4A (Expenses $ 5051253037 including grants of $ 21558631) (Revenue $ 8922531425)
SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE HEALTH CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES: - PROVIDENCE ACROSS SEVEN WESTERN STATES - COVENANT HEALTH IN WEST TEXAS - PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA- HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA- KADLEC IN SOUTHEAST WASHINGTON - PACIFIC MEDICAL CENTERS IN SEATTLE, WA. - SWEDISH HEALTH SERVICES IN SEATTLE, WA. 2021 WAS MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT ENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSOVER THE LAST TWO YEARS, PROVIDENCE ADVANCED A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION, AND ENVIRONMENTAL STEWARDSHIP. WE UPDATED OUR INTEGRATED STRATEGIC & FINANCIAL PLAN TO MORE CLEARLY EXPRESS OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. IN 2021, OUR SUSTAINABLE AND INCLUSIVE PURCHASING PROGRAM COMMITTED TO INCREASE OUR SPEND WITH WOMEN AND MINORITY OWNED BUSINESS ENTERPRISES BY OVER $300 MILLION ACROSS THE NEXT FIVE YEARS. WE ALSO DEPLOY AN INVESTING PORTFOLIO WHICH INCLUDES SHAREHOLDER ADVOCACY, IMPACT INVESTING, AND SOCIALLY CONSCIOUS PORTFOLIO SCREENS. IN 2021, PROVIDENCE MADE PROGRESS TOWARDS ITS CLIMATE COMMITMENT TO BECOME CARBON NEGATIVE BY 2030. WE ARE IMPLEMENTING AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL. 2021 PROGRAM SERVICE ACCOMPLISHMENTSIN 2021, PROVIDENCE WASHINGTON AND PROVIDENCE ALASKA CONTINUED THE TRADITION OF COMPASSION AND DEDICATION TO OUR COMMUNITIES BY INVESTING TO ADDRESS COMMUNITY NEED. THE FOLLOWING ARE HIGHLIGHTED ACCOMPLISHMENTS IN 2021.PARTNERSHIPS AND INVESTMENTS DRIVE PROGRESS TOWARD HOUSING AND BEHAVIORAL HEALTH SOLUTIONS, ACCESS TO CARE, AND HEALTH EQUITY:IN SOUTHWEST WASHINGTON (THURSTON AND LEWIS COUNTIES), CRITICAL PARTNERSHIPS, PROJECTS, AND PROGRAMS ARE SUPPORTED BY RESOURCES FROM PROVIDENCE ST. PETER AND PROVIDENCE CENTRALIA HOSPITALS, AS WELL AS A VARIETY OF OTHER PROVIDENCE FUNDING SOURCES, SUCH AS PROVIDENCE SYSTEM COMMUNITY HEALTH INVESTMENT AND THE ST. JOSEPH COMMUNITY PARTNERSHIP FUND (SJCPF).THE REST PROGRAM (RESTORATIVE EXPERIENCE FOR A SAFER TRANSITION) IS A FLAGSHIP PARTNERSHIP BETWEEM PROVIDENCE AND INTERFAITH WORKS IN OLYMPIA, OFFERING A SAFE, HEALING ENVIRONMENT FOR UNHOUSED INDIVIDUALS WHO ARE DISCHARGING FROM PROVIDENCE ST. PETER HOSPITAL. IT PROVIDES A STREAMLINED, COST-EFFECTIVE SOLUTION TO THE NEED FOR COMPREHENSIVE SUPPORTIVE RECOVERY SPACE, AS WELL AS ON-SITE COORDINATION OF SUPPORT SERVICES TO SET UP THESE PATIENTS FOR SUCCESS. IN ADDITION TO LOCAL HOSPITAL FUNDING, INTERFAITH HAS RECEIVED A SJCPF CAPACITY-BUILDING GRANT FOR THIS PROGRAM.THE PROVIDENCE COMMUNITY CARE CENTER (PCCC) PROVIDES INTEGRATED CARE TO VULNERABLE PEOPLE THROUGH COMPASSIONATE SERVICE IN A SAFE ENVIRONMENT. THE PCCC RESPONDS TO THE NEEDS OF MARGINALIZED AND UNDERSERVED INDIVIDUALS AND WORKS TO ENSURE THOSE NEEDS ARE MET. ON-SITE IN DOWNTOWN OLYMPIA, PROVIDENCE PROVIDES BEHAVIORAL HEALTH SERVICES, INCLUDING SHORT-TERM CASE MANAGEMENT AND THERAPY AND PSYCHIATRIC BRIDGE-MEDICATION MANAGEMENT. COMMUNITY PARTNERS, INCLUDING THE OLYMPIA FREE CLINIC AND THE CITY OF OLYMPIA'S CRISIS RESPONSE UNIT (CRU), PROVIDE CARE AND SERVICES AT THE PCCC AS WELL. A PROVIDENCE NURSE IS ALSO EMBEDDED WITHIN THE CRU TO HELP THE PROGRAM PROVIDE A HOLISTIC, COMPREHENSIVE RESPONSE TO VULNERABLE INDIVIDUALS EXPERIENCING CRISES IN OLYMPIA.THE OLYMPIA FREE CLINIC (TOFC) PROVIDES LOW-BARRIER HEALTH CARE SERVICES TO ADULTS WHO EXPERIENCE DIFFICULTIES ACCESSING MAINSTREAM HEALTH CARE SERVICES. THESE BARRIERS INCLUDE HOMELESSNESS, LANGUAGE, FINANCIAL, INSURANCE STATUS, CITIZENSHIP AND IMMIGRATION STATUS, SOCIOECONOMIC FACTORS, TRANSPORTATION, MOBILITY, AND SOCIAL STIGMA, AMONG OTHERS. IN ADDITION TO PROVIDING SERVICES AT THE PROVIDENCE COMMUNITY CARE CENTER, TOFC INSTITUTED A WEEKLY MOBILE CLINIC THAT UTILIZES A POP-UP TENT TO PROVIDE ON-SITE MEDICAL AND COVID-19 VACCINATION SERVICES AT VARIOUS HOMELESS ENCAMPMENTS THROUGHOUT THURSTON COUNTY. PROVIDENCE FUNDING SUPPORTS ONGOING EFFORTS TO PROVIDE ACCESS TO HEALTH CARE SERVICES FOR UNDERSERVED COMMUNITY MEMBERS, PARTICULARLY THOSE WHO ARE UNINSURED, AS WELL AS EFFORTS TO ADD MENTAL HEALTH CARE TO THE SUITE OF SERVICES AVAILABLE IN TOFC'S ENCAMPMENT CLINICS.A PARTNERSHIP BETWEEN CATHOLIC COMMUNITY SERVICES AND THE CITY OF OLYMPIA, THE MITIGATION SITE (NOW KNOWN AS QUINCE STREET VILLAGE) IS A TEMPORARY, LEGAL CAMPING SITE THAT PROVIDES A LEVEL OF ORDER, SAFETY, DIGNITY, AND CLEANLINESS. PROVIDENCE FUNDING HAS SUPPORTED THE BUILDING AND FURNISHING OF MICRO-HOMES, INCLUDING SHELTERS, BEDS, AND MATTRESSES.IN THURSTON AND LEWIS COUNTIES, WASHINGTON, COMMUNITY YOUTH SERVICES EMPOWERS YOUTH AT-RISK AND THEIR FAMILIES TO MEET THEIR GOALS FOR SAFETY, STABILITY, BELONGING AND SUCCESS BY PROVIDING A CONTINUUM OF INDIVIDUALIZED SERVICES AND ADVOCACY. IT SERVES AS THURSTON COUNTY'S COORDINATED ENTRY AGENCY FOR UNACCOMPANIED HOMELESS YOUTH AGED 12-24. PROVIDENCE INVESTMENTS SUPPORT A VARIETY OF SERVICES AND, IN PARTICULAR, ROSIE'S PLACE YOUTH RESOURCE CENTER AND YOUNG ADULT SHELTER. FUNDING HELPS MEET BASIC NEEDS AMONG YOUTH SERVED AT ROSIE'S BY PROVIDING NUTRITIOUS MEALS AND PROVIDING VITAL SURVIVAL GEAR (SUCH AS FIRST AID SUPPLIES, HAND WARMERS, EMERGENCY BLANKETS). THESE FOOD AND EMERGENCY SUPPLIES HELP ENSURE YOUTH ARE NOT JUST RECEIVING TEMPORARY SHELTER BUT TOOLS THAT SUPPORT THEIR ABILITY TO REMAIN STABLE AND SELF-SUFFICIENT ONCE THEY RETURN TO THE COMMUNITY.THE FAMILY SUPPORT CENTER OF SOUTH SOUND (FSC) IN LEWIS AND THURSTON COUNTIES, WASHINGTON, SERVES AS THURSTON COUNTY'S COORDINATED ENTRY POINT FOR ALL HOMELESS FAMILIES WITH CHILDREN AND SURVIVORS OF DOMESTIC VIOLENCE WHO ARE IN NEED OF HOUSING ASSISTANCE. FAMILIES AND SURVIVORS GAIN ACCESS TO MENTAL HEALTH SERVICES, CIVIL LEGAL ASSISTANCE, HEALTH CARE ENROLLMENT, EARLY LEARNING AND INTERVENTION PROGRAMS, HUMAN TRAFFICKING SERVICES, AND MORE. STAFF COMPLETE TARGETED OUTREACH, PROVIDING HOMELESS PREVENTION SERVICES TO THE HISPANIC AND TRIBAL COMMUNITIES, WHICH LOCAL DATA DEMONSTRATES ARE THE MOST DISPROPORTIONATELY REPRESENTED IN THURSTON COUNTY'S HOMELESS HOUSING SYSTEM. PROVIDENCE FUNDING SUPPORTS A VARIETY OF SERVICES AND PROGRAMS, INCLUDING PEAR BLOSSOM PLACE, THE REGION'S LARGEST 24/7 FAMILY SHELTER. IN ADDITION TO 36 YEAR-ROUND SHELTER BEDS, WITH AN OPEN-ENDED STAY, THERE ARE SEVEN PERMANENT SUPPORTIVE APARTMENTS ON SITE. THERE ARE ONSITE CHILDREN'S PLAY AREAS, A COMMUNITY LIVING ROOM, LAUNDRY FACILITIES, AND 24/HOUR ONSITE SUPPORT FROM STAFF AND VOLUNTEERS.PROVIDENCE FUNDS THE LEWIS COUNTY GOSPEL MISSION, WHICH HELPS MEET THE MENTAL AND PHYSICAL NEEDS OF THOSE EXPERIENCING HOMELESSNESS AND THOSE WITH MENTAL HEALTH OR SUBSTANCE ABUSE DISORDERS. THEY PROVIDE FOR THE BASIC NEEDS OF AND RELIEVE HUNGER FOR THE HOMELESS AND UNDER-RESOURCED COMMUNITY MEMBERS OF LEWIS COUNTY. THEIR MEAL PROGRAM SERVES A BRIDGE THAT ALLOWS THEM TO CONNECT HOMELESS AND UNDER-RESOURCED/MARGINALIZED RESIDENTS WITH COMMUNITY RESOURCE PARTNERS TO PROVIDE HOUSING & EMPLOYMENT SERVICES, MENTAL HEALTH SERVICES, AND MEDICAL SERVICES.

PROVIDENCE ST. MARY MEDICAL CENTER (8)
PART V, SECTION B, LINE 3J: PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS: PRIORITY 1, BEHAVIORAL HEALTH CHALLENGES AND ACCESS TO CARE. BARRIERS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES SIGNIFICANTLY IMPACT YOUTH AND THOSE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH. PRIORITY 2, ACCESS TO HEALTH CARE SERVICES. BARRIERS TO ACCESS TO HEALTH CARE SERVICES ARE RELATED TO INSURANCE OR COST, PROVIDER AVAILABILITY, DISTANCE TO CARE, OR TRANSPORTATION AND SIGNIFICANTLY IMPACT THE AGING POPULATION, THOSE LIVING WITH DISABILITIES, AND THOSE WHO ARE BLACK, BROWN, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC). PRIORITY 3, HOMELESSNESS/LACK OF SAFE, AFFORDABLE HOUSING. BARRIERS TO ADDRESSING HOMELESSNESS INCLUDE THE LACK OF AFFORDABLE HOUSING AND ECONOMIC INSECURITY.

PROVIDENCE KODIAK IS. MED. CTR. (11)
PART V, SECTION B, LINE 3J: PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

PROVIDENCE ST. MARY MEDICAL CENTER (8)
PART V, SECTION B, LINE 5: TO BETTER UNDERSTAND THE UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE OF COMMUNITY MEMBERS, REPRESENTATIVES FROM PSMMC CONDUCTED 15 STAKEHOLDER INTERVIEWS, INCLUDING 21 PARTICIPANTS, AND THREE LISTENING SESSIONS WITH 15 COMMUNITY MEMBERS BETWEEN MAY AND JUNE OF 2021. STAKEHOLDERS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND THEIR ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WITH LOW INCOMES, AND UNDERSERVED AND UNDER-RESOURCED COMMUNITIES. STAKEHOLDERS WERE FROM THE FOLLOWING ORGANIZATIONS AND MUNICIPALITIES: BLUE MOUNTAIN ACTION COUNCIL, BLUE MOUNTAIN HEART TO HEART, CATHOLIC CHARITIES WALLA WALLA, CENTER FOR HUMANITARIAN ENGAGEMENT-WALLA WALLA UNIVERSITY, CITY OF COLLEGE PLACE, CITY OF WALLA WALLA, COMPREHENSIVE HEALTHCARE, DAYTON CHRONICLE, FAMILY MEDICAL CENTER/YAKIMA VALLEY FARM WORKERS CLINIC, MILTON-FREEWATER DOWNTOWN ALLIANCE AND BROADWAY DENTAL CARE, PROVIDENCE MEDICAL GROUP POPULATION HEALTH, WALLA WALLA PUBLIC SCHOOLS, YMCA, YOUTH WOMEN AND CHILDREN'S CENTER, AS WELL AS THE PUBLIC HEALTH OFFICER/MEDICAL DIRECTOR AND THE ADMINISTRATIVE DIRECTOR FROM THE WALLA WALLA COUNTY DEPARTMENT OF COMMUNITY HEALTH, THE LOCAL HEALTH DEPARTMENT. LISTENING SESSION PARTICIPANTS WERE THOSE RECEIVING SERVICES THROUGH AGING & LONG TERM CARE, RESIDENTS OF THE SLEEP CENTER WHICH IS A SHELTER COMMUNITY FOR THE UNSHELTERED HOMELESS POPULATION, AND MOTHERS OF THOSE LIVING WITH DISABILITIES WHO UTILIZE THE SERVICES AND RESOURCES OF THE DISABILITY NETWORK. PSMMC FIELDED A COMMUNITY SURVEY FROM JULY 6 TO AUGUST 16, 2021 IN ENGLISH AND SPANISH. ABOUT 50 COMMUNITY MEMBERS TOOK THE SURVEY IN ENGLISH.

