THROUGH AT LEAST 15 COMMUNITY OPPORTUNITIES IN UNDERSERVED COMMUNITIES.PROGRAM 3. COMMUNITY GARDEN INITIATIVE - IMPROVE ACCESS TO FRUITS, VEGETABLES AND NUTRITION EDUCATION WITHIN THE SERVICE AREA.SHORT TERM OBJECTIVES (YEAR 1)1. PLANT AT LEAST 2 COMMUNITY/SENSORY GARDENS IN THE SERVICE AREA.- ENGAGE LOCAL PARTNERS AND COMMUNITY MEMBERS.- COMPLETE A FOOD INSECURITY SURVEY, IDENTIFYING BARRIERS TO ACCESSING FOOD.MEDIUM-TERM OBJECTIVES (YEAR 2)1. OFFER 3 NUTRITION AND GARDENING EDUCATION PROGRAMS AT COMMUNITY GARDENS.LONG-TERM OBJECTIVES (YEAR 3)1. OFFER 6 NUTRITION AND GARDENING EDUCATION PROGRAMS AT COMMUNITY GARDENS.ELEMENT 3. PHYSICAL ACTIVITYRESPONSIBLE PARTY: PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER, PENN STATE HEALTH HAMPDEN MEDICAL CENTER AND PENN STATE HEALTH REHABILITATION HOSPITALGOAL: IMPROVE HEALTH, FITNESS AND QUALITY OF LIFE THROUGH DAILY PHYSICAL ACTIVITY. OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS: - INCREASE THE NUMBER OF FREE EXERCISE OPPORTUNITIES FOR ALL AGES IN ZIP CODES IDENTIFIED BY OUR CHNA AND COMMUNITY PARTNERS AS HAVING THE GREATEST RISK FACTORS FOR POOR HEALTH. - REDUCE THE PERCENTAGE OF ADULTS WHO DO NOT ENGAGE IN LEISURE-TIME PHYSICAL ACTIVITY.PROGRAM 1. COMMUNITY PHYSICAL ACTIVITY PROGRAMS AND INFRASTRUCTURE - 1. COLLABORATE TO SHARE OPPORTUNITIES FOR SAFE, COMMUNITY EXERCISE PROGRAMS.2. ENHANCE POLICIES AND INFRASTRUCTURE TO INCREASE OPPORTUNITIES FOR PHYSICAL ACTIVITY.SHORT TERM OBJECTIVES (YEAR 1)1. CREATE AN INVENTORY OF FREE COMMUNITY EXERCISE PROGRAMS.2. JOIN COMMUNITY COLLABORATIVES ALREADY IN PLACE TO INCREASE PHYSICAL ACTIVITY.3. INVESTIGATE OPPORTUNITIES WITH LOCAL, COUNTY AND STATEWIDE PARKS AND RECREATION SYSTEMS IN ALL 6 COUNTIES; ESTABLISH A PARTNERSHIP WITH 1.4. INVESTIGATE OPPORTUNITIES TO FOSTER PHYSICAL ACTIVITY AT ALL PSH HOSPITAL LOCATIONS AND EXTENDING INTO LOCAL COMMUNITIES.5. COLLABORATE WITH 1 SCHOOL DISTRICT OR COMMUNITY ORGANIZATION TO IDENTIFY WAYS TO ENHANCE THE BUILT ENVIRONMENT FOR YOUTH PHYSICAL ACTIVITY.MEDIUM-TERM OBJECTIVES (YEAR 2)1. PROMOTE AND SHARE THE INVENTORY OF FREE COMMUNITY PROGRAMS THROUGH 5 OPPORTUNITIES.2. COLLABORATE ON ENHANCING 1 EXISTING COMMUNITY PHYSICAL ACTIVITY OPPORTUNITY IN 3 OF OUR 6 COUNTIES.3. ESTABLISH 1 ADDITIONAL PARTNERSHIP WITH A LOCAL, COUNTY OR STATEWIDE PARKS AND RECREATION SYSTEM.4. INCREASE/ENHANCE 2 OPPORTUNITIES FOR PHYSICAL ACTIVITY AT PSH HOSPITAL LOCATIONS AND EXTENDED INTO LOCAL COMMUNITIES.5. COLLABORATE WITH 1 ADDITIONAL SCHOOL DISTRICT OR COMMUNITY ORGANIZATION TO IDENTIFY WAYS TO ENHANCE THE BUILT ENVIRONMENT FOR YOUTH PHYSICAL ACTIVITYLONG-TERM OBJECTIVES (YEAR 3)1. PROMOTE AND SHARE THE INVENTORY OF FREE COMMUNITY PROGRAMS THROUGH 5 NEW OPPORTUNITIES.2. COLLABORATE ON ENHANCING ONE EXISTING COMMUNITY PHYSICAL ACTIVITY OPPORTUNITY IN ALL 6 OF OUR COUNTIES.3. ESTABLISH 1 ADDITIONAL PARTNERSHIP WITH A LOCAL, COUNTY OR STATEWIDE PARKS AND RECREATION SYSTEM.4. INCREASE/ENHANCE 2 OPPORTUNITIES FOR PHYSICAL ACTIVITY AT PSH HOSPITAL LOCATIONS AND EXTENDED INTO LOCAL COMMUNITIES.5. COLLABORATE WITH 1 ADDITIONAL SCHOOL DISTRICT OR COMMUNITY ORGANIZATION TO IDENTIFY WAYS TO ENHANCE THE BUILT ENVIRONMENT FOR YOUTH PHYSICAL ACTIVITY.