PROVIDENCE KODIAK IS. MED. CTR. (11)
PART V, SECTION B, LINE 5: PROVIDENCE KODIAK ISLAND MEDICAL LEADERS FORMED THE KODIAK CHNA ADVISORY COMMITTEE. COMMITTEE MEMBERS WERE INVITED AND SELECTED TO ENSURE THE ASSESSMENT PROCESS WAS GUIDED BY COMMUNITY STAKEHOLDERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. TOGETHER, THESE PARTNERS BROUGHT IN THE PUBLIC HEALTH PERSPECTIVE AND THE INTERESTS OF MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. COMMITTEE MEMBERS WERE: -CINDY BALDWIN, CLINIC OPERATIONS DIRECTOR, KODIAK AREA NATIVE ASSOCIATION-BARBARA BIGELOW, CEO PKIMC, PROVIDENCE KODIAK ISLAND MEDICAL CENTER -PAT BRANSON, EXECUTIVE DIRECTOR, SENIOR CITIZENS OF KODIAK; MAYOR, CITY OF KODIAK -ELSA DEHART, RN, DIRECTOR, KODIAK PUBLIC HEALTH CENTER, STATE OF ALASKA DEPARTMENT OF HEALTH AND SOCIAL SERVICES -MARY GUILAS HAWVER, PRESIDENT, FILIPINO AMERICAN ASSOCIATION; DIRECTOR, PROVIDENCE KODIAK ISLAND COUNSELLING CENTER -CAROL JUERGENS, M.D., CO-OWNER KODIAK ISLAND MEDICAL ASSOCIATES -MERISSA KOLLER, COMMUNITY WELLNESS PROGRAM COORDINATOR, HEALTHY TOMORROWS KODIAK-JUDY CHRISTINE (JC) RATHJE, EXECUTIVE DIRECTOR, KODIAK COMMUNITY HEALTH CENTER -DAN ROHRER, ASSEMBLYMAN, KODIAK ISLAND BOROUGH; BUSINESS OWNER, SUBWAY -RHONDA WALLACE, CHIEF OF POLICE, CITY OF KODIAK COMMUNITY HEALTH SURVEYTHE 36 QUESTION SURVEY WAS FIELDED FROM MAY 18 - JUNE 1, 2019 WITH EXTENSIVE HELP FROM THE KODIAK CHNA ADVISORY COMMITTEE. EVERY EFFORT WAS MADE TO ENSURE THAT THE SURVEY REPRESENTED THE DIVERSITY OF THE COMMUNITY AND CAPTURED INPUT FROM THOSE WITH LOW INCOMES AND OTHERWISE UNDERSERVED IN THE COMMUNITY.STAKEHOLDER INTERVIEWS: IN THE MONTH OF JUNE, NINE COMMUNITY LEADERS WERE INTERVIEWED INDIVIDUALLY REGARDING THE HEALTH NEEDS OF THE COMMUNITYCOMMUNITY FORUMPROVIDENCE KODIAK ISLAND MEDICAL CENTER HOSTED A COMMUNITY FORUM (MAY 28, 2019) WITH THE GOAL OF LEARNING MORE ABOUT COMMUNITY MEMBERS' VISION FOR A HEALTHY COMMUNITY AND THE HEALTH-RELATED NEEDS THEY WOULD LIKE TO SEE PRIORITIZED (SEE APPENDIX 2B). COMMUNITY MEMBERS AND STAKEHOLDERS WERE DIVIDED INTO SIX GROUPS WHICH INCLUDED STAFF AND BOARD MEMBERS FROM PROVIDENCE ST. JOSEPH HEALTH - ALASKA REGION.

PROVIDENCE ST. MARY MEDICAL CENTER (8)
PART V, SECTION B, LINE 6B: BLUE MOUNTAIN REGIONAL COMMUNITY HEALTH PARTNERSHIP: (BMRCHP) IS AN ACTION ORIENTED, CROSS-SECTOR COALITION CONSISTING OF PUBLIC HEALTH, EDUCATION, CLINICAL, PUBLIC SAFETY, SOCIAL SERVICES, LONG-TERM CARE, HOUSING, MANAGED CARE, LAW ENFORCEMENT, TRANSPORTATION, FAITH-BASED ORGANIZATIONS, PHILANTHROPY, LONG-TERM CARE, EARLY LEARNING AND OTHER COMMUNITY BASED ORGANIZATIONS. THESE PARTNERS COORDINATE TO ASSESS THE NEEDS OF THE BLUE MOUNTAIN REGION AND DEVELOP A UNIFIED RESPONSE TO MEET THESE NEEDS.MEMBER ORGANIZATIONS LISTED ON PAGE 31 OF CHNA. AVAILABLE AT: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS UNDER WASHINGTON: WALLA WALLA

PROVIDENCE ST. MARY MEDICAL CENTER (8)
PART V, SECTION B, LINE 11: AS A RESULT OF THE FINDINGS OF OUR 2021 CHNA AND THROUGH A PRIORITIZATION PROCESS ALIGNED WITH OUR MISSION, RESOURCES, AND HOSPITAL STRATEGIC PLAN, PSMMC WILL FOCUS ON THE FOLLOWING AREAS FOR ITS 2022-2024 COMMUNITY BENEFIT EFFORTS OUTLINED IN THE PSMMC CHIP: PRIORITY 1, BEHAVIORAL HEALTH CHALLENGES AND ACCESS TO CARE. BARRIERS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES SIGNIFICANTLY IMPACT YOUTH AND THOSE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH. PRIORITY 2, ACCESS TO HEALTH CARE SERVICES. BARRIERS TO ACCESS HEALTH CARE SERVICES ARE RELATED TO INSURANCE OR COST, PROVIDER AVAILABILITY, DISTANCE TO CARE, OR TRANSPORTATION AND SIGNIFICANTLY IMPACT THE AGING POPULATION, THOSE LIVING WITH DISABILITIES, AND THOSE WHO ARE BLACK, BROWN, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC). PRIORITY 3, HOMELESSNESS / LACK OF SAFE, AFFORDABLE HOUSING. BARRIERS TO ADDRESSING HOMELESSNESS INCLUDE THE LACK OF AFFORDABLE HOUSING AND ECONOMIC INSECURITY. STRATEGIES TO ADDRESS BEHAVIORAL HEALTH CHALLENGES AND ACCESS TO CARE INCLUDE BEHAVIORAL HEALTH NAVIGATION SERVICES IN THE EMERGENCY DEPARTMENT (ED), COMMUNITY PARAMEDIC PROGRAM, INTEGRATING BEHAVIORAL HEALTH IN PRIMARY CARE, ENHANCING TELEHEALTH FOR BEHAVIORAL HEALTH SERVICES VIA ED AND ON MOBILE OUTREACH SERVICES TEAM (MOST) MOBILE VAN, AND BY CONNECTING WITH PEOPLE IN NEED OF CULTURALLY RESPONSIVE BEHAVIORAL HEALTH SERVICES WHO PRIMARY LANGUAGE IS SPANISH THROUGH PROMOTORES DE SALUD. STRATEGIES TO ADDRESS ACCESS TO HEALTH CARE SERVICES INCLUDE UTILIZING COMMUNITY HEALTH WORKERS AND PROMOTORES DE SALUD AND THE MOBILE OUTREACH SERVICES TEAM (MOST) MOBILE VAN TO OUTREACH TO PEOPLE WITH LOW INCOMES, UNDERSERVED AND UNDER-RESOURCED COMMUNITIES, THE SOUTHEAST WASHINGTON (SEWA) FALLS PREVENTION COMMUNITY PARTNERSHIP PROGRAM TO DECREASE EMERGENCY MEDICAL SERVICE CALLS FOR LIFT ASSISTS, AND THE HEALTH EQUITY NURSE SERVING EARLY HEAD START FAMILIES. STRATEGIES TO ADDRESS HOMELESSNESS AND LACK OF SAFE, AFFORDABLE HOUSING INCLUDE SUPPORTING THE WORK OF THE ANCHOR COMMUNITY INITIATIVE, IMPLEMENTING COMMUNITY SOLUTIONS BUILT FOR ZERO (BFZ), HAVING A PSMMC REPRESENTATIVE FILL THE OPEN HEALTH CARE POSITION ON THE WALLA WALLA COUNCIL ON HOUSING, THROUGH COMMUNITY COLLABORATIONS, EXPLORE OPPORTUNITIES TO INCREASE PERMANENT SUPPORTIVE HOUSING, EXPLORE COLLABORATIONS AND INVEST IN MEDICAL RESPITE SERVICES TO CLOSE THE GAP IN CARE IN THE HEALTH AND HOMELESS SERVICES CONTINUUM, COLLABORATE WITH COMMUNITY PARTNERS TO CREATE PERMANENTLY AFFORDABLE HOME OWNERSHIP OPPORTUNITIES FOR LOW-AND MODERATE-INCOME HOUSEHOLDS.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO COLLABORATING WITH PARTNER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS THE NEEDS IDENTIFIED IN OUR CHNA, WITH FULL ACKNOWLEDGEMENT THAT THESE NEEDS ARE AMONG THE MOST CHALLENGING TO ADDRESS IN ANY COMMUNITY AND REQUIRE LONG-TERM FOCUS AND INVESTMENT FROM ALL LEVELS OF COMMUNITY STAKEHOLDERS.

PROVIDENCE KODIAK IS. MED. CTR. (11)
PART V, SECTION B, LINE 11: IN THE FALL OF 2019, MEMBERS OF THE CHNA ADVISORY COMMITTEE WERE ASKED TO RATE THE HEALTH ISSUES IDENTIFIED PREVIOUSLY ACCORDING TO THREE KEY CRITERIA, INCLUDING SIZE, SERIOUSNESS, AND ABILITY TO IMPACT. THE COMMITTEE INDIVIDUALLY RATING THE HEALTH ISSUES AND THE GROUP CONVENED TO IDENTIFY THE TOP PRIORITIES. THE CHNA ADVISORY COMMITTEE IDENTIFIED THE FOLLOWING THREE PRIORITIES. THE FOLLOWING IS AN OUTLINE OF THE PKIMC COMMUNITY HEALTH IMPROVEMENT PLAN TO ADDRESS THE THREE PRIORITIES AND ACCOMPLISHMENTS.WITH THE EMERGENCE OF THE COVID-19 PANDEMIC SUBSTANTIALLY IMPACTED PKIMC/PKICC'S IMPLEMENTATION OF SERVICES AND DID NOT HAVE A PERMANENT HOSPITAL ADMINISTRATOR FOR A SIGNIFICANT PERIOD OF 2020 AND 2021. BEHAVIORAL HEALTH(INCLUDES BOTH SUBSTANCE ABUSE AND MENTAL HEALTH) POOR MENTAL HEALTH AND THE RELATED ISSUE OF SUBSTANCE ABUSE WERE IDENTIFIED AS PROBLEMS IN THE KODIAK COMMUNITY. REMOTE, RAINY CLIMATES ALONG WITH LONG, DARK WINTERS ARE KNOWN TO HAVE A NEGATIVE IMPACT ON MENTAL HEALTH AND ARE FREQUENTLY ASSOCIATED WITH INCREASED SUBSTANCE ABUSE. PKIMC AND PROVIDENCE KODIAK ISLAND COUNSELLING CENTER (PKICC) PROVIDED SAFETY-NET SERVICES THROUGH PSYCHIATRIC EMERGENCY SERVICESPKICC ADDRESSED THE MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT NEEDS OF KODIAK YOUTH THROUGH THE YOUTH OUTPATIENT SUBSTANCE ABUSE PROGRAM, MENTAL HEALTH CLINICIANS IN THE SCHOOLS PROGRAM, ALCOHOL SAFETY ACTION PROGRAM (ASAP), KODIAK SCHOOLS SUBSTANCE ABUSE TASK FORCE AND ONGOING COLLABORATIONS WITH THE TEEN COURT AND OTHER COMMUNITY PARTNERS.PKICC ADDRESSED THE MENTAL HEALTH SERVICE NEEDS OF THE GENERAL COMMUNITY AND THE CHRONICALLY MENTALLY HILL THROUGH THE COMMUNITY SUPPORT PROGRAM AND THROUGH CONTINUING EFFORTS TO FURTHER INTEGRATE BEHAVIORAL HEALTH IN THE PRIMARY CARE SETTING CURRENTLY BEING DONE IN COLLABORATION WITH THE KODIAK COMMUNITY HEALTH CENTER.PKICC ADDRESSES THE SUBSTANCE ABUSE TREATMENT NEEDS OF THE COMMUNITY THROUGH ITS OUTPATIENT CHEMICAL DEPENDENCY TREATMENT PROGRAM SAFE HARBOR, THROUGH ITS CASE-MANAGEMENT PROGRAM ASAP AND THROUGH A RESIDENTIAL TREATMENT COLLABORATION WITH SALVATION ARMY. PKICC CONTINUED TO BE PROACTIVE IN ITS OUTREACH SERVICES IN COLLABORATION WITH MANY COMMUNITY PARTNERS SUCH AS THE BROTHER FRANCIS SHELTER, KODIAK WOMEN'S RESOURCE AND CRISIS CENTER AND MANY OTHER ORGANIZATIONS AND GOVERNMENT AGENCIES IN THE KODIAK COMMUNITY. PKICC CONTINUED TO BE A LEADER IN COMMUNITY EDUCATION, GRANT-SEEKING, ADVOCACY, COLLABORATION, PLANNING AND ACTION TO HELP IMPROVE THE HEALTH OF THE KODIAK COMMUNITY AND THE LIVES OF THOSE WHO SUFFER FROM MENTAL HEALTH AND SUBSTANCE ABUSE. PRIMARY CARE UTILIZATION AND ACCESSTHE NEED TO IMPROVE AVAILABILITY, ACCESS AND USE OF PRIMARY CARE SERVICES WERE IDENTIFIED BY THE COMMUNITY AS SIGNIFICANT ISSUES. AT PRESENT, KODIAK HAS ADEQUATE PRIMARY CARE CAPACITY WITH KODIAK AREA NATIVE ASSOCIATION CLINIC (KANA) AND MILL BAY HEALTH CENTER, KODIAK COMMUNITY HEALTH CENTER, THE U.S. COAST GUARD ROCKMORE-KING MEDICAL CLINIC, AND THE KODIAK ISLAND AMBULATORY CLINIC PROVIDING PRIMARY CARE SERVICES TO THE RESIDENTS OF KODIAK. BECAUSE OF THIS, PKIMC DOES NOT OFFER TRADITIONAL, NON-SPECIALIZED PRIMARY CARE SERVICES, BUT WILL CONTINUE TO WORK WITH KODIAK PRIMARY CARE PROVIDERS TO EXPLORE OPPORTUNITIES TO SUPPORT THESE PROVIDERS AND THE COMMUNITY IN THE EFFORT TO IMPROVE PRIMARY CARE UTILIZATION. IN ADDITION TO CONTINUED COLLABORATION WITH COMMUNITY PARTNERS, PROVIDENCE KODIAK ISLAND MEDICAL CENTER'S INCLUDED SPECIFIC STEPS INCLUDING HIRING A PEDIATRICIAN TO SUPPORT ACCESS TO PRIMARY CARE IN ADDITION TO A RECENTLY HIRED OB/GYN TO SUPPORT WOMEN'S HEALTH. HEALTHY LIFESTYLE/CHRONIC CONDITIONSSURVEY RESPONSES AND HEALTH DATA INDICATE DIFFICULTY WITH MAINTAINING A HEALTHY LIFESTYLE, ENGAGING IN PREVENTATIVE HEALTH, AND MANAGING CHRONIC DISEASE IN THE COMMUNITY.PROVIDENCE KODIAK ISLAND MEDICAL CENTER'S IS IMPLEMENTING SPECIFIC STEPS TO ADDRESS HEALTHY LIFESTYLE AND CHRONIC CONDITIONS. THE PLAN INCLUDES A PAIN MANAGEMENT CLINIC OPERATED THROUGH THE SPECIALTY CLINIC.

PROVIDENCE ST. MARY MEDICAL CENTER (8)
PART V, SECTION B, LINE 24: FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES

PROVIDENCE KODIAK IS. MED. CTR. (11)
PART V, SECTION B, LINE 24: FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.

PART V, SECTION B, LINE 9:
PROVIDENCE ST. MARY MEDICAL CENTER (8)THE HOSPITAL FACILITY ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT ON APRIL 22, 2022, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1).

PART V, SECTION B, LINE 9:
PHS - WASHINGTON (GROUP D - 1 & 12) THE HOSPITAL FACILITY ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT ON APRIL 19, 2022, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1).

PART V, SECTION B
FACILITY REPORTING GROUP A

FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 3: PROVIDENCE ST. PETER HOSPITAL, - FACILITY 7: PROVIDENCE CENTRALIA HOSPITAL

PHS - WASHINGTON (GROUP A - 3 & 7) PART V, SECTION B, LINE 3J:
PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

PHS - WASHINGTON (GROUP A - 3 & 7) PART V, SECTION B, LINE 5:
BETWEEN MAY 27 AND JULY 14, 2020 REPRESENTATIVES FROM PROVIDENCE SOUTHWEST WASHINGTON CONDUCTED INTERVIEWS WITH REPRESENTATIVES FROM 5 COMMUNITY-BASED ORGANIZATIONS, INCLUDING 24 STAKEHOLDERS, PEOPLE WHO ARE INVESTED IN THE WELL-BEING OF THE COMMUNITY AND HAVE FIRST-HAND KNOWLEDGE OF COMMUNITY NEEDS AND STRENGTHS. A TOTAL OF 5 STAKEHOLDER INTERVIEWS, WHICH INCLUDED 24 PARTICIPANTS, WERE COMPLETED BY REPRESENTATIVES FROM PROVIDENCE SOUTHWEST WASHINGTON. STAKEHOLDERS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO HAVE LOW INCOMES, HAVE CHRONIC CONDITIONS, AND/OR ARE MEDICALLY UNDERSERVED. PROVIDENCE SOUTHWEST WASHINGTON AIMED TO ENGAGE STAKEHOLDERS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES. SEVERAL ATTEMPTS WERE MADE TO CONNECT WITH REPRESENTATIVES FROM LEWIS COUNTY PUBLIC HEALTH AND SOCIAL SERVICES AND THURSTON COUNTY PUBLIC HEALTH AND SOCIAL SERVICES, BUT DUE TO COMPETING PRIORITIES RELATED TO COVID-19, THEY WERE NOT ABLE TO PARTICIPATE IN STAKEHOLDER INTERVIEWS. DR. RACHEL WOOD, LEWIS COUNTY'S HEALTH OFFICER, IS A PROVIDENCE BOARD MEMBER AND SERVED ON THE CHNA OVERSIGHT COMMITTEE, PROVIDING INSIGHT DURING THE DATA REVIEW AND PRIORITIZATION PROCESSES.FOR DETAILED LIST OF STAKEHOLDERS GO TO PG. 58 OF CHNA REPORT LOCATED AT: HTTPS://WWW.PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/REPORTS/PCHANDPSPH_SWWA_2020CHNA.PDF?LA=EN&REV=DF96D25CB1DB463296534BFE53AE1FED&HASH=2C244717D79B80EEA2BC3EA0D6FE65E4.

PHS - WASHINGTON (GROUP A - 3 & 7) PART V, SECTION B, LINE 11:
AS A RESULT OF THE FINDINGS OF OUR 2020 CHNA AND THROUGH A PRIORITIZATION PROCESS ALIGNED WITH OUR MISSION, RESOURCES, AND HOSPITAL STRATEGIC PLAN, PROVIDENCE SOUTHWEST WASHINGTON WILL FOCUS ON THE FOLLOWING AREAS FOR ITS 2021-2023 COMMUNITY BENEFIT EFFORTS: PRIORITY 1: HOMELESSNESS/LACK OF SAFE AND AFFORDABLE HOUSINGHOMELESSNESS AND A LACK OF SAFE, AFFORDABLE HOUSING WAS PRIORITIZED BY ALL STAKEHOLDERS AND CONSISTENTLY RANKED AS THE MOST IMPORTANT ISSUE THAT NEEDS TO BE ADDRESSED IN THE SERVICE AREA. DESPITE EFFORTS TO ADDRESS HOUSING CHALLENGES, THERE IS A LACK OF HOUSING AVAILABLE IN THURSTON AND LEWIS COUNTIES, PARTICULARLY AFFORDABLE RENTAL UNITS AND PERMANENT SUPPORTIVE HOUSING. STRATEGIES TO ADDRESS HOMELESSNESS AND LACK OF SAFE AND AFFORDABLE HOUSING INCLUDE: SUPPORT OF COMMUNITY BASED RESPITE CARE SERVICES; IMPLEMENTATION OF A CRISIS RESPONSE UNIT MODEL WITH COMMUNITY PARTNERS; COLLABORATION WITH PROVIDENCE REGIONAL EFFORTS TO IMPLEMENT COMMUNITY SOLUTIONS' BUILT FOR ZERO MODEL PRIORITY 2: BEHAVIORAL HEALTH (INCLUDES MENTAL HEALTH AND SUBSTANCE USE)THERE IS A LACK OF MENTAL HEALTH AND SUBSTANCE USE TREATMENT SERVICES IN THE COMMUNITY. GAPS INCLUDE A LACK OF BEHAVIORAL HEALTH INTEGRATION INTO PRIMARY CARE, SCHOOL-BASED MENTAL HEALTH SERVICES, A LOCAL INPATIENT DETOX FACILITY, AND CASE MANAGEMENT SERVICES. PEOPLE HAVE DIFFICULTY ACCESSING MENTAL HEALTH SERVICES DUE TO LONG WAIT TIMES, A LACK OF PROVIDERS WHO TAKE MEDICAID AND MEDICARE, AND TRANSPORTATION BARRIERS. THESE POPULATIONS INCLUDE SCHOOL-AGED CHILDREN, OLDER ADULTS, PEOPLE EXPERIENCING HOMELESSNESS, PEOPLE LIVING IN RURAL COMMUNITIES, VETERANS, PEOPLE WHO ARE UNDOCUMENTED, AND MONOLINGUAL SPANISH SPEAKERS. STRATEGIES TO ADDRESS BEHAVIORAL HEALTH (INCLUDING MENTAL HEALTH AND SUBSTANCE USE) INCLUDE: INTEGRATING HEALTH SERVICES IN PRIMARY AND BEHAVIORAL HEALTH CARE; INTEGRATED MEDICATION-ASSISTED TREATMENT FOR OPIOID USE DISORDER; MENTAL HEALTH CRISIS RESPONSE FOR PEOPLE EXPERIENCING HOMELESSNESS. PRIORITY 3: ACCESS TO HEALTH CARE THERE ARE A NUMBER OF BARRIERS TO ACCESSING HEALTH CARE. A COMMON CONCERN WAS TRANSPORTATION, PARTICULARLY FOR OLDER ADULTS, PEOPLE EXPERIENCING HOMELESSNESS, AND PEOPLE LIVING IN RURAL COMMUNITIES. LANGUAGE BARRIERS PREVENT PEOPLE FROM RECEIVING APPROPRIATE AND RESPONSIVE CARE AND DOCUMENTATION STATUS IS A BARRIER TO ACCESSING HEALTH INSURANCE.STRATEGIES TO ADDRESS ACCESS TO CARE INCLUDE: IMPLEMENTATION OF CRISIS RESPONSE UNIT MOBILE OUTREACH CLINICS WITH COMMUNITY PARTNERS; SUPPORT OF PATIENTS IN NEED OF RESOURCES TO SAFELY DISCHARGE OR IN NEED OF ACCESS TO CARE.EQUITY FRAMEWORK STAKEHOLDERS CHOSE TO PRIORITIZE A FOURTH HEALTH-RELATED NEED, HEALTH AND RACIAL EQUITY, THROUGHOUT THE IMPROVEMENT PLANS FOR ALL THREE NEEDS LISTED ABOVE. THIS MEANS WHEN ADDRESSING HOUSING, MENTAL HEALTH AND SUBSTANCE USE, AND ACCESS TO CARE, PROVIDENCE SOUTHWEST WASHINGTON WILL USE AN EQUITY FRAMEWORK FOR APPROACHING PLANNING AND IMPLEMENTATION.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. IN ADDITION TO THE PRIORITIZED NEEDS, PROVIDENCE SOUTHWEST IDENTIFIED IN THE COURSE OF THE CHNA THE FOLLOWING NEEDS: UNEMPLOYMENT AND LACK OF LIVING WAGE JOBS; FOOD INSECURITY; ACCESS TO ORAL HEALTH CARE. WHILE THESE NEEDS HAVE NOT BEEN PRIORITIZED FOR THE 2021-2023 CHIP, PROVIDENCE SOUTHWEST RECOGNIZES THESE NEEDS AS IMPORTANT TO THE OVERALL HEALTH OF OUR COMMUNITIES. WE ARE COMMITTED TO COLLABORATING WITH PARTNER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS THE NEEDS PRIORITIZED IN THIS CHIP, WITH FULL ACKNOWLEDGMENT THAT THESE NEEDS ARE AMONG THE MOST CHALLENGING TO ADDRESS IN ANY COMMUNITY, AND REQUIRE LONG-TERM FOCUS AND INVESTMENT FROM ALL LEVELS OF COMMUNITY STAKEHOLDERS.

PHS - WASHINGTON (GROUP A - 3 & 7) PART V, SECTION B, LINE 24:
FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.

PART V, SECTION B
FACILITY REPORTING GROUP B

FACILITY REPORTING GROUP B CONSISTS OF:
- FACILITY 4: PROVIDENCE REGIONAL MED. CTR.,COLBY, - FACILITY 5: PROVIDENCE REGIONAL MED. CTR.,PACIFIC

PHS - WASHINGTON (GROUP B - 4 & 5) PART V, SECTION B, LINE 3J:
PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

PHS - WASHINGTON (GROUP B - 4 & 5) PART V, SECTION B, LINE 5:
PRMCE FORMED THE PROVIDENCE INSTITUTE FOR A HEALTHIER COMMUNITY (PIHC) AS A PARTNERSHIP BETWEEN BUSINESS, GOVERNMENT, HEALTHCARE PROVIDERS, SCHOOLS, AND NON-PROFITS WITH THE GOAL OF ENCOURAGING RESIDENTS OF SNOHOMISH COUNTY TO MAKE SMALL BUT IMPORTANT BEHAVIORAL CHANGES TO IMPROVE THEIR HEALTH. RECOGNIZING THAT HEALTH IS MORE THAN HEALTHCARE, PIHC STARTS WITH A SHARED UNDERSTANDING OF HEALTH AS DEFINED BY OUR COMMUNITY AND WORKS TOGETHER TO CREATE A HEALTHIER FUTURE. PIHC SERVES AS THE CONVENER AND FACILITATOR BY HELPING ESTABLISH INNOVATIVE COMMUNITY PARTNERSHIPS TO SUPPORT HEALTH AND WELL-BEING. TO BETTER UNDERSTAND THE COMMUNITY'S PERSPECTIVE, OPINIONS, EXPERIENCES, AND KNOWLEDGE, PIHC REACHES OUT AND LISTENS TO THE COMMUNITY, LETTING THEM DEFINE WHAT HEALTH AND HAPPINESS MEAN TO THEM. PIHC COLLECTS THIS FEEDBACK THROUGH VARIOUS METHODS INCLUDING THE HEALTH & WELL-BEING MONITOR, THE EDGE OF AMAZING COMMUNITY HEALTH SUMMIT, PIHC STRATEGIC OVERSIGHT TEAM, PIHC STRATEGIC PLANNING COUNCIL, AND THE PIHC SUSTAINABILITY, INCLUSION AND CO-CREATION TASK FORCE. IN ADDITION, FEEDBACK WAS OBTAINED FROM THE PRMCE MISSION AND HEALTHIER COMMUNITIES COMMITTEE AND THE SNOHOMISH HEALTH DISTRICT COMMUNITY HEALTH ASSESSMENT TEAM. THROUGH THESE FORUMS, COMMUNITY MEMBERS, NONPROFIT ORGANIZATIONS, AND GOVERNMENT STAKEHOLDERS PROVIDE INPUT ON THE ISSUES AND OPPORTUNITIES OF THE PEOPLE, NEIGHBORHOODS, AND CITIES OF SNOHOMISH COUNTY. COMMUNITY INPUT WAS OBTAINED AT VARIOUS TIMES, WITH THE MAJORITY BETWEEN JUNE AND OCTOBER 2019. APPENDIX 3 IN THE CHNA INCLUDES A COMPLETE LIST OF SOURCES AND PARTICIPANTS, PG. 71 LOCATED AT:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS UNDER WASHINGTON: EVERETT.