PART V, SECTION B, LINE 16
THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING WEBSITE: WWW.PENNSTATEHEALTH.ORG/PATIENTS-VISITORS/BILLING-MEDICAL-RECORDS/FINANCIAL-ASSISTANCESUPPLEMENTAL PART V INFORMATION:COMMUNITY GRANTS AND CHARITABLE PURPOSE SPONSORSHIPSIN ORDER TO ALSO PARTNER WITH COMMUNITY ORGANIZATIONS TO ADDRESS PRIORITIZED HEALTH NEEDS, GRANTS AND SPONSORSHIPS ARE PROVIDED ON AN ANNUAL BASES. CALENDAR YEAR 2022 IS THE SEVENTH YEAR OF THESE GRANTS AND, OVER THIS TIME FRAME, 94 PROJECT TEAMS WERE FUNDED BY $350,000. THIS SUCCESSFUL ENDEAVOR ENGAGES EMPLOYEES FROM ALL PSH HOSPITALS TO PARTNER WITH COMMUNITY ORGANIZATIONS TO START A PROGRAM ADDRESSING AT LEAST ONE OF THE HEALTH NEED PRIORITIES NAMED IN THE CHNA. PRIORITY IS GIVEN TO SUSTAINABLE START-UP PROJECTS THAT WILL HAVE A POSITIVE HEALTH IMPACT ON OUR COMMUNITY. APPLICATIONS MAY ALSO BE SUBMITTED TO SUPPORT PREEXISTING PROGRAMS AND CONTINUE THEIR EXCELLENT WORK. NOT ONLY DO THESE GRANTS PROVIDE LOCAL HEALTH PROGRAMMING, BUT THEY ALSO 1) ENGAGE EMPLOYEE TALENT IN COMMUNITY OUTREACH, 2) HELP DEVELOP AN ORGANIZATIONAL CULTURE OF COMMUNITY HEALTH IMPROVEMENT AND 3) PROVIDE OUR EMPLOYEES AND STUDENTS WITH THE OPPORTUNITY TO LEARN FROM COMMUNITY PARTNERS AND BETTER UNDERSTAND THE SOCIAL INFLUENCES ON HEALTH THAT EXIST OUTSIDE OF OUR HOSPITAL WALLS.