PHS - WASHINGTON (GROUP B - 4 & 5) PART V, SECTION B, LINE 11:
"THERE ARE A NUMBER OF HEALTH NEEDS IN OUR COMMUNITY, HOWEVER, DUE TO LACK OF IDENTIFIED EFFECTIVE INTERVENTIONS, RESOURCE CONSTRAINTS, OR ABSENCE OF EXPERTISE, PRMCE CANNOT DIRECTLY ADDRESS ALL NEEDS IDENTIFIED IN A CHNA. BASED ON THE OUTCOME OF THE EVALUATION, PRMCE MADE A COMMITMENT TO FOCUS ON FOUR AREAS OF NEED (MENTAL HEALTH, OPIOID USE DISORDER, HOMELESSNESS, AND ACCESS TO PRIMARY CARE) BECAUSE WE BELIEVE THAT WE CAN HAVE THE GREATEST IMPACT AND POSITIVE INFLUENCE ON OUTCOMES. AT THE SAME TIME, PRMCE IS ALSO ACTIVELY INVOLVED IN SUPPORTING OUR COMMUNITY THROUGH MANY OTHER COMMUNITY BENEFIT PROGRAMS. PRMCE ANTICIPATES THAT IMPLEMENTATION STRATEGIES AND TACTICS MAY CHANGE AND THEREFORE, A FLEXIBLE APPROACH IS BEST SUITED FOR THE DEVELOPMENT OF ITS RESPONSE TO THE CHNA. FOR EXAMPLE, CERTAIN COMMUNITY HEALTH NEEDS MAY BECOME MORE PRONOUNCED AND REQUIRE CHANGES TO THE INITIATIVES IDENTIFIED IN THE CHIP. THE FOLLOWING INFORMATION OUTLINES PRMCE'S PLAN TO ADDRESS THE FOUR PRIORITY AREAS OVER A THREE-YEAR PERIOD. THE TARGET POPULATION FOR THE IMPROVEMENT PLAN IS THE SNOHOMISH COUNTY COMMUNITY, WITH EMPHASIS ON VULNERABLE POPULATIONS. MENTAL HEALTH CARE IS FOUNDATIONAL TO AN INDIVIDUAL'S QUALITY OF LIFE AND PHYSICAL HEALTH. ACCESS TO MENTAL HEALTH CARE INCLUDES THE AVAILABILITY OF QUALITY, INTEGRATED CARE FOR INDIVIDUALS WITH A RANGE OF MENTAL DISORDERS. DUE TO THE LACK OF ACCESS TO MENTAL HEALTH CARE, PATIENTS ARE EITHER GOING WITHOUT CARE, HAVE LONG WAIT TIMES TO SEE A PROVIDER, OR ARE CARED FOR IN FACILITIES THAT ARE NOT EQUIPPED TO CARE FOR THEM. THE GOAL IS TO IMPROVE ACCESS TO QUALITY, TIMELY MENTAL HEALTH SERVICES IN SNOHOMISH COUNTY, AND REDUCE THE STIGMA AND DISCRIMINATION ASSOCIATED WITH MENTAL ILLNESS. ACCOMPLISHMENTS IN 2021 INCLUDE:A. STRATEGY: IMPROVE WHOLE PERSON CARE BY EMBEDDING MENTAL HEALTH PROGRAMS INTO PRIMARY CARE.ACCOMPLISHMENTS: 1) ADDED PEDIATRIC PSYCHIATRIST, THERAPIST AND SOCIAL WORKERS INTO PRIMARY CARE, 2) EXPANDED INTEGRATED BEHAVIORAL HEALTH IN WOMEN'S SERVICES CLINIC, 3) ADDING CLINICAL SOCIAL WORKER AND PSYCHIATRICS IN INTERNAL MEDICINE RESIDENCY CLINICB. STRATEGY: INCREASE ACCESS TO MENTAL HEALTH SERVICES.ACCOMPLISHMENTS: 1) OPENED A 24-BED INPATIENT PSYCHIATRIC UNIT, 2) MENTAL HEALTH URGENT CARE CLINIC EXPANDING HOURS.C. STRATEGY: EDUCATE CAREGIVERS, PROVIDERS, AND THE COMMUNITY IN ORDER TO DECREASE THE STIGMA AND DISCRIMINATION ASSOCIATED WITH MENTAL ILLNESS.ACCOMPLISHMENTS: 1) INCREASED STAFF AND PROVIDER EDUCATION ON TRAUMA INFORMED CARE, 2) IMPROVED BEHAVIORAL HEALTH COMPETENCIES OF STAFF, 3) COORDINATED CONFERENCE FOR COMMUNITY PRIMARY CARE PROVIDERS FOCUSING ON ADULT ADHD AND BIPOLAR DISORDERS AND FUTURE OF MENTAL HEALTH SERVICES.A. STRATEGY: COLLABORATE WITH AND SUPPORT COMMUNITY PARTNERS TO DIRECTLY ADDRESS MENTAL HEALTH CARE.ACCOMPLISHMENTS 1) PROVIDING FINANCIAL AND IN-KIND SUPPORT TO ORGANIZATIONS ADDRESSING MENTAL HEALTH SUCH AS UNITED WAY, DOMESTIC VIOLENCE SERVICES, AND COMPASS HEALTH, 2) COORDINATE ANNUAL COMMUNITY EDGE OF AMAZING CONFERENCE WITH BREAK-OUT GROUPS DISCUSSING COMMUNITY BARRIERS AND SOLUTIONS TO BEHAVIORAL HEALTH. OPIOID USE DISORDER HAS A SIGNIFICANT HEALTH AND SOCIAL IMPACT ON INDIVIDUALS AND THE COMMUNITY. MISUSE OF PRESCRIPTION OPIOIDS FOR PAIN SUCH AS MORPHINE, OXYCODONE, HYDROCODONE/FENTANYL, AND USE OF ILLEGAL DRUGS SUCH AS HEROIN ARE SERIOUS PROBLEMS IN SNOHOMISH COUNTY. THE GOAL IS TO IMPLEMENT PREVENTION AND INTERVENTION STRATEGIES TO REDUCE THE MORBIDITY AND MORTALITY CAUSED BY THE MISUSE OF OPIOID MEDICATIONS AND USE OF ILLEGAL OPIOIDS IN SNOHOMISH COUNTY, AND REDUCE THE STIGMA AND DISCRIMINATION ASSOCIATED WITH SUBSTANCE USE DISORDERS. ACCOMPLISHMENTS IN 2021 INCLUDE:A. STRATEGY: INCREASE ACCESS TO TREATMENT OPTIONS.ACCOMPLISHMENTS: 1) THE CONTINUATION OF PRMCE SUBSTANCE USE DISORDER TREATMENT SERVICES AS A SUBSIDIZED SERVICE AND EXPANDED ACCESS, 2) EXPANSION OF MEDICATION ASSISTED TREATMENT IN THE EMERGENCY DEPARTMENT AND INPATIENT MEDICAL AND SURGICAL HOSPITALIST TEAMS, 3) IMPLEMENTED CLINICAL RESEARCH STUDY FOR THOSE WANTING TO CEASE OPIOID USE AND GO INTO MEDICATION ASSISTED TREATMENT.B. STRATEGY: PREVENT INAPPROPRIATE OPIOID PRESCRIBING TO REDUCE OPIOID MISUSE.ACCOMPLISHMENTS: 1) EDUCATION ON PAIN CONTROL ALTERNATIVES TO PROVIDERS IN PERIOPERATIVE AND OBSTETRICS, 2) HARDWIRE ORDER SETS TO MINIMIZE NARCOTIC PRESCRIBING. 3) COORDINATED CONFERENCE FOR COMMUNITY MEDICAL PROVIDERS ON PAIN RELIEF BEYOND OPIOIDS. C. STRATEGY: PROVIDE SCREENING/ASSESSMENT FOR COMMUNITY MEMBERS AND PATIENTS TO IDENTIFY SOCIAL DETERMINANTS OF HEALTH WITH A SPECIFIC FOCUS ON DRUG USE.ACCOMPLISHMENTS: 1) EXPANSION OF TOTAL HEALTH TO COMMUNITY PARTNERS IN ORDER TO SCREEN COMMUNITY MEMBERS FOR SOCIAL NEEDS, 2) TRAIN FAMILY MATERNITY CENTER NURSES TO SCREEN PREGNANT MOTHERS FOR SUBSTANCE USE DISORDERS AND OFFER TREATMENT, 3) IMPLEMENT SUBSTANCE USE DISORDER SCREENING FOR INPATIENTSD. STRATEGY: COLLABORATE WITH AND SUPPORT COMMUNITY PARTNERS TO DIRECTLY ADDRESS OPIOID USE DISORDER.ACCOMPLISHMENTS: 1) FINANCIAL AND IN-KIND SUPPORT TO ORGANIZATIONS ADDRESSING OPIOID USE DISORDER SUCH AS POISON CONTROL, COMPASS HEALTH, MARCH OF DIMES, UNITED WAY, COCOON HOUSE, 2) PROVIDED ""INSIDE OUT ORGAN SHOW"" EDUCATION TO SCHOOLS WHERE REAL HUMAN ORGANS ARE SHOWN TO CHILDREN TO EDUCATE THEM ON THE IMPACT SUBSTANCE USE HAS ON INTERNAL ORGANS, 3) COORDINATE ANNUAL COMMUNITY EDGE OF AMAZING CONFERENCE WITH BREAK-OUT GROUPS DISCUSSING COMMUNITY BARRIERS AND SOLUTIONS TO OPIOID USE DISORDER, 4) IN COORDINATION WITH MED-PROJECT AND SNOHOMISH HEALTH DISTRICT, OFFER MEDICATION TACK BACK OPTIONS IN THE PROVIDENCE PHARMACIES IN EVERETT AND MONROE.HOMELESSNESS HAS A HIGH NEGATIVE IMPACT ON AN INDIVIDUAL'S HEALTH STATUS AND PERSONS EXPERIENCING HOMELESSNESS HAVE INCREASED NEED OF MEDICAL SYSTEMS. THE TERM ""HOMELESS"" IS A PROGRAMMATIC DEFINITION APPLIES TO A PERSONS' EXPERIENCE WITHOUT PERMANENT HOUSING AS THEY WHO MAY LIVE ON THE STREETS, STAY IN A SHELTER, MISSION, SINGLE ROOM OCCUPANCY FACILITY, ABANDONED BUILDING OR VEHICLE, OR IN ANY OTHER UNSTABLE OR NON-PERMANENT SITUATION. THE GOAL IS TO REDUCE THE NUMBER OF INDIVIDUALS AND FAMILIES IN SNOHOMISH COUNTY EXPERIENCING HOMELESSNESS, CONNECT PRMCE PATIENTS TO STABLE HOUSING, AND DECREASE THE STIGMA AND DISCRIMINATION ASSOCIATED WITH PERSONS EXPERIENCING HOMELESSNESS. ACCOMPLISHMENTS IN 2021 INCLUDE:A. STRATEGY: IDENTIFY SOLUTIONS TO THE HEALTH CARE NEEDS OF THE PERSONS WITHOUT HOUSING POST DISCHARGE. ACCOMPLISHMENTS: 1) COLLABORATION WITH EVERETT GOSPEL MISSION FOR A MEN'S MEDICAL RESPITE PROGRAM, 2) COLLABORATING WITH AND PROVIDE FINANCIAL ASSISTANCE TO THE NORTHWEST JUSTICE PROJECT TO ASSIST PATIENTS WITH REMOVING BARRIERS TO DISCHARGE TO A HOME SETTING, 3) LEADER PARTICIPATION IN VARIOUS COMMUNITY COLLABORATIVES TO ADDRESS CONDITIONS AND DYNAMICS THAT CHALLENGE COMMUNITY MEMBERS IN MEETING THEIR HOUSING NEEDS (PARTNERSHIP TO END HOMELESSNESS AS AN EXAMPLE), 4) PROVIDE INFLUENZA VACCINE TO VULNERABLE HOMELESS INDIVIDUALS THAT ARE SEEN IN THE EMERGENCY DEPARTMENT.B. STRATEGY: PROVIDE SCREENING/ASSESSMENT FOR COMMUNITY MEMBERS AND PATIENTS TO IDENTIFY SOCIAL DETERMINANTS OF HEALTH WITH A SPECIFIC FOCUS ON HOUSING/HOMELESSNESS. ACCOMPLISHMENTS: 1) EXPANSION OF TOTAL HEALTH TO SCREEN INDIVIDUALS FOR SOCIAL DETERMINANTS OF HEALTH TO FIRST GENERATION LATINO IMMIGRANTS AND UNDOCUMENTED RESIDENTS.C. STRATEGY: COLLABORATE WITH AND SUPPORT COMMUNITY PARTNERS TO ALLEVIATE BARRIERS TO HOUSING. ACCOMPLISHMENTS: 1) FINANCIAL SUPPORT TO CLARE'S PLACE TO SUPPORT A LOW-BARRIER HOUSING PROJECT, 2) PROVIDE FINANCIAL SUPPORT TO OTHER ORGANIZATIONS DIRECTLY ADDRESSING HOUSING NEEDS SUCH AS HOUSING HOPE, PEORIA HOME, VOLUNTEERS OF AMERICA, AMERICAN RED CROSS, 3) COORDINATE ANNUAL COMMUNITY EDGE OF AMAZING CONFERENCE WITH BREAK-OUT GROUPS DISCUSSING COMMUNITY BARRIERS AND SOLUTIONS TO THE HOUSING CRISIS. 4) PARTICIPATE IN PILOT TO REDUCE BARRIERS TO HOMEOWNERSHIP FOR BIPOC COMMUNITY MEMBERS, 5) PARTICIPATE IN COMMUNITY COLLABORATIVE ON IMPROVING SCHOOL ATTENDANCE FOR FAMILIES EXPERIENCE HOMELESSNESS."

PHS - WASHINGTON (GROUP B - 4 & 5) PART V, SECTION B, LINE 24:
FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.

PART V, SECTION B
FACILITY REPORTING GROUP C

FACILITY REPORTING GROUP C CONSISTS OF:
- FACILITY 6: PROVIDENCE HOLY FAMILY HOSPITAL, - FACILITY 2: PROVIDENCE SHMC & CHILDREN'S HOSPITAL, - FACILITY 13: ST. LUKE'S REHABILITATION INSTITUTE

PHS - WASHINGTON (GROUP C - 2, 6 & 13) PART V, SECTION B, LINE 3J:
PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

PHS - WASHINGTON (GROUP C - 2, 6 & 13) PART V, SECTION B, LINE 5:
PROVIDENCE SACRED HEART MEDICAL CENTER , PROVIDENCE HOLY FAMILY HOSPITAL AND ST. LUKE'S REHABILITATION HOSPITAL PROVIDE CARE TO SPOKANE COUNTY, WHICH INCLUDES A POPULATION OF APPROXIMATELY 528,652 PEOPLE.APPROXIMATELY 60 INDICATORS WERE CHOSEN THAT HELP ILLUSTRATE THE HEALTH OF THE COMMUNITY. DEMOGRAPHIC DATA AND DATA ON KEY SOCIOECONOMIC DRIVERS OF HEALTH STATUS - INCLUDING POVERTY, HOUSING AND EDUCATIONAL ATTAINMENT - ARE PRESENTED FIRST. THIS IS FOLLOWED BY THE DATA AND ANALYSIS OF EACH HEALTH INDICATOR AND IDENTIFIED DISPARITIES AND TRENDS IN THE DATA. INPUT WAS GATHERED THROUGH KEY INFORMANT INTERVIEWS AND FOCUS GROUPS FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THEIR COMMUNITIES. PARTICIPANTS WERE PRIORITIZED TO INCLUDE GROUPS EXPERIENCING INEQUITIES IN THE DETERMINANTS OF HEALTH OR WHO HAVE HISTORICALLY BEEN EXCLUDED FROM COMMUNITY CONVERSATIONS. A LIST OF PARTICIPATING COMMUNITY PARTNERS CAN BE FOUND IN THE 2021 CHNA. THE 2021 CHNA WAS APPROVED BY THE PROVIDENCE HEALTH CARE COMMUNITY MINISTRY BOARD ON NOVEMBER 4, 2021 AND MADE PUBLICLY AVAILABLE BY DECEMBER 28, 2021.

PHS - WASHINGTON (GROUP C - 2, 6 & 13) PART V, SECTION B, LINE 6A:
SACRED HEART MEDICAL CENTER AND CHILDREN'S HOSPITAL, PROVIDENCE HOLY FAMILY, ST. LUKE'S REHABILITATION CENTER AND WA MULTICARE HEALTH SYSTEM, SPOKANE, WA.

PHS - WASHINGTON (GROUP C - 2, 6 & 13) PART V, SECTION B, LINE 6B:
SACRED HEART MEDICAL CENTER AND CHILDREN'S HOSPITAL, PROVIDENCE HOLY FAMILY, ST. LUKE'S REHABILITATION CENTER AND WA MULTICARE HEALTH SYSTEM, SPOKANE, WA.CHNA WAS CONDUCTED IN PARTNERSHIP WITH PRIORITY SPOKANE, SPOKANE, WA SPOKANE REGIONAL HEALTH DISTRICT, SPOKANE, WA MULTICARE HEALTH SYSTEM, SPOKANE, WA

PHS - WASHINGTON (GROUP C - 2, 6 & 13) PART V, SECTION B, LINE 11:
AS A RESULT OF THE FINDINGS OF OUR 2021 CHNA AND THROUGH A PRIORITIZATION PROCESS ALIGNED WITH OUR MISSION, RESOURCES, AND HOSPITAL STRATEGIC PLAN, PROVIDENCE SACRED HEART MEDICAL CENTER AND CHILDREN'S HOSPITAL, PROVIDENCE HOLY FAMILY HOSPITAL, AND ST. LUKE'S REHABILITATION CENTER WILL FOCUS ON THE FOLLOWING AREAS FOR ITS 2022-2024 COMMUNITY BENEFIT EFFORTS:HIGH HOUSING COST BURDEN/HOMELESSNESS: THIS NEED INCLUDES THE LACK OF AVAILABLE HOUSING (LOW VACANCY RATE) AND THE LACK OF AFFORDABLE HOUSING, ALONG WITH SPECIFIC BARRIERS THAT PREVENT PEOPLE FROM ACCESSING HOUSING. HOUSING INSTABILITY AND A LACK OF AFFORDABLE HOUSING IS A THREAT TO HEALTH AND WELL-BEING. FOOD INSECURITY IS RELATED TO HOUSING INSTABILITY, AND ALSO AN IMPORTANT COMPONENT OF HEALTH. DOMESTIC VIOLENCE AND CHILD ABUSE: DOMESTIC VIOLENCE AND CHILD ABUSE WERE IDENTIFIED THROUGHOUT ALL AREAS OF NEED, FROM HOUSING AND ECONOMIC PRESSURES TO MENTAL HEALTH AND DISCRIMINATION. PROVIDENCE IS INCLUDING CHILD ABUSE DUE TO OUR CHILDREN'S HOSPITAL AND THE EXTREME CASES OF CHILD ABUSE WE SEE THROUGH THAT SPECIALTY. POOR MENTAL HEALTH: THERE IS A LACK OF MENTAL HEALTH SERVICES AVAILABLE IN LANGUAGES OTHER THAN ENGLISH, AND THE BARRIERS TO ACCESSING MENTAL HEALTH SERVICES ARE EVEN GREATER FOR PEOPLE THAT ARE UNDOCUMENTED. STIGMA AND SHAME AROUND MENTAL HEALTH IS PREVALENT IN SOME COMMUNITIES AND THEREFORE MENTAL HEALTH ISSUES ARE UNDERREPORTED OR HIDDEN. STAKEHOLDERS SHARED STRESSORS, TRAUMA, CULTURE SHOCK, THE FEAR OF DEPORTATION, BASIC NEEDS NOT BEING MET, FAMILY VIOLENCE, RACISM, AND DISCRIMINATION AS SOME OF THE CAUSES FOR MENTAL HEALTH ISSUES. ACCESS TO HEALTH SERVICES: THROUGHOUT THE PANDEMIC THERE HAS BEEN A NEED TO FOCUS ON ACCESS TO HEALTH CARE, INCLUDING HEALTH EDUCATION AND PREVENTIVE SERVICES. THIS HAS BEEN A CONTINUED NEED OF PEOPLE WITH LOW INCOMES AND THOSE EXPERIENCING VULNERABILITIES, AS EVIDENT IN THE DATA RELATED TO HOMELESSNESS AND FEEDBACK FROM FOCUS GROUPS AND INTERVIEWS.NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUING OUR MISSION THROUGH OUR COMMUNITY BENEFIT GRANTS FUNDING PROGRAM AS WELL AS PARTNERSHIP OPPORTUNITIES. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW:RACISM/DISCRIMINATION: PROVIDENCE IS NOT THE LEADER IN THIS EFFORT. WE SEE A FIFTH HEALTH-RELATED NEED, RACISM AND DISCRIMINATION, THROUGHOUT THE IMPROVEMENT PLANS FOR ALL FOUR NEEDS LISTED ABOVE. THIS MEANS WHEN ADDRESSING THE OTHER COMMUNITY NEEDS WE WILL USE AN EQUITY AND ANTI-RACIST FRAMEWORK. WE ARE ALSO COMMITTED TO SUPPORTING ORGANIZATIONS THAT ARE PROMOTING HEALTH EQUITY IN OUR COMMUNITY AND ARE CONTINUALLY LOOKING TO IMPROVE OUR KNOWLEDGE AND INTERNAL PROCESSES, AS WELL AS ADDRESS HEALTH DISPARITIES AND SOCIAL INEQUITIES IN OUR COMMUNITIES. WE WILL LOOK TO THOSE WITH LIVED EXPERIENCE TO GUIDE US IN IDENTIFYING HOW TO ADDRESS THE NEEDS OUR COMMUNITIES ARE EXPERIENCING.

PHS - WASHINGTON (GROUP C - 2, 6 & 13) PART V, SECTION B, LINE 24:
FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.

PART V, SECTION B
FACILITY REPORTING GROUP D

FACILITY REPORTING GROUP D CONSISTS OF:
- FACILITY 1: PROVIDENCE ALASKA MEDICAL CENTER, - FACILITY 12: ALASKA SPECIALTY HOSPITAL

PHS - WASHINGTON (GROUP D - 1 & 12) PART V, SECTION B, LINE 3J:
PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

PHS - WASHINGTON (GROUP D - 1 & 12) PART V, SECTION B, LINE 5:
PAMC WITH ALASKA SPECIALTY HOSPITAL CONDUCTED THE 2021 CHNA IN COLLABORATION WITH A DIVERSE STAKEHOLDER GROUP OF COMMUNITY PARTNERS IN ORDER TO IDENTIFY AND ADDRESS THE MOST SIGNIFICANT COMMUNITY HEALTH NEED PRIORITIES IN ANCHORAGE. REPRESENTATIVES FROM EACH OF THE PARTNER ORGANIZATIONS COMPRISED THE ANCHORAGE CHNA ADVISORY GROUP, WHICH DIRECTED THE ASSESSMENT PROCESS FROM ITS INCEPTION TO COMPLETION. THESE ORGANIZATIONS WERE CHOSEN DUE TO THE FACT THAT THEY SERVE AND REPRESENT THE BROADEST INTERESTS OF THE COMMUNITY OF ANCHORAGE. THE PERSONS CONSULTED IN CONDUCTING THE CHNA TO ENSURE BROAD COMMUNITY REPRESENTATION AND PROCESS INTEGRITY WERE: CATHOLIC SOCIAL SERVICES:- LISA AQUINO, CEO UNITED WAY:- SUE BROGAN- CLARK HALVERSON, CEO ANCHORAGE NEIGHBORHOOD HEALTH CENTER:- SHANNON SAVAGE, CHIEF COMS/DEV OFFICER- TAMMY GREEN, CEO ANCHORAGE COMMUNITY LAND TRUST:- RADHIKA KRISHNA DIRECTOR OF OPERATIONS- KIRK ROSE, CEO ANCHORAGE HEALTH DEPARTMENT:- NICOLE LEBO, DIVISION MANAGERANCHORAGE LITERACY PROGRAM:- LORI PICKETT, CEO ALASKA NATIVE HERITAGE CENTER:- EMILY EDENSHAW, CEO PROVIDENCE ALASKA:- NATHAN JOHNSON, REGIONAL DIRECTOR COMMUNITY HEALTH INVESTMENT THE COMPLETE LIST OF ALL COMMUNITY PARTICIPANTS CAN BE VIEWED AT:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS

PHS - WASHINGTON (GROUP D - 1 & 12) PART V, SECTION B, LINE 6A:
PROVIDENCE ALASKA MEDICAL CENTER AND ALASKA SPECIALTY HOSPITAL.

PHS - WASHINGTON (GROUP D - 1 & 12) PART V, SECTION B, LINE 6B:
THE CHNA FOR PROVIDENCE ALASKA MEDICAL CENTER WAS PREPARED IN COLLABORATION WITH CATHOLIC SOCIAL SERVICES, UNITED WAY, ANCHORAGE NEIGHBORHOOD HEALTH CENTER, ANCHORAGE COMMUNITY LAND TRUST, ANCHORAGE HEALTH DEPARTMENT, ANCHORAGE LITERACY PROGRAM, AND ALASKA NATIVE HERITAGE CENTER.

PHS - WASHINGTON (GROUP D - 1 & 12) PART V, SECTION B, LINE 11:
PAMC DEVELOPED ANCHORAGE COMMUNITY HEALTH IMPROVEMENT PLAN IN RESPONSE TO THE NEEDS IDENTIFIED IN THE 2021 CHNA. THE DEVELOPMENT PROCESS INCLUDED INPUT FROM PROVIDENCE CAREGIVERS, COMMUNITY PARTNERS AND THE PROVIDENCE HEALTH AND SERVICES ALASKA COMMUNITY MINISTRY BOARD. GREAT ATTENTION HAS BEEN PAID TO STABLISHING MEANINGFUL MEASURES BY WHICH WE INTEND TO EVALUATE THE IMPACT OF OUR ACTIVITIES AND THE ACTIVITIES OF OUR PARTNERS. IN SOME CASES, OUR EFFORTS HAVE BEEN CONFOUNDED BY THE LACK OF OR LIMITED AVAILABILITY OF DATA. THE EFFORT TO MEASURE OUR IMPACT WILL BE AN ONGOING CHALLENGE AND JOURNEY AS WE SEEK TO IMPROVE THE HEALTH OF OUR COMMUNITY. NOTE: THE EMERGENCE OF THE COVID-19 PANDEMIC SUBSTANTIALLY IMPACTED PAMC IMPLEMENTATION OF SERVICES. PRIORITIZED COMMUNITY HEALTH NEEDS: 1. POVERTY/SOCIAL DETERMINANTS OF HEALTH (HOMELESSNESS): SERVING THE POOR AND VULNERABLE IS CORE TO PROVIDENCE'S MISSION. HOWEVER, PROVIDING THE BASIC FOOD AND SHELTER NEEDS OF THE COMMUNITY DIRECTLY IS NOT WITHIN THE CORE COMPETENCIES OR SERVICES OF PROVIDENCE. TO ADDRESS THIS ISSUE, PROVIDENCE COLLABORATES WITH, AND PROVIDES COMMUNITY INVESTMENT FUNDING SUPPORT TO SISTER AGENCIES AND ORGANIZATIONS THAT DIRECTLY ADDRESS THE CAUSES AND IMPACTS OF POVERTY. PROVIDENCE HEALTH SERVICES ALASKA (PHSA) HAS MADE THE FIGHT AGAINST HOMELESSNESS A PRIORITY SINCE 2015, PROVIDING ABOUT $2.5 MILLION PER YEAR IN FUNDING. THAT WORK HAS PRIMARILY LED TO ADVANCES IN INFRASTRUCTURE AND THE COLLECTING OF DATA SO THAT HOMELESS SERVICE PROVIDERS CAN GET A TRUE SENSE OF THE SCALE OF THE PROBLEM. THEN IN 2019, PROVIDENCE PARTNERED WITH RASMUSON FOUNDATION, PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, AND WEIDNER APARTMENT HOMES TO PLEDGE A COMBINED $40 MILLION TO CREATING SOLUTIONS FOR HOMELESSNESS IN THE STATE - A JOINT EFFORT THAT WAS SUCCESSFUL ENOUGH TO ATTRACT PARTNERS LIKE THE BEZOS FOUNDATION. WHEN THE PANDEMIC LANDED IN ALASKA, AND CROWDED HOMELESS SHELTERS AND FACILITIES HAD TO RETHINK THEIR SPACES TO ACCOMMODATE FOR ADEQUATE SOCIAL DISTANCING TO PREVENT THE SPREAD OF COVID-19, PROVIDENCE JOINED WITH THE CITY OF ANCHORAGE AND OTHER LOCAL AGENCIES TO CONVERT THE CITY'S 8,600-SEAT SULLIVAN ARENA INTO AN EMERGENCY SHELTER. IT'S SUCCESS IN PROVIDING SHELTER TO MORE THAN 400 PEOPLE AT A TIME AND KEEPING INFECTION RATES LOW AMONG ONE OF THE HIGHEST-RISK POPULATIONS GARNERED NATIONAL ATTENTION. 2. MENTAL HEALTH: PHSA IS THE LARGEST MENTAL HEALTH SERVICES PROVIDER IN THE STATE OF ALASKA AND IS CONTINUING ITS COMMITMENT BY PROVIDING THE ONLY PSYCHIATRIC EMERGENCY DEPARTMENT SERVING THE ANCHORAGE COMMUNITY, INPATIENT AND OUTPATIENT SERVICES FOR ADULTS AND ADOLESCENTS, TELEHEALTH AND TELEPSYCH SERVICES, CRISIS RECOVERY CENTER, RESIDENTIAL TREATMENT PROGRAMS, PMGA BEHAVIORAL HEALTH CLINICS, AS WELL AS INTEGRATING MENTAL HEALTH INTO PROVIDENCE RUN PRIMARY CARE CLINICS INCLUDING THE ALASKA FAMILY MEDICINE RESIDENCY. MENTAL HEALTH IS ANOTHER ISSUE THAT PERENNIALLY APPEARS ON PROVIDENCE'S COMMUNITY NEEDS ASSESSMENTS. BUT THE PANDEMIC - THE HEALTH CRISIS, ITSELF, THE ADVERSE ECONOMIC IMPACT, AND THE EFFECTS OF THE SOCIAL ISOLATION - HAS ONLY HEIGHTENED THE IMPORTANCE OF ACCESS TO BEHAVIORAL HEALTHCARE, PARTICULARLY FOR ADOLESCENTS. THAT'S WHY PROVIDENCE HAS PARTNERED WITH VOLUNTEERS OF AMERICAN ALASKA TO EMBED BEHAVIORAL HEALTH COUNSELORS IN ANCHORAGE SCHOOL DISTRICT (ASD) SCHOOLS. THIS WILL BOOST DELIVERY, RAISE AWARENESS OF THE NEED FOR SERVICES, AND BOLSTER THE COMMUNITY'S OVERALL ABILITY TO COORDINATE CARE AMONG YOUTH. IN 2020 PROVIDENCE PARTNERED WITH ANCHORAGE NEIGHBORHOOD HEALTH CENTER AND SOUTHCENTRAL FOUNDATION TO SET UP A FULL-SERVICE CLINIC IN THE BOX OFFICE OF THE SULLIVAN SPORTS ARENA THAT HAD BEEN CONVERTED INTO AN EMERGENCY HOMELESS SHELTER. PROVIDENCE DIVERTED STAFF, RESOURCES, AND EQUIPMENT TO PROVIDE MEDICAL CARE, BEHAVIORAL HEALTH CARE, AND EVEN AN ONSITE PHARMACY. THERE WAS ALSO HELP FOR SUBSTANCE USE, ADDICTION, AND WITHDRAWAL FROM PSYCHIATRISTS, BOTH IN PERSON AND VIA MAKESHIFT TELEHEALTH TERMINALS. 3. HEALTHY BEHAVIORS: PHSA WORKS TO PROMOTE AND SUPPORT HEALTHY BEHAVIORS IN THE COMMUNITY THROUGH A NUMBER OF DIFFERENT PROGRAMS AND INITIATIVES. FAITH COMMUNITY NURSING PROVIDES A NURSE COORDINATOR, EDUCATOR AND RESOURCE PERSON FOR PARISHES AND CHURCHES OF ANY DENOMINATION TO INCREASE HEALTH LITERACY AND PROMOTE HEALTHY BEHAVIORS AT THE COMMUNITY LEVEL TO IMPROVE UNDERSTANDING OF HEALTH ISSUES, PREVENTION, HEALTHY BEHAVIORS AND HEALTH CARE. PROVIDENCE PROVIDES HEALTH MINISTRY OUTREACH TO INCREASE HEALTH LITERACY AND HEALTHY BEHAVIORS OF ENGLISH LEARNERS, SPECIFICALLY IMMIGRANTS AND REFUGEES. PROVIDENCE WILL CONTINUE ITS INJURY PREVENTION AND OUTREACH PROGRAM SAFE KIDS ALASKA - THE PRIMARY MISSION OF WHICH IS CHILDHOOD INJURY PREVENTION. NURSE FAMILY PARTNERSHIP WILL PROVIDE IN-HOME INTENSIVE FAMILY SERVICES TO LOW-INCOME, FIRST-TIME MOTHERS IN THE MUNICIPALITY OF ANCHORAGE TO IMPROVE PREGNANCY HEALTH AND OUTCOMES, CHILD HEALTH AND DEVELOPMENT AND MATERNAL OUTCOMES FROM PREGNANCY THROUGH THE CHILD'S SECOND YEAR. PROVIDENCE FAMILY MEDICINE CENTER WILL CONTINUE THE MEDICAID COORDINATED CARE DEMONSTRATION PROJECT, A PATIENT CENTERED MEDICAL HOME MODEL OF CARE DELIVERY, UTILIZES AN INTEGRATED DIRECT CARE TEAM (IDCT) COMPRISED OF BEHAVIORAL HEALTH, SOCIAL WORK, NURSE CASE MANAGEMENT, HOME VISITS, AND PHARMACY SERVICES ALL COORDINATED WITH THE PATIENT'S PRIMARY CARE PHYSICIAN TO INCREASE ACCESS, DECREASE INAPPROPRIATE UTILIZATION, AND IMPROVE PATIENT OUTCOMES. THE PROMOTION OF PREVENTION AND HEALTHY BEHAVIORS IS AT THE CENTER OF THIS MODEL OF CARE. THE COMMUNITY HEALTH WORKER PROGRAM WAS DEVELOPED IN 2020 AND FOUR COMMUNITY HEALTH WORKERS WERE HIRED, WHO CAME OUT OF PRIOR COHORTS OF OUR PEER NAVIGATOR PROGRAM. THEY SERVE AS COMMUNITY EDUCATORS AND LIAISON AROUND HEALTH ISSUES AND HEALTHY BEHAVIORS. PROVIDENCE ALASKA OVER $100,000 FUNDED THE ANCHORAGE LITERACY PEER LEADER PROGRAM WHICH WAS THE LEAD AGENCY IN THE COMMUNITY REACHING OUT TO MARGINALIZED COMMUNITIES TO ADDRESS VACCINE HESITANCY. 4. SUBSTANCE USE DISORDER: CONTINUE TO ADD AMBULATORY PSYCHIATRIC/SUBSTANCE-ABUSE DETOXIFICATION SERVICES TO THE CRISIS RECOVERY CENTER TO HELP ADDRESS UNMET NEED IN THE COMMUNITY FOR DETOX SERVICES. CONTINUE TO PROVIDE AND EXPAND CHEMICAL DEPENDENCY PROGRAMS TO HELP ADDRESS THE GROWING NEED FOR SUBSTANCE ABUSE PROGRAMS IN ANCHORAGE AND ALASKA. INCREASE REMOTE AND OUT-OF-CLINIC ACCESS TO CARE BY PILOTING TWO TELE-HEALTH INITIATIVES. CONTINUE PROVIDING THIS NECESSARY COMMUNITY SERVICE TO ADDRESS EMERGENT COMMUNITY NEED FOR ACUTE PSYCHIATRIC AND SUBSTANCE ABUSE CARE, ESPECIALLY AS THERE IS NO OTHER PROVIDER DOING SO IN THE ANCHORAGE COMMUNITY. PROVIDENCE IS WORKING TO ADDRESS THE INCREASING CHALLENGES OF OPIOID USE DISORDER BY IMPLEMENTING NEW INTEGRATED CARE PATHWAYS, WORKING TO INCREASE THE NUMBER OF SUBOXONE WAIVERED PHYSICIANS IN THE COMMUNITY PROVIDING MEDICATION ASSISTED TREATMENT (MAT) AND IMPLEMENTING SCREENING, BRIEF INTERVENTION AND REFERRAL TOOL (SBIRT) IN MORE CLINICAL SETTINGS. PROVIDENCE IS ALSO EXPANDING SERVICES AT THE CRISIS RECOVERY CENTER TO INCLUDE AMBULATORY DETOX WITH GREATER PSYCHIATRIC RESOURCES TO ADDRESS INCREASED LEVELS OF ACUITY RELATED TO SUD. 5. ACCESS TO HEALTHCARE: CONTINUE TO PROVIDE MEDICALLY NECESSARY HEALTH CARE SERVICES TO MEMBERS OF THE COMMUNITY WHO ARE UNABLE TO PAY FOR SUCH SERVICES. INCREASE THE SERVICE CAPACITY IN THE SENIOR CLINIC TO ADDRESS THE HEALTH CARE NEEDS OF THE AGING BY ADDRESSING THE SHORTAGE OF PROVIDERS ACCEPTING MEDICAID AND/OR MEDICARE IN THE COMMUNITY. CONTINUE TO PROVIDE PRIMARY CARE SERVICES AT THE ALASKA FAMILY MEDICINE RESIDENCY ON A SLIDING FEE SCALE TO REMOVE COST AS A BARRIER TO NEEDED CARE. CONTINUE SUPPORT OF THE NURSE FAMILY PARTNERSHIP PROGRAM, PROVIDING EDUCATION AND SUPPORT SERVICES TO FIRST-TIME LOW-INCOME MOTHERS TO IMPROVE MATERNAL-CHILD OUTCOMES. PROVIDENCE ALSO CONTINUES TO ADDRESS THE NEED FOR PEDIATRIC SUBSPECIALISTS TO MEET COMMUNITY NEED NOT ADDRESSED ELSEWHERE. PROVIDENCE IS COMMITTED TO CONTINUE TO PROVIDE SEXUAL AND PHYSICAL ABUSE EVALUATIONS AND FOLLOW-UP SERVICES 24/7, 365 DAYS A YEAR FOR CHILDREN, NEWBORN TO AGE 18 YEARS FOR THE STATE OF ALASKA THROUGH ALASKA CARES, THE ONLY ACCREDITED CHILDREN'S ADVOCACY CENTER (CAC) OUTPATIENT CLINIC IN ANCHORAGE. PROVIDENCE FORENSIC NURSING SERVICES PROGRAM WILL CONTINUE TO PROVIDE PHYSICAL AND SEXUAL ASSAULT EVALUATIONS AND FOLLOW-UP SERVICES 24/7, 365 DAYS A YEAR FOR VICTIMS 16 YEARS OF AGE AND OLDER. THE ALASKA MEDICAL CENTER HAS THE ONLY PRIMARY CARE RESIDENCY CLINIC THAT SERVES THE MEDICAID POPULATION OF ALASKA, AND ONE OF VERY FEW CLINICS THAT ACCEPT MEDICAID AND MEDICARE. IN ADDITION, IT IS TRAINING HEALTH CARE PROVIDERS TO SERVE MARGINALIZED COMMUNITIES.