PRIOR CHNA IMPLEMENTATION PLAN
"ALSO DURING FY 2022, WHILE PSH WAS CONDUCTING THE NEXT CHNA AND DEVELOPING THE THREE YEAR PLAN, ALL HOSPITALS WERE ALSO CARRYING OUT THE THIRD YEAR OF THE CURRENT PLAN. A DESCRIPTION OF KEY ACCOMPLISHMENTS OF THIS PLAN, INCLUDING HIGHLIGHTS FROM THE THIRD YEAR (FY 2022) FOLLOWS.THE IMPLEMENTATION PLAN AND ANNUAL REPORT CARDS CAN BE FOUND AT: HTTPS://WWW.PENNSTATEHEALTH.ORG/COMMUNITY. THE FINDINGS OF THE 2018 CHNA IDENTIFIED THREE OVERARCHING PRIORITIES, AND EACH OF THESE HAD SUBCATEGORIES OF GOALS AND MEASUREABLE OBJECTIVES ESTABLISHED: 1) BEHAVIORAL HEALTH - MENTAL HEALTH AND SUBSTANCE USE DISORDER 2) HEALTH LIFESTYLES - NUTRITION, ORAL HEALTH, PHYSICAL ACTIVITY 3) DISEASE MANAGEMENT - CANCER, CARDIOVASCULAR DISEASE, DIABETES. ADDRESSING ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH WERE SEEN AS CROSSCUTTING STRATEGIES NEEDED TO IMPROVE OUTCOMES ACROSS ALL PRIORITY AREAS. THIS PLAN COVERED FIVE PENNSYLVANIA COUNTIES: BERKS, CUMBERLAND, DAUPHIN, LANCASTER AND LEBANON. THE THIRD YEAR OF THE PLAN WAS CARRIED OUT BY- PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER- PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER- PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER- PENNSYLVANIA PSYCHIATRIC INSTITUTE. IMPACT OVER THE THREE YEAR PLAN- AN AVERAGE OF 91% OF THE INDICATORS SET FOR THE THREE YEARS OF OUR CHNA IMPLEMENTATION PLAN WERE ACHIEVED THANKS TO THE EFFORTS OF OUR COMMUNITY PARTNERS, CHNA TASK FORCES AND COMMUNITY HEALTH TEAM- 40 COMMUNITY RELATIONS GRANTS VALUED AT $150,000 WERE AWARDED TO ADDRESS OUR PRIORITIES.- ABOUT 89,000 COMMUNITY MEMBERS WERE REACHED BY A VARIETY OF BEHAVIORAL HEALTH PROGRAMS INCLUDING MENTAL HEALTH TRAINING, DRUG TAKE BACK INITIATIVES, NARCAN EDUCATION AND DISTRIBUTION, MANDATED REPORTER TRAINING, AND COMMUNITY BASED TRAUMA-INFORMED CARE (TIC) TRAINING SESSIONS. SURVEY FINDINGS FROM THE TIC TRAININGS DEMONSTRATED THAT ATTENDEES HAD A BETTER UNDERSTANDING OF TIC AND SENSORY NEEDS IN CHILDREN AFTER PARTICIPATING. - 94,000 PEOPLE PARTICIPATED IN PHYSICAL ACTIVITY PROGRAMMING INCLUDING INITIATIVES TO IMPROVE WALKABILITY, A BIKE-SHARE PROGRAM, WALKING AND BIKING TRAILS AND SOCIAL WALKING AND SAFETY PROGRAMS, AS WELL AS A YOUTH TENNIS PROGRAM INITIATED IN UNDERSERVED COMMUNITIES.- PEDIATRIC TRAUMA AND INJURY PREVENTION USED COMMUNITY RELATIONS GRANT FUNDS TO ENGAGE WITH 16 LOCAL POLICE DEPARTMENTS AND PROVIDE 720 BIKE HELMETS TO PROMOTE BIKE SAFETY TO AVOID INJURY, AS WELL AS BRING COMMUNITIES TOGETHER. OFFICERS TOOK A SEVEN QUESTION PRE-TEST, COMPLETED A TRAINING (TRAIN THE TRAINER), THEN TOOK A SEVEN QUESTION POST-TEST. A STATISTICALLY SIGNIFICANT INCREASE IN KNOWLEDGE WAS SHOWN.- THE DENTAL OPERATORY OPENED AT HERSHEY MEDICAL CENTER, AND PLANNING HAS BEGUN TO INITIATE A DENTAL RESIDENCY PROGRAM. AN ORAL HEALTH RESOURCE WAS COLLABORATED ON WITH PA211.ORG, AND ORAL HEALTH MESSAGING FOCUSED ON BRUSHING TWICE PER DAY AND THE IMPORTANCE OF FLUORIDE. A PEDIATRIC ONGOING QUALITY STUDY HAS DEMONSTRATED THAT BRUSHING HABITS AND FLUORIDE USE HAVE IMPROVED. ST. JOSEPH MEDICAL CENTER WORKED WITH THE PENNSYLVANIA AREA HEALTH EDUCATION CENTER (AHEC) OFFICE AND ORAL HEALTH TASK FORCE TO UPDATE THE COMMUNITY HEALTH WORKER (CHW) TRAINING CURRICULUM TO INCLUDE EARLY CHILDHOOD ORAL HEALTH EDUCATION WITH AN ONLINE COMPONENT THAT IS PUBLICLY AVAILABLE.- 115,000 COMMUNITY MEMBERS ATTENDED SESSIONS TO LEARN HOW TO PREVENT AND MANAGE DISEASE THROUGH PREVENTION SCREENING, EDUCATION, NAVIGATION AND SUPPORT PROGRAMS FOCUSED ON CANCER, CARDIOVASCULAR DISEASES AND STROKE. THESE TEAMS COORDINATED EFFORTS TO ORGANIZE A COMMON MESSAGE BETWEEN DISEASE PROGRAMS AND OFFER THESE PROGRAMS IN HIGH-NEED COMMUNITIES.- COMMUNITY PARAMEDICINE REDUCED CHRONIC DISEASE READMISSIONS FOR HEART FAILURE AND STROKE PATIENTS AND EXPANDED THESE EFFORTS FROM HERSHEY MEDICAL CENTER TO ST. JOSEPH MEDICAL CENTER. OUR CHW PROGRAMS AND TRAINING INSTITUTE AND PATIENT NAVIGATION PROGRAM ALSO IMPROVED ACCESS TO CARE AND IMPORTANT COMMUNITY SERVICES.- THE ""LET'S GET EDUCATED AGAINST CANCER"" SPANISH MONTHLY WEBINAR SERIES WAS INITIATED IN PARTNERSHIP WITH THE SPANISH AMERICAN CIVIC ASSOCIATION (SACA).- OVER 152,000 PEOPLE BENEFITED FROM PENN STATE HEALTH NUTRITION AND FOOD OUTREACH SERVICES AT OVER 40 COMMUNITY LOCATIONS. - ACCORDING TO COUNTY HEALTH RANKINGS (COUNTYHEALTHRANKINGS.ORG), THE PERCENT OF PERSONS WHO LACK ADEQUATE ACCESS TO FOOD IMPROVED OVER THE THREE YEARS OF THIS PLAN. ALL FIVE OF OUR COUNTIES (BERKS, CUMBERLAND, DAUPHIN, LANCASTER AND LEBANON) ARE PERFORMING BETTER THAN THE REST OF PA. THREE OF THESE COUNTIES (BERKS, CUMBERLAND AND DAUPHIN) HAVE SCORES BETTER THAN TOP PERFORMERS IN THE USA.PRIORITY SPOTLIGHT - NUTRITION AND FOOD ACCESSPENN STATE HEALTH (PSH) HAS A LONG COMMITMENT TO IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITY, BUT IT IS IMPOSSIBLE TO BE TRULY HEALTHY IF OUR COMMUNITY IS NOT ABLE TO ACCESS FOOD. IT IS WELL KNOWN THAT FOOD INSECURITY IS LINKED TO TOXIC STRESS AND POOR HEALTH OUTCOMES. PSH HAS PARTNERED CLOSELY WITH COMMUNITY ORGANIZATIONS TO ADDRESS FOOD ACCESS NEEDS THROUGH A VARIETY OF PROGRAMS THAT HAVE EVOLVED OVER THE YEARS, INCLUDING ADAPTING DURING THE COVID-19 PANDEMIC. PROGRAMS FOCUS ON NOT ONLY IMPROVING FOOD ACCESS BUT OFFERING MORE HEALTHY FOOD OPTIONS AND EDUCATION.INITIALLY, THE FARMERS MARKET IN HERSHEY AND COMMUNITY GARDEN WERE DEVELOPED ON OUR HERSHEY CAMPUS. THESE INITIATIVES HAVE EXPANDED TO TAKE FRESH FRUITS AND VEGETABLES, FLOWERS AND HONEY TO HARD TO REACH LOCATIONS IN OUR COMMUNITY. IN 2015, PSH INITIATED PANTRIES AND WELLNESS SUPPORT (PAWS) IN PARTNERSHIP WITH TWO COMMUNITY BASED FOOD PANTRIES. PAWS COMMUNITY HEALTH NURSES NOW PROVIDE HEALTH EDUCATION, CARDIOVASCULAR SCREENING AND SUPPLEMENTAL PRODUCE AT 12 DIFFERENT LOCATIONS. THESE COMMUNITY ACCESS POINTS ARE SO IMPORTANT SINCE MANY PARTICIPANTS FACE BARRIERS TO SEEKING PREVENTIVE HEALTH SCREENINGS ELSEWHERE. THIS INITIATIVE HAS PROVEN INCREDIBLY SUCCESSFUL IN MANY WAYS INCLUDING REDUCING BLOOD PRESSURES AT MULTIPLE LOCATIONS.ST. JOSEPH MEDICAL CENTER IN BERKS COUNTY OFFERS A WEEKLY FARM STAND AT THE DOWNTOWN CAMPUS. THE FARM STAND BRINGS FRESH PRODUCE INTO AN AREA WITH LOW FOOD ACCESS AND IS A REDEMPTION SPOT FOR FARMERS MARKET NUTRITION PROGRAM VOUCHERS. IT MOVED OUTSIDE TO CONTINUE DURING THE PANDEMIC. HEALTH EDUCATION AND COMMUNITY NURSING IS ALSO OFFERED ON LOCATION, AND THE STAND HAS SERVED OVER 9,200 VISITORS IN THREE YEARS. THE VEGGIE RX PROGRAM EMERGED TO COMPLIMENT THE FARM STAND. PARTICIPANTS WITH A DIAGNOSIS OF DIABETES RECEIVE IN DEPTH EDUCATION AND FARM BUCKS REDEEMABLE AT THE STAND WITH AN ALMOST 80% REDEMPTION RATE. BOTH OF THESE PROGRAMS HAVE BEEN SO SUCCESSFUL THAT THEY ARE BEING REPLICATED IN ADDITIONAL COUNTIESPSH OFFERS AN EMERGENCY FOOD BOX PROGRAM AT MULTIPLE CLINIC SITES. PATIENTS ARE SCREENED FOR FOOD INSECURITY AT THEIR VISIT, AND IF THEY ARE FOOD INSECURE, THEY ARE OFFERED FOOD BOXES THAT INCLUDE NUTRITIONALLY DENSE SHELF STABLE PRODUCTS TO PROVIDE FOR THEIR FAMILY FOR THREE DAYS. FAMILIES ARE THEN CONNECTED WITH A SOCIAL WORKER WHO WILL CONNECT THEM TO A LONG-TERM, SUSTAINABLE FOOD SOURCE. THIS PROGRAM HAS PIVOTED TO ALSO OFFER FOOD COUPONS REDEEMABLE AT LOCAL GROCERY STORES, PRODUCE DISTRIBUTION AND COMMUNITY REFRIGERATORS AT COMMUNITY CENTERS AND FREE CLINICS, INCLUDING OUR HOLY SPIRIT MEDICAL CENTER OUTREACH CLINIC IN ALLISON HILL, HARRISBURG.PSH IS ALSO FINDING WAYS TO GROW FOOD DIRECTLY IN SEVEN COMMUNITIES MOST IN NEED. IN APRIL OF 2022, PSH PARTNERED WITH RITE AID HEALTHY FUTURES TO CONSTRUCT THEIR FIRST COMMUNITY GARDEN IN LEBANON COUNTY. LOCATED AT THE CHESTNUT STREET COMMUNITY CENTER, THIS GARDEN IS ACROSS THE STREET FROM HARDING ELEMENTARY SCHOOL. NEAR A SCHOOL AND COMMUNITY CENTER IS CRITICAL SINCE OUR CHNA IDENTIFIED THAT JUST OVER 14% OF CHILDREN IN LEBANON COUNTY WORRIED ABOUT RUNNING OUT OF FOOD. THE GARDEN IS A PLACE WHERE FAMILIES CAN HARVEST RADISHES, KALE, LETTUCE, CUCUMBERS, ONIONS AND OTHER PRODUCE. ADDITIONALLY, IT IS A PLACE TO BRING THE COMMUNITY TOGETHER.PSH IS COMMITTED TO FURTHER EXPANDING PROGRAMS TO MEET OUR COMMUNITY'S FOOD ACCESS AND NUTRITION NEEDS BY PARTNERING WITH COMMUNITY ORGANIZATIONS TO MAKE THIS POSSIBLE TOGETHER, AND ULTIMATELY REACH THE LARGER GOAL OF ELIMINATING HUNGER."

COVID-19 RESPONSE
"ALTHOUGH COVID-19 CHANGED MANY OF OUR PLANS, WE WERE ABLE TO QUICKLY ADAPT TO THE PANDEMIC AND SERVE OUR COMMUNITY IN OTHER WAYS NEEDED, SUCH AS WITH INCREASING ACCESS TO COMMUNITY COVID-19 VACCINES THROUGH POP-UP SITES AND TRANSPORTATION VOUCHERS, EMPLOYEE FOOD PANTRIES AND COLLABORATING WITH THE CARING CUPBOARD FOOD PANTRY TO SUPPORT FOOD DELIVERY TO COVID-POSITIVE PATIENTS. ADDITIONAL INITIATIVES INCLUDED AN OUTDOOR FARM STAND IN DOWNTOWN READING THAT ALSO DISTRIBUTED ""COVID RELIEF BUCKS"" THE FORM OF $2 IN BERKS FARM BUCKS (VOUCHERS) TO EVERY SHOPPER, THE ONDEMAND COVID-19 SCREENING APP, DRIVE-THRU TESTING, COMMUNITY DONATION CENTER, CONTACT TRACING, NURSING HOME SUPPORT AND RADIO/TV EDUCATIONAL SESSIONS. THE COVID-19 ONDEMAND APP IS PROVIDED AS A FREE COMMUNITY BENEFIT TO INCREASE ACCESS TO SCREENING, TESTING AND CONTACT TRACING AND REACHED OVER 13,000 PEOPLE DURING THE PANDEMIC. A FOCUS GROUP WAS HELD WITH COMMUNITY PARTNERS TO ASSESS THE INTEREST IN COVID-19 VACCINATIONS, HESITANCY CONCERNS AND COMMUNITY LOCATIONS WHERE THEY SHOULD BE OFFERED. AS A RESULT, COVID-19 VACCINE POP-UP EVENTS WERE HELD IN 46 UNDERSERVED COMMUNITIES, THUS TAKING ALMOST 10,000 DOSES OF THIS IMPORTANT INTERVENTION TO COMMUNITY MEMBERS WHO, FOR MANY REASONS, MAY NOT HAVE BEEN ABLE TO RECEIVE THEIR VACCINATION."

PART I, LINE 6A:
"COMMUNITY BENEFIT REPORT: ST. JOSEPH REGIONAL HEALTH NETWORK PREPARES A FORM OF A COMMUNITY BENEFIT REPORT (""REPORT CARD"") AND MAKES IT AVAILABLE TO THE PUBLIC."

PART I, LINE 7:
COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE: A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. BASED ON THAT FORMULA, ($72,895,917/$302,598,243) RESULTS IN A 24.1% COST-TO-CHARGE RATIO.

PART I, LINE 7G:
SUBSIDIZED HEALTH SERVICES: THERE ARE NO PHYSICIAN PRACTICES INCLUDED IN SUBSIDIZED HEALTH SERVICES.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY BUILDING ACTIVITIES: EACH HOSPITAL WITHIN THE PENN STATE HEALTH SYSTEM ENGAGED IN ACTIVITIES TO PROTECT AND IMPROVE EACH OF ITS COMMUNITY'S HEALTH AND SAFETY. OVERALL FOR FY2022, THE PENN STATE HEALTH SYSTEM SERVED 875,682 COMMUNITY MEMBERS WITH 131,858 EMPLOYEE HOURS AND 83,216 VOLUNTEER HOURS, RESULTING IN $6,309,659 IN COMMUNITY HEALTH SERVICES PROVIDED TO THE COMMUNITIES. A PORTION OF THE COMMUNITY HEALTH IMPROVEMENT SERVICES IS PRESENTED IN PART I, LINE 7 AND THE REMAINDER IS PRESENTED IN PART II, ALONG WITH OTHER CATEGORIES OF INFORMATION IN PART II SUCH AS ECONOMIC DEVELOPMENT AND OTHER.

PART III, LINE 2:
THE INITIAL IMPLICIT PRICE CONCESSIONS (BAD DEBT) RESERVE IS DETERMINED BASED ON THE DIFFERENCE BETWEEN THE 18 MONTH AND THE 6 MONTH ZERO BALANCE CLAIMS RATE. IF A NEGATIVE IMPLICIT RATE IS CALCULATED, NO IMPLICIT RATE IS APPLIED BASED ON THE RESULTS OF THE PRIOR YEAR LOOKBACK. ADDITIONAL IMPLICIT PRICE CONCESSION ESTIMATES ARE CONSIDERED TO ACCOUNT FOR (1) SELF-PAY AFTER INSURANCE BALANCES THAT HAVE NOT YET TRANSFERRED FROM AN INSURANCE BALANCE TO PATIENT BALANCE DUE TO TIMING OF THE REVENUE CYCLE PROCESS, AND (2) UNCOLLECTIBLE AMOUNTS THAT OCCUR ON A PATIENT ACCOUNT GREATER THAN 18 MONTHS.

PART III, LINE 3:
PATIENTS' ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND ARE RECLASSIFIED TO CHARITY CARE (100% DISCOUNTED CARE) WHENEVER A PATIENT BECOMES ELIGIBLE UNDER THE HOSPITAL'S UNCOMPENSATED OR CHARITY CARE POLICY.

PART III, LINE 4:
PAGE 12, FOOTNOTE FOR NET PATIENT SERVICE REVENUE

PART III, LINE 8:
"THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND THE COST OF BAD DEBT ARE COMMUNITY BENEFIT AND SHOULD BE INCLUDED ON FORM 990, SCHEDULE H, PART I. THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND IS CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER THE INTERNAL REVENUE CODE (""IRC"") 501(C)(3). SATISFYING THE ""COMMUNITY BENEFIT STANDARD,"" AS ARTICULATED BY THE INTERNAL REVENUE SERVICE (IRS) IN REVENUE RULING 69-545, IS CURRENTLY REQUIRED FOR A HOSPITAL TO BE RECOGNIZED AS A CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE (IRC) 501(C)(3). AS DEVELOPED IN REVENUE RULING 69-545, UNDER THE COMMUNITY BENEFIT STANDARD, HOSPITALS WERE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS ""PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY"" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO THOSE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER FACTORS THAT DEMONSTRATED COMMUNITY BENEFIT INCLUDED: SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND FACILITIES AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; AND IT WAS CONTROLLED BY A BOARD OF DIRECTORS THAT CONSISTED OF INDEPENDENT CIVIC LEADERS.PENNSYLVANIA REQUIRES NON-PROFIT HOSPITALS TO PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT TO RETAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO STATE GUIDANCE AND CASE LAW, THE UNREIMBURSED COST OF MEDICARE AND BAD DEBT IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES."

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THE MEDICAL CENTER'S DEBT COLLECTION POLICY PROVIDES THAT THE MEDICAL CENTER WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT FOR TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE MEDICAL CENTER'S COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE MEDICAL CENTER COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO THE MEDICAL CENTER FOR APPROPRIATE FOLLOW-UP. THE MEDICAL CENTER REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE.THE MEDICAL CENTER'S CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS: - NEITHER THE MEDICAL CENTER NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; - NEITHER THE MEDICAL CENTER NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; - NO COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL.FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE MEDICAL CENTER'S MISSION, CORE VALUES AND STANDARD OF CONDUCT TO MAKE SURE ALL PATIENTS ARE TREATED WITH DIGNITY AND RESPECT.

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COMMUNITY HEALTH NEEDS ASSESSMENT:SEE CHNA INFORMATION ABOVE. OCCASIONALLY ADDITIONAL ASSESSMENTS ARE CONDUCTED BY DISEASE SPECIFIC DEPARTMENTS, INSTITUTES, AND PROGRAMS.

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COMMUNITY INFORMATIONTHE SERVICE AREA DEFINED FOR PURPOSES OF THE CHNA ENCOMPASSES 225 ZIP CODES IN SIX PENNSYLVANIA COUNTIES: BERKS, CUMBERLAND, DAUPHIN, LANCASTER, LEBANON AND PERRY. THESE SIX FOCUS COUNTIES REPRESENT THE COMMUNITY WHERE HEALTH CARE RESOURCES ARE AVAILABLE AND PROVIDED BY THE PARTNERING PENN STATE HEALTH ORGANIZATIONS. THE COUNTIES ARE ALSO HOME TO THE MAJORITY OF PENN STATE HEALTH'S PATIENT POPULATION. TOTAL POPULATION OF THESE SIX COUNTIES: 1,707,543. FOR ADDITIONAL DEMOGRAPHIC INFORMATION SEE FULL CHNA REPORT PAGE 2 AND STARTING ON PAGE 33.

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AFFILIATED HEALTH CARE SYSTEMST. JOSEPH REGIONAL HEALTH NETWORK IS A MEMBER OF THE PENN STATE HEALTH SYSTEM. EACH HOSPITAL IN THE SYSTEM HAS A ROLE IN ADDRESSING COMMUNITY HEALTH NEEDS; THESE ROLES ARE DISCUSSED IN THE CHNA AND THE IMPLEMENTATION PLAN. ADDITIONALLY, WE ENCOURAGE READING EACH HOSPITAL'S OWN FEDERAL FORM 990, SCHEDULE H TO HEAR MORE ABOUT PROGRAMS OFFERED IN ITS COMMUNITIES.

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PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEWE BELIEVE THAT RECEIVING HEALTHCARE IS A BASIC HUMAN RIGHT. ST. JOSEPH PARTICIPATES IN THE WIDEST NUMBER OF INSURANCE PROGRAMS OF THE HOSPITALS IN THE REGION. WE REALIZE THAT MANY PEOPLE EITHER CANNOT AFFORD HEALTH INSURANCE OR DO NOT HAVE ENOUGH INSURANCE TO COVER THEIR BILLS. THOSE ARE THE REASONS FOR OUR PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROGRAM, WHICH IS PUBLICLY POSTED ON THE HOSPITAL WEBSITE: HTTPS://WWW.PENNSTATEHEALTH.ORG/PATIENTS-VISITORS/BILLING-MEDICAL-RECORDS/FINANCIAL-ASSISTANCE. A PRICE ESTIMATOR ALSO WAS ADDED IN ORDER TO FURTHER CREATE PRICE AND COST TRANSPARENCY.WE UNDERSTAND THAT THE NEED FOR HEALTH CARE AND HOSPITAL SERVICES IS OFTEN UNPLANNED, AND SOME PATIENTS MAY NOT HAVE SUFFICIENT INSURANCE, OR MAY BE UNABLE TO PAY THEIR ENTIRE BILL RIGHT AWAY. WE ASSURE PATIENTS THAT ADMISSION TO PENN STATE HEALTH ST. JOSEPH IS A MEDICAL, NOT A FINANCIAL, DECISION. FOR THOSE WHO NEED TO TAKE ADVANTAGE OF OUR FINANCIAL ASSISTANCE PROGRAMS, WE PROVIDE THE NECESSARY ASSISTANCE IN COMPLETING APPLICATIONS THAT HELP TO DETERMINE ELIGIBILITY FOR FEDERAL, STATE OR COUNTY GOVERNMENT HEALTH CARE ASSISTANCE. WE ALSO OFFER PENN STATE HEALTH ST. JOSEPH'S OWN ASSISTANCE PLAN THAT CAN PAY ALL OR A SIGNIFICANT PORTION OF HOSPITAL BILLS.

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PROMOTION OF COMMUNITY HEALTHPENN STATE HEALTH HAS COMPLETED FIVE CYCLES OF COMMUNITY HEALTH NEEDS ASSESSMENTS AND HAS ESTABLISHED A LONG LEGACY OF COMMUNITY HEALTH PROGRAMMING. MANY PROGRAMS IDENTIFIED IN OUR CURRENT PLAN WILL CARRY FORWARD INTO THE NEW PLAN AND BE FURTHER DEVELOPED AND ENHANCED; INCLUDING THOSE COLLABORATED ON WITH MANY PROGRAMS AND PROJECTS WITHIN THE PENN STATE COLLEGE OF MEDICINE: - PENN STATE CANCER INSTITUTE CANCER NAVIGATION AND SURVIVORSHIP NETWORK - PENN STATE ADDICTION CENTER FOR TRANSLATION - PENN STATE CENTER FOR THE PROTECTION OF CHILDREN - PENN STATE REACH (RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH) PROGRAM - PENN STATE PRO WELLNESS - PENN STATE PROJECT ECHO (EXTENSION FOR COMMUNITY HEALTHCARE OUTCOMES) - BAND TOGETHER, STRENGTH TRAINING PROGRAM - MEDICAL STUDENT PROGRAMS, INCLUDING THE HEALTH SYSTEMS SCIENCE PATIENT NAVIGATION AND CULINARY MEDICINE COURSES AND THE STUDENT-RUN AND COLLABORATIVE OUTREACH PROGRAM FOR HEALTH EQUITY (SCOPE). - PENN STATE HEALTH OFFICE FOR DIVERSITY, EQUITY AND INCLUSION PIPELINE PROGRAMS - PENN STATE COLLEGE OF MEDICINE DEPARTMENT OF PUBLIC HEALTH SCIENCES - COMMUNITY HEALTH EQUITY & ENGAGEMENT IN RESEARCH (CHEER) PROGRAM - PENN STATE COLLEGE OF NURSING - ASERT COMMUNITY OUTREACH - BAND TOGETHERSPECIFIC COMMUNITY HEALTH PROGRAMMING EXECUTED ON BY PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER IS AS FOLLOWS:- THE BERKS COUNTY VEGGIE RX PROGRAM HAS BEEN SO SUCCESSFUL, IT WILL BE EXPANDED INTO LEBANON AND LANCASTER COUNTIES; AND THE FARMSTAND WILL CONTINUE AT THE DOWNTOWN CENTER IN READING. ADDITIONAL COMMUNITY PROGRAMS: - COMMUNITY HEALTH WORKER TRAINING INSTITUTE- BREAST HEALTH SCREENING PROGRAMS- CHRONIC CONDITIONS SUPPORT GROUP- DIABETES MANAGEMENT COMMUNITY OUTREACH- DRUG SAFETY PROGRAM - COMMUNITY HEALTH FAIRS AND CULTURAL EVENTS- COMMUNITY PARAMEDICINE- READING YOUTH VIOLENCE PREVENTION PROGRAM- WALK WITH A DOC- DISEASE SPECIFIC AND BEREAVEMENT SUPPORT GROUPS- BLOOD DRIVES- CANCER EDUCATION AND SUPPORT SERVICES / GROUPS- UNITED WAY CAMPAIGN, UNITED WAY DAY OF CARING AND STUFF THE BUS EVENT- STUDENT SHADOWING AND EDUCATION SOCIAL WORKERS, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, RESPIRATORY THERAPY, NURSING, RADIOLOGY/DIAGNOSTIC, ETC.- COMMUNITY BUILDING / DIVERSE BUSINESS PROGRAM - ANGEL TREE GIVING PROGRAM - PROJECT SEARCH

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COMMUNITY BENEFIT REPORT STATE FILINGSNOT APPLICABLESUPPLEMENTAL INFORMATION:THROUGHOUT THESE NARRATIVES, ST. JOSEPH REGIONAL HEALTH NETWORK IS ALSO KNOWN AS: PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER AND ST. JOSEPH MEDICAL CENTER.