PHS - WASHINGTON (GROUP D - 1 & 12) PART V, SECTION B, LINE 24:
FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES

PART V, SECTION B
FACILITY REPORTING GROUP E

FACILITY REPORTING GROUP E CONSISTS OF:
- FACILITY 9: PROVIDENCE MT. CARMEL HOSPITAL, - FACILITY 10: PROVIDENCE ST. JOSEPH'S HOSPITAL

PHS - WASHINGTON (GROUP E - 9 & 10) PART V, SECTION B, LINE 3J:
PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

PHS - WASHINGTON (GROUP E - 9 & 10) PART V, SECTION B, LINE 5:
PROVIDENCE MOUNT CARMEL HOSPITAL AND ST. JOSEPH HOSPITAL UTILIZED SURVEYS OF THE COMMUNITY THROUGHOUT THE MONTH OF APRIL 2019. A LIST OF THOSE WILLING TO GIVE THEIR NAMES IS LISTED ON PAGE 38 OF THE NEEDS ASSESSMENT DOCUMENT. OVER 100 EMAIL AND PERSONAL INVITATIONS WERE SENT TO TARGETED ORGANIZATIONS AND INDIVIDUALS, INCLUDING LOCAL CITY GOVERNMENT, COUNTY GOVERNMENT, SCHOOL DISTRICTS, THE CHEWELAH TRIBE, AND VARIOUS SOCIAL SERVICE AGENCIES. ANNOUNCEMENTS WERE PLACED IN LOCAL NEWSPAPERS AND POSTED IN COMMUNITY CENTERS. THE COMPLETE LIST OF ALL COMMUNITY PARTICIPANTS CAN BE VIEWED ATHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS UNDER WASHINGTON: CHEWELAH AND COLVILLE.

PHS - WASHINGTON (GROUP E - 9 & 10) PART V, SECTION B, LINE 6A:
PROVIDENCE MOUNT CARMEL HOSPITAL & PROVIDENCE ST. JOSEPH HOSPITAL

PHS - WASHINGTON (GROUP E - 9 & 10) PART V, SECTION B, LINE 11:
THE FOLLOWING NEEDS WERE PRIORITIZED IN THE DISCUSSION GROUP. BASED ON ALL OF THE INPUT RECEIVED THROUGH THIS ASSESSMENT PROCESS, THE FOLLOWING IS THE RANK ORDERED LIST OF SIGNIFICANT HEALTH NEEDS. SUPPORT FOR YOUTH AND FAMILIES 1. ADDRESS THE CYCLE OF POVERTY FOR FAMILIES WITH SUBSTANCE ABUSE AND MENTAL HEALTH TREATMENT ACCESS2. HOMELESSNESS INCLUDING HABITABLE DWELLINGS3. PROPER NUTRITION FOR CHILDREN AND FAMILIESACCOMPLISHMENTS: PARTNERSHIP WITH COLVILLE PUBLIC LIBRARY: WELCOME BABY COMMITTEE OFFERS LIBRARY SERVICES AND OTHER HELPFUL RESOURCES FOR PARENTS OF BABIES BORN AT PROVIDENCE MOUNT CARMEL HOSPITAL; LIBRARY BOOKS ARE DELIVERED TO AND FROM THE PINEWOOD TERRACE, PARKVIEW, AND BUENA VISTA NURSING HOMES, PROVIDING BOOKS AND AUDIOBOOKS FOR MANY OF COLVILLE'S SENIOR CITIZENS.PARTNERSHIP WITH COLVILLE SCHOOL DISTRICT: YOUTH RECEIVE SUPPORT TO REMAIN IN SCHOOL UNTIL GRADUATION; 5-YEAR GRADUATION RATE IS 85% PARTNERSHIP WITH N.E.W. HUNGER COALITION: PROGRAMMING INCLUDING TRAILERS TO TRANSPORT FRESH PRODUCE TO RURAL FOOD PANTRIES; HOME GARDEN SUPPORT CONTINUING CARE OF THE AGING POPULATION1. GAP IN RURAL HOME HEALTH CARE NEEDS AND ISOLATION2. HOMELESSNESS INCLUDING HABITABLE DWELLINGS3. PROPER NUTRITION FOR THE AGING POPULATION TO HELP WITH CHRONIC DISEASES. ACCOMPLISHMENTS: PARTNERSHIP WITH COLVILLE SENIOR AND COMMUNITY CENTER: ONGOING ACCESS TO COMMUNITY ACTIVITIES AND MEALS PARTNERSHIP WITH N.E.W. HUNGER COALITION: PROGRAMMING INCLUDING TRAILERS TO TRANSPORT FRESH PRODUCE TO RURAL FOOD PANTRIES; HOME GARDEN SUPPORTACCESS TO CARE1. IMMUNIZATIONS2. TRANSPORTATION3. HEALTH EDUCATION-MEDICAID -DIABETES -NUTRITION -SUBSTANCE ABUSE - TECHNOLOGY - PALLIATIVE CARE - MENTAL HEALTHACCOMPLISHMENTS: ACCESS TO SPECIALTY CARE PROVIDED THROUGH SEVERAL PROVIDENCE CLINICS TO PROVIDE RANGE OF SERVICES AVAILABLE TO SUPPORT INDIVIDUAL AND COMMUNITY HEALTH: OUTPATIENT PHYSICAL THERAPY (PROVIDENCE ST. JOSEPH HOSPITAL IN CHEWELAH); OUTPATIENT WOUND CARE (PROVIDENCE MOUNT CARMEL IN COLVILLE); FAMILY MATERNITY CENTER (PROVIDENCE MOUNT CARMEL IN COLVILLE).SUPPORT OF STEVENS COUNTY AMBULANCE: BEGINNING IN 2021, THE ORGANIZATION MOVED FROM RELYING ON ALL-VOLUNTEER SERVICE TO EMPLOYING EMTS AND PARAMEDICS TO SERVE STEVENS COUNTYOUR PLAN DOES NOT INCLUDE SPECIFIC STEPS TO ACCELERATE TOWARD LOW-INCOME HOUSING. THERE IS A LACK OF HOUSING RESOURCES IN STEVENS COUNTY WITHOUT BUILDING MORE HOUSING PROVIDENCE WOULD NOT BE IN A POSITION TO HELP ADDRESS THIS NEED. BY ADDRESSING THE CURRENT STATED NEEDS, WE HOPE WE CAN INDIRECTLY ADDRESS LOW INCOME HOUSING BY HELPING PEOPLE STAY STABLY HOUSED, OR ACQUIRE THE SKILLS TO OBTAIN EMPLOYMENT AND THE MEANS TO AFFORD HOUSING. THERE ARE MANY ORGANIZATIONS IN THE COMMUNITY ADDRESSING LOW INCOME HOUSING. WE WORK WITH MANY OF THESE AGENCIES TO ADDRESS SOCIAL DETERMINANTS OF HEALTH THAT AFFECT MANY DIFFERENT IDENTIFIED NEEDS. PROVIDENCE AND PARTNERS CANNOT ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS INDEPENDENTLY. IMPROVING COMMUNITY HEALTH REQUIRES COLLABORATION ACROSS COMMUNITY STAKEHOLDERS. NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH THE COMMUNITY BENEFITS GRANTING PROGRAM. SOME OF THESE AREAS MAY BE OUT OF OUR SCOPE. HOWEVER, WE SEE THE INTERCONNECTEDNESS OF HEALTH, HOUSING, EDUCATION, AND INCOME AND THIS NEEDS ASSESSMENT PROCESS IDENTIFIED NEEDS THAT WE WILL BE ADDRESSING. IF WE CAN IMPROVE THE HEALTH OF OUR WORKFORCE, THEY WILL BE BETTER EMPLOYEES. IF WE CAN ADDRESS MEDICAL NEEDS IN HOUSING SITUATIONS, THEY MAY BE ABLE TO LIVE IN THEIR HOMES LONGER. IN ADDITION, PROVIDENCE MOUNT CARMEL HOSPITAL AND PROVIDENCE ST. JOSEPH HOSPITAL CHEWELAH WILL CONTINUE TO COLLABORATE WITH LOCAL ORGANIZATIONS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS.

PHS - WASHINGTON (GROUP E - 9 & 10) PART V, SECTION B, LINE 24:
FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.

PART V, SECTION B, LINE 11 (CONTINUED):
PHS - WASHINGTON (GROUP B - 4 & 5)ACCESS TO PRIMARY CARE HAS ALWAYS BEEN A GREAT CHALLENGE FOR THE COMMUNITY. LACK OF ACCESS DISPROPORTIONATELY EFFECTS THOSE LIVING IN POVERTY AND PRESENTS BARRIERS TO GOOD HEALTH. ADDRESSING THESE BARRIERS WILL IMPROVE HEALTH AND HELP PEOPLE GET THE RIGHT CARE, AT THE RIGHT TIME, AND IN THE RIGHT CARE SETTING. INDIVIDUALS WHO HAVE A PRIMARY CARE PROVIDER ARE MORE LIKELY TO RECEIVE PREVENTIVE CARE, CHRONIC DISEASE MANAGEMENT AND MEDICATION MANAGEMENT, ALL OF WHICH LEAD TO BETTER HEALTH OUTCOMES. THOSE WITHOUT ACCESS TO A PRIMARY CARE PROVIDER MAY CHOOSE TO RECEIVE CARE IN AN EMERGENCY DEPARTMENT FOR NON-EMERGENT CONDITIONS BECAUSE THEY FEEL THEY HAVE NOWHERE ELSE TO GO, OR THEY DEFER CARE UNTIL AN ILLNESS PROGRESSES. THE GOAL IS TO ASSIST SNOHOMISH COUNTY RESIDENTS WITH ACCESSING PRIMARY CARE AT THE RIGHT TIME AND IN THE RIGHT CARE SETTING. ACCOMPLISHMENTS IN 2021 INCLUDE:A. STRATEGY: IMPROVE THE PATIENT EXPERIENCE WITH NEW ACCESS OPTIONS, DIGITAL TOOLS, AND CONVENIENT ACCESS.ACCOMPLISHMENTS: 1) INCREASE IN THE NUMBER OF AVAILABLE APPOINTMENTS, 2) UTILIZING A VALUE STREAM MANAGEMENT APPROACH TO IDENTIFY BARRIERS, 3) OFFERED ELECTRONIC SCHEDULING AND APPOINTMENT REMINDER APPS, 4) CREATED A CENTRALIZED HUB FOR PEDIATRIC SERVICESB. STRATEGY: COLLABORATE WITH COMMUNITY PARTNERS TO INCREASE THE AVAILABLE WORKFORCE AND INTEREST IN THE HEALTH CARE SECTOR.ACCOMPLISHMENTS: 1) PARTICIPATION IN THE SEAMAR FAMILY MEDICINE RESIDENCY PROGRAM AND THE WSU MEDICAL SCHOOL RESIDENCY PROGRAM, 2) COLLABORATION WITH AREA COMMUNITY COLLEGES AND HIGH SCHOOLS TO INCREASE INTERESTS IN HEALTHCARE CAREER PATHS.C. STRATEGY: RECRUIT ADDITIONAL PRIMARY CARE PROVIDERS TO MEET THE NEEDS OF THE COMMUNITY WHERE IT IS CONVENIENT FOR THE PATIENT.ACCOMPLISHMENTS: 1) ADDED ADDITIONAL PRIMARY CARE PROVIDERS TO PMG NORTHWEST LOCATIONS 2) OPENED AN INTERNAL MEDICINE CLINIC AS A PLACE THAT WSU RESIDENCY PROVIDERS CAN PRACTICE AND PROVIDE CARE TO THE COMMUNITY WITH A SPECIFIC FOCUS ON THOSE THAT DO NOT HAVE A PRIMARY CARE PROVIDER.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMDUE TO THE LACK OF IDENTIFIED EFFECTIVE INTERVENTIONS, RESOURCE CONSTRAINTS, OR ABSENCE OF EXPERTISE, PRMCE WILL NOT ADDRESS OBESITY/DIET/EXERCISE OR ACCESS TO YOUTH DENTAL CARE. GIVEN THE SCOPE OF CARE WE PROVIDE TO OUR COMMUNITY, WE WILL HAVE AN INDIRECT IMPACT ON THESE COMMUNITY NEEDS THROUGH OUR ONGOING WORK AS ENGAGED PARTNERS WITH OTHER COMMUNITY-LED COLLABORATIVE EFFORTS. ADDITIONALLY, SUICIDE WILL NOT BE DIRECTLY ADDRESS BY PRMCE. HOWEVER, WE ANTICIPATE THAT THE FOCUS ON ACCESS TO MENTAL HEALTH WILL ALSO HAVE A POSITIVE IMPACT ON SUICIDE.PHS - WASHINGTON (GROUP D - 1 & 12)IN 2021 PROVIDENCE PARTNERED WITH ANCHORAGE NEIGHBORHOOD HEALTH CENTER AND SOUTHCENTRAL FOUNDATION TO SET UP A FULL-SERVICE CLINIC IN THE BOX OFFICE OF THE SULLIVAN SPORTS ARENA THAT HAD BEEN CONVERTED INTO AN EMERGENCY HOMELESS SHELTER. PROVIDENCE DIVERTED STAFF, RESOURCES, AND EQUIPMENT TO PROVIDE MEDICAL CARE, BEHAVIORAL HEALTH CARE, AND EVEN AN ONSITE PHARMACY. THERE WAS ALSO HELP FOR SUBSTANCE USE, ADDICTION, AND WITHDRAWAL FROM PSYCHIATRISTS, BOTH IN PERSON AND VIA MAKESHIFT TELEHEALTH TERMINALS.

PART I, LINE 3C:
IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.

PART I, LINE 7:
THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO AND GENERAL LEDGER.

PART I, LINE 7G:
NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.

PART II, COMMUNITY BUILDING ACTIVITIES:
PROVIDENCE ACTIVELY ENGAGES WITH COMMUNITY PARTNERS TO PROMOTE HEALTH AND WELL-BEING FOR THE RESIDENTS OF SPOKANE AND SNOHOMISH COUNTY. BY PARTNERING WITH OTHERS, WE ARE ABLE TO MAXIMIZE RESOURCES TO REACH THE GREATEST NUMBER OF PEOPLE.A FEW OF THE WAYS IN WHICH WE PARTNER WITH OTHERS TO PROMOTE COMMUNITY BUILDING ACTIVITIES ARE DESCRIBED BELOW:- PROVIDENCE LIVEWELL LOCAL - CONNECTS PEOPLE WITH A CLEARINGHOUSE THAT MAKES IT EASIER TO FIND AND ACCESS HEALTH AND WELL-BEING INFORMATION AND TOOLS AND CONNECT WITH THE COMMUNITY ASSETS THROUGHOUT THE COUNTY THAT SUPPORT HEALTH AND HEALING. - PROVIDENCE HEALTH AND WELL-BEING MONITOR PROVIDENCE PARTNERED WITH OTHERS IN THE COMMUNITY TO DEVELOP A COUNTY-WIDE AND COMMUNITY SPECIFIC HEALTH AND WELL-BEING MONITOR TO DEFINE, MEASURE AND PRIORITIZE WHAT SOCIAL DETERMINATES OF HEALTH ARE IMPORTANT TO THE COMMUNITY BASED ON FEEDBACK FROM SNOHOMISH COUNTY RESIDENTS. - PROVIDENCE TOTAL HEALTH A SCREENING TOOL USED IN A PRIMARY CARE CLINIC TO SCREEN FOR SOCIAL DETERMINANT NEEDS AND REFERRING THOSE PERSONS IDENTIFIED AS HAVING AN UNMET NEED TO COMMUNITY SERVICES.- PROVIDENCE EDGE OF AMAZING ANNUAL COMMUNITY HEALTH SUMMIT THAT BRINGS TOGETHER PEOPLE FROM ORGANIZATIONS THAT ARE COMMITTED TO IMPROVING COMMUNITY HEALTH AND EQUITY. PARTICIPANTS OF THE SUMMIT SHARE PROJECTS AND GOALS TO HELP CREATE COLLABORATIVE PARTNERSHIPS THAT WILL INCREASE IMPACT AND EFFICIENCIES OF COMMUNITY BUILDING ACTIVITIES. - PROVIDENCE HEALTH EDUCATION PROMOTION COLLECTIVELY WITH OUR COMMUNITY PARTNERS, WE PROMOTE AWARENESS OF KEY PRIORITY PUBLIC HEALTH, HEALTH EDUCATION, AND PREVENTION MESSAGES FOR OUR COMMUNITIES. CLASSES, SUPPORT GROUPS, AND EDUCATIONAL EVENTS ARE HELD IN VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY. TOPICS ARE TAILORED TO THE AUDIENCE AND COVER A WIDE VARIETY OF HEALTH AND WELL-BEING AREAS.PROVIDENCE MOUNT CARMEL HOSPITAL AND PROVIDENCE ST. JOSEPH'S HOSPITAL ALSO PARTICIPATE AS MAJOR SPONSORS OF COMMUNITY EVENTS THAT BENEFIT THE COMMUNITY AT LARGE. EXAMPLES INCLUDE:-AMERICAN CANCER SOCIETY-AMERICAN RED CROSS-TRI COUNTY ECONOMIC DEVELOPMENT DISTRICTWE ARE ALSO MEMBERS OF MANY BOARDS IN THE COMMUNITY INCLUDING:-COLVILLE CHAMBER OF COMMERCEPROVIDENCE SACRED HEART, CHILDREN'S HOSPITAL, HOLY FAMILY AND ST. LUKE'S REHABILITATION INSTITUTE ALSO PARTICIPATE AS MAJOR SPONSORS OF COMMUNITY EVENTS THAT BENEFIT THE COMMUNITY AT LARGE. EXAMPLES INCLUDE:-AMERICAN BRAIN TUMOR ASSOCIATION-AMERICAN HEART ASSOCIATION-AMERICAN CANCER SOCIETY-AMERICAN RED CROSS-CANCER PATIENT CARE-CATHOLIC CHARITIES-HOPE HOUSE-INLAND NW BLOOD CENTER-MARCH OF DIMES-SPECIAL OLYMPICS-SPOKANE REGIONAL LAW AND JUSTICE COUNCIL-WOMEN HELPING WOMEN-YWCAPROVIDENCE ST. MARY MEDICAL CENTER PROVIDES MANY FREE, PREVENTATIVE, DIAGNOSTIC AND EDUCATIONAL SERVICES IN THE COMMUNITIES IT SERVES. PROVIDENCE MEDICAL GROUP PHYSICIANS OFFER FREE SPORTS PHYSICALS TO WALLA WALLA STUDENTS GRADES 6-11 IN COORDINATION WITH WALLA WALLA PUBLIC SCHOOLS, PROVIDENCE ST. MARY REHABILITATION AND PROVIDENCE ST. MARY FOUNDATION.A PROVIDENCE MEDICAL GROUP PRACTICE MANAGER CONTRIBUTES TIME TO THE SOS HEALTH SERVICES BOARD, WHICH SERVES ALL PEOPLE IN THE WALLA WALLA VALLEY, PARTICULARLY THOSE WITHOUT INSURANCE COVERAGE, AND REGARDLESS OF IMMIGRATION STATUS. THE PRACTICE MANAGER ALSO PROVIDES MENTORSHIP TO THE CLINIC'S COORDINATOR. A PROVIDENCE ST. MARY PHYSICIAN ALSO VOLUNTEERS AT THE SOS CLINIC.

PART III, LINE 4:
AS A RESULT OF ADOPTING ASU 2014-09 AS DESCRIBED IN NOTE 1, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019.

PART III, LINE 8:
THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.

PART III, LINE 9B:
OUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THIS INFORMATION IS INCLUDED IN OUR CHARITY POLICY HOWEVER THIS DETAIL IS NOT ADDRESSED IN OUR COLLECTION POLICY.

PART VI, LINE 4:
"COMMUNITY INFORMATION: PROVIDENCE ST. PETER HOSPITAL AND CENTRALIA HOSPITAL THE COMMUNITY SERVED BY PROVIDENCE ST. PETER AND PROVIDENCE CENTRALIA HOSPITALS, THE SOUTHWEST WASHINGTON SERVICE AREA, CONSISTS OF FIVE COUNTIES WITH A TOTAL POPULATION OF APPROXIMATELY 506,000.WITHIN THIS GEOGRAPHICAL AREA, THURSTON AND LEWIS COUNTIES ARE DESIGNATED AS THE PRIMARY SERVICE AREA FOR THE TWO HOSPITALS, WITH A POPULATION OF APPROXIMATELY 368,367 PEOPLE, AN INCREASE OF 6.3% FROM THE PRIOR ASSESSMENT. THE SECONDARY SERVICE AREA INCLUDES GRAYS HARBOR, MASON, AND PACIFIC COUNTIES.OF THE OVER 368,000 PERMANENT RESIDENTS OF THURSTON AND LEWIS COUNTIES, ROUGHLY 47% LIVE IN THE ""HIGH NEED"" AREA, DEFINED BY LOWER LIFE EXPECTANCY AT BIRTH, LOWER HIGH SCHOOL GRADUATION RATES, AND MORE HOUSEHOLDS AT OR BELOW 200% FPL COMPARED TO CENSUS TRACTS ACROSS THE COUNTY. FOR REFERENCE, IN 2020, 200% FPL REPRESENTS AN ANNUAL HOUSEHOLD INCOME OF $52,400 OR LESS FOR A FAMILY OF FOUR. THESE HOUSEHOLDS ARE MORE LIKELY TO REGULARLY MAKE SPENDING TRADEOFFS REGARDING UTILITIES, RENT, GROCERIES, MEDICINE, AND OTHER BASIC EXPENSES. THE HIGH NEED SERVICE AREA CONSISTS OF A DISPROPORTIONATE AMOUNT OF RESIDENTS AGES 18 TO 34, WHILE OLDER ADULTS, AGES 65 TO 84 ARE LESS LIKELY TO LIVE IN THE HIGH NEED SERVICE AREA. LEWIS AND THURSTON COUNTIES HAVE HIGHER PERCENTAGES OF PEOPLE OVER AGE 65 THAN THE STATE. THE MALE-TO-FEMALE DISTRIBUTION IS ROUGHLY EQUAL ACROSS SOUTHWEST WASHINGTON GEOGRAPHIES. IN THE SERVICE AREA, THE MAJORITY POPULATION (80.3%) ARE WHITE. 5.9% OF SERVICE AREA RESIDENTS IDENTIFY AS TWO OR MORE RACES, 5.9% ARE ASIAN/PACIFIC ISLANDER, 3.4% ARE ANOTHER RACE, 2.9% ARE BLACK, AND 1.6% ARE AMERICAN INDIAN. IN THE HOSPITALS' SERVICE AREA, 9.77% OF THE POPULATION IS OF HISPANIC ETHNICITY. WITHIN THE HIGH NEED PORTION OF THE SERVICE AREA, 11.07% OF THE POPULATION IS OF HISPANIC ETHNICITY. INDIVIDUALS WHO IDENTIFY AS HISPANIC OR ""OTHER"" RACE ARE MORE LIKELY TO LIVE IN HIGH NEEDS CENSUS TRACTS THAN THEIR PEERS OF OTHER RACES. PEOPLE WHO IDENTIFY AS WHITE ARE SLIGHTLY LESS LIKELY TO LIVE IN HIGH NEED CENSUS TRACTS, HIGHLIGHTING INEQUITIES BY RACE.THE HOSPITALS' SERVICE AREA HAS A LOWER ECONOMIC STATUS WHEN COMPARED TO THE STATE. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS $66,242. OVER ONE QUARTER (29.4%) OF THE AREA IS CONSIDERED LOW-INCOME, LIVING AT 200% OF LESS OF THE FEDERAL POVERTY LEVEL (FPL). 6.7% OF AREA ADULTS ARE UNEMPLOYED AND 16.1% ACCESS SNAP (FOOD STAMP) BENEFITS. AMONG AREA RENTERS, 25.6% EXPERIENCE A SEVERE HOUSING COST BURDEN, AS THEY SPEND 50% OR MORE OF THEIR INCOME ON RENT.OTHER HOSPITALS IN SERVICE AREAOTHER HOSPITALS IN THE COMMUNITY INCLUDE MASON GENERAL HOSPITAL AND FAMILY CLINICS, GRAYS HARBOR COMMUNITY HOSPITAL, WILLAPA HARBOR HOSPITAL, OCEAN BEACH HOSPITAL AND MEDICAL CLINICS.PROVIDENCE REGIONAL MEDICAL CENTER COLBY AND REGIONAL MEDICAL CENTER PACIFICTHE COMMUNITY SERVED BY THE HOSPITAL IS DEFINED BASED ON THE PRIMARY GEOGRAPHIC AREA IN WHICH THE MAJORITY OF PRMCE'S INPATIENT POPULATION RESIDES. AS A TERTIARY REFERRAL CENTER, PRMCE SERVES PATIENTS FROM THE SURROUNDING REGION CONSISTING OF SKAGIT, WHATCOM, ISLAND, SAN JUAN, AND SNOHOMISH COUNTIES. HOWEVER, MORE THAN 75 PERCENT OF PRMCE'S PATIENT POPULATION RESIDES IN SNOHOMISH COUNTY. PRMCE SERVES ONE OUT OF EVERY FOUR RESIDENTS OF SNOHOMISH COUNTY AND FOR THIS REASON THE GEOGRAPHIC DEFINITION FOR THE CHNA IS SNOHOMISH COUNTY. SNOHOMISH COUNTY IS LOCATED IN NORTHWEST WASHINGTON STATE. THE COUNTY LAND AREA IS COMPRISED OF 68 PERCENT FOREST LAND, 18 PERCENT RURAL, 9 PERCENT URBAN/CITY, AND 5 PERCENT AGRICULTURAL. THE TOTAL POPULATION OF SNOHOMISH COUNTY IS 805,624. AMONG SNOHOMISH COUNTY RESIDENTS, 73% OF RESIDENTS ARE WHITE, 12% ASIAN, AND 4% AFRICAN AMERICAN. OF THE TOTAL POPULATION, 11% ARE HISPANIC, AND 5% REPORT TWO OR MORE RACES. THE MEDIAN AGE FOR SNOHOMISH COUNTY IS 38.6 YEARS FOR MALES AND 40.5 YEARS FOR FEMALES. NEARLY 25% OF THE POPULATION IS UNDER THE AGE OF 19. IN THE NEXT FIVE YEARS, THE POPULATION OVER THE AGE OF 65 IS EXPECTED TO INCREASE. THE MEDIAN FAMILY INCOME EXCEEDS THAT OF THE STATE AND THE NATIONAL MEDIAN AT $91,181 AND 7.78% OF THE POPULATION ARE WITHOUT HEALTH INSURANCE COVERAGE. HEALTH PROFESSION SHORTAGE AREA THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). SNOHOMISH COUNTY HAS SEVERAL AREAS THAT ARE DESIGNATED AS A SHORTAGE AREA. THIS INFORMATION CAN BE USED TO UNDERSTAND ACCESS ISSUES, STATE AND LOCAL HEALTH CARE PLANNING, PLACEMENT OF PROVIDERS, AND ALLOCATION OF LIMITED HEALTH CARE RESOURCES.HOSPITALS LOCATED IN EVERETT WASHINGTON, IN ADDITION TO PROVIDENCE, ARE KAISER PERMANENTE MEDICAL CENTER, BHC FAIRFAX HOSPITAL. PROVIDENCE SACRED HEART MEDICAL CENTER AND CHILDREN'S HOSPITAL, HOLY FAMILY AND ST. LUKE'S REHABILITATION INSTITUTEIN 2019, THE POPULATION OF SPOKANE COUNTY WAS 515,251, THE POPULATION HAS INCREASED FROM 492,530 IN 2016. SENIORS MADE UP THE SMALLEST PROPORTION OF SPOKANE COUNTY'S POPULATION BUT SAW AN INCREASE OF 2% FROM 2016. OVER THE LAST DECADE THE PERCENTAGE OF SENIORS HAS INCREASED BY 4% WHILE THE PERCENTAGE UNDER THE AGE OF 18 HAS REMAINED STEADY.ACCORDING TO 2019 DATA, SPOKANE COUNTY IS PREDOMINANTLY WHITE. AMONG COUNTY RESIDENTS, 88.6% WERE WHITE, 4.4% WERE OF TWO OR MORE RACES, 2.6% WERE ASIAN, 2% WERE BLACK, 1.7% WERE AMERICAN INDIAN/ALASKA NATIVE, AND 0.6% WERE NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER. RESIDENTS OF LATINO/A ETHNICITY ACCOUNTED FOR 5.7% OF SPOKANE COUNTY'S POPULATION.DEMOGRAPHIC DATA FOR YOUTH UNDER THE AGE OF 18 SHOWS A SLIGHTLY MORE DIVERSE POPULATION WITH 82.3% WHITE AND 9.7% TWO OR MORE RACES.SEVERE HOUSING COST BURDEN IS DEFINED AS HOUSEHOLDS SPENDING 50% OF MORE OF THEIR INCOME ON HOUSING COSTS.THE RELATIONSHIP BETWEEN HIGHER LEVELS OF ECONOMIC WEALTH AND OPTIMAL HEALTH, AND LOWER LEVELS OF ECONOMIC WEALTH AND POOR HEALTH, ARE WELL DOCUMENTED. INCOME IS THE INDICATOR THAT MOST DIRECTLY MEASURES MATERIAL RESOURCES AND CAN INFLUENCE HEALTH BY ITS DIRECT EFFECT ON LIVING STANDARDS; SPECIFICALLY, ACCESS TO BETTER QUALITY FOOD, HOUSING AND HEALTHCARE SERVICES.- IN 2019, THE MEDIAN HOUSEHOLD INCOME IN SPOKANE COUNTY WAS $59,974 COMPARED TO $78,687 FOR WASHINGTON STATE. THE MEDIAN HOUSEHOLD INCOME IN SPOKANE COUNTY HAS INCREASED BY 24% SINCE 2015.- THE UNEMPLOYMENT RATE IN SPOKANE COUNTY WAS 6.3% IN 2019 COMPARED TO 4.6% STATEWIDE.HOUSING IS A BASIC HUMAN NEED. WHEN AN INDIVIDUAL IS WORRIED ABOUT MEETING THIS NEED, THEY CANNOT PURSUE OTHER AREAS OF THEIR LIFE, SUCH AS EDUCATION, WORK, AND FAMILY DEVELOPMENT. FROM A HEALTH PERSPECTIVE, THERE IS A CLEAR LINK BETWEEN HOUSING AVAILABILITY AND QUALITY, AND HEALTH. POOR-QUALITY HOUSING IS ASSOCIATED WITH MULTIPLE NEGATIVE HEALTH OUTCOMES, INCLUDING CHRONIC DISEASE, INJURY, AND POOR MENTAL HEALTH. LOW-INCOME FAMILIES AND RACIAL AND ETHNIC MINORITIES MAY BE MORE LIKELY TO LIVE IN POOR-QUALITY HOUSING AND SUFFER ADVERSE HEALTH OUTCOMES AS A RESULT. THE AVAILABILITY OF AFFORDABLE HOUSING CHOICES FOR SPOKANE COUNTY RESIDENTS IS CURRENTLY LOW. MAKING HOUSING MORE AFFORDABLE AND AVAILABLE TO ALL RESIDENTS HAS BEEN IDENTIFIED AS A TOP PRIORITY IN PREVIOUS SPOKANE COUNTY NEEDS ASSESSMENTS.COVID - 19 HAS HAD A SIGNIFICANT IMPACT ON THE WORLD OVER THE PAST YEAR. IN SPOKANE COUNTY, PACIFIC ISLANDER, LATINO/A AND BLACK COMMUNITIES EXPERIENCED SIGNIFICANTLY HIGHER RATES OF CASES, DEATHS AND HOSPITALIZATIONS ASSOCIATED WITH COVID-19 THAN WHITE COMMUNITIES. AS OF AUGUST 25, 2021, SPOKANE COUNTY RECORDED 55,083 CASES AND 727 DEATHS.OTHER HOSPITALS IN SERVICE AREAOTHER HOSPITALS IN SPOKANE INCLUDE SHRINERS HOSPITALS FOR CHILDREN - SPOKANE, MULTICARE DEACONESS HOSPITAL, US DEPT OF VETERANS AFFAIRS-MANN-GRANDSTAFF.PROVIDENCE ALASKA MEDICAL CENTER (PAMC) AND ALASKA SPECIALTY HOSPITAL THE MUNICIPALITY OF ANCHORAGE IS THE LARGEST COMMUNITY IN THE STATE OF ALASKA. IT IS LOCATED IN SOUTHCENTRAL ALASKA ALONG COOK INLET. ANCHORAGE SITS IN A BOWL WITH COOK INLET ON ONE SIDE AND CHUGACH STATE PARK ON THE OTHER. HOME TO NEARLY HALF THE STATE'S RESIDENTS, ANCHORAGE HAS A POPULATION OF ROUGHLY 300,000 AND INCLUDES THE COMMUNITIES OF ANCHORAGE, CHUGIAK, EAGLE RIVER, GIRDWOOD, AND JOINT BASE ELMENDORF-RICHARDSON. IT IS THE HUB OF ALASKA'S INFRASTRUCTURE AND BUSINESS COMMUNITY. ETHNICALLY AND CULTURALLY DIVERSE, THREE OF THE TOP 10 MOST DIVERSE CENSUS TRACTS IN THE UNITED STATES ARE WITHIN ANCHORAGE."

PART VI, LINE 5:
PROVIDENCE PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. PROVIDENCE IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) OPEN MEDICAL STAFF2) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS.

PART VI, LINE 7, REPORTS FILED WITH STATES
WA,OR,CA,MT,AK,TX

PART VI, LINE 4 (CONTINUED):
"ST. LUKE'S REHABILITATION CENTERIN 2019, THE POPULATION OF SPOKANE COUNTY WAS 515,251, THE POPULATION HAS INCREASED FROM 492,530 IN 2016. SENIORS MADE UP THE SMALLEST PROPORTION OF SPOKANE COUNTY'S POPULATION BUT SAW AN INCREASE OF 2% FROM 2016. OVER THE LAST DECADE THE PERCENTAGE OF SENIORS HAS INCREASED BY 4% WHILE THE PERCENTAGE UNDER THE AGE OF 18 HAS REMAINED STEADY.ACCORDING TO 2019 DATA, SPOKANE COUNTY IS PREDOMINANTLY WHITE. AMONG COUNTY RESIDENTS, 88.6% WERE WHITE, 4.4% WERE OF TWO OR MORE RACES, 2.6% WERE ASIAN, 2% WERE BLACK, 1.7% WERE AMERICAN INDIAN/ALASKA NATIVE, AND 0.6% WERE NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER. RESIDENTS OF LATINO/A ETHNICITY ACCOUNTED FOR 5.7% OF SPOKANE COUNTY'S POPULATION.DEMOGRAPHIC DATA FOR YOUTH UNDER THE AGE OF 18 SHOWS A SLIGHTLY MORE DIVERSE POPULATION WITH 82.3% WHITE AND 9.7% TWO OR MORE RACES.SEVERE HOUSING COST BURDEN IS DEFINED AS HOUSEHOLDS SPENDING 50% OF MORE OF THEIR INCOME ON HOUSING COSTS.THE RELATIONSHIP BETWEEN HIGHER LEVELS OF ECONOMIC WEALTH AND OPTIMAL HEALTH, AND LOWER LEVELS OF ECONOMIC WEALTH AND POOR HEALTH, ARE WELL DOCUMENTED. INCOME IS THE INDICATOR THAT MOST DIRECTLY MEASURES MATERIAL RESOURCES AND CAN INFLUENCE HEALTH BY ITS DIRECT EFFECT ON LIVING STANDARDS; SPECIFICALLY, ACCESS TO BETTER QUALITY FOOD, HOUSING AND HEALTHCARE SERVICES.- IN 2019, THE MEDIAN HOUSEHOLD INCOME IN SPOKANE COUNTY WAS $59,974 COMPARED TO $78,687 FOR WASHINGTON STATE. THE MEDIAN HOUSEHOLD INCOME IN SPOKANE COUNTY HAS INCREASED BY 24% SINCE 2015.- THE UNEMPLOYMENT RATE IN SPOKANE COUNTY WAS 6.3% IN 2019 COMPARED TO 4.6% STATEWIDE.HOUSING IS A BASIC HUMAN NEED. WHEN AN INDIVIDUAL IS WORRIED ABOUT MEETING THIS NEED, THEY CANNOT PURSUE OTHER AREAS OF THEIR LIFE, SUCH AS EDUCATION, WORK, AND FAMILY DEVELOPMENT. FROM A HEALTH PERSPECTIVE, THERE IS A CLEAR LINK BETWEEN HOUSING AVAILABILITY AND QUALITY, AND HEALTH. POOR-QUALITY HOUSING IS ASSOCIATED WITH MULTIPLE NEGATIVE HEALTH OUTCOMES, INCLUDING CHRONIC DISEASE, INJURY, AND POOR MENTAL HEALTH. LOW-INCOME FAMILIES AND RACIAL AND ETHNIC MINORITIES MAY BE MORE LIKELY TO LIVE IN POOR-QUALITY HOUSING AND SUFFER ADVERSE HEALTH OUTCOMES AS A RESULT. THE AVAILABILITY OF AFFORDABLE HOUSING CHOICES FOR SPOKANE COUNTY RESIDENTS IS CURRENTLY LOW. MAKING HOUSING MORE AFFORDABLE AND AVAILABLE TO ALL RESIDENTS HAS BEEN IDENTIFIED AS A TOP PRIORITY IN PREVIOUS SPOKANE COUNTY NEEDS ASSESSMENTS.COVID-19 HAS HAD A SIGNIFICANT IMPACT ON THE WORLD OVER THE PAST YEAR. IN SPOKANE COUNTY, PACIFIC ISLANDER, LATINO/A AND BLACK COMMUNITIES EXPERIENCED SIGNIFICANTLY HIGHER RATES OF CASES, DEATHS AND HOSPITALIZATIONS ASSOCIATED WITH COVID-19 THAN WHITE COMMUNITIES. AS OF AUGUST 25, 2021, SPOKANE COUNTY RECORDED 55,083 CASES AND 727 DEATHS.OTHER HOSPITALS IN SERVICE AREAOTHER HOSPITALS IN SPOKANE INCLUDE SHRINERS HOSPITALS FOR CHILDREN - SPOKANE, MULTICARE DEACONESS HOSPITAL, US DEPT OF VETERANS AFFAIRS-MANN-GRANDSTAFF.KODIAK IS. MEDICAL CENTERBEING THE ONLY ACUTE CARE HOSPITAL ON KODIAK ISLAND, OUR SERVICE AREA IS THE ENTIRETY OF THE KODIAK ISLAND BOROUGH AND ALL OF ITS COMMUNITIES, ENCOMPASSING THE ENTIRE POPULATION OF KODIAK ISLAND. THE BOROUGH IS SITUATED IN THE GULF OF ALASKA AND COMPRISED OF 16 MAJOR ISLANDS. KODIAK ISLAND TOTALS 3,588 SQUARE MILES AND IS THE SECOND LARGEST ISLAND IN THE UNITED STATES - SECOND ONLY TO HAWAII. KODIAK ISLAND, WHICH IS MOST FAMOUS FOR ITS LARGE AND IMPRESSIVE POPULATION OF BROWN BEARS, IS ALSO RICH IN OTHER FORMS OF WILDLIFE, CULTURE, NATURAL RESOURCES AND SCENIC BEAUTY. WITH THE LARGEST FISHING PORT IN THE STATE, THE ISLAND IS THE THIRD LARGEST FISHING PORT IN THE COUNTRY. IN ADDITION, KODIAK ISLAND HOSTS THE LARGEST U.S. COAST GUARD BASE. THUS, COMMERCIAL FISHING AND THE U.S. COAST GUARD ARE THE DOMINANT INDUSTRIES FOLLOWED BY RETAIL TRADE, TRANSPORTATION, UTILITIES AND TOURISM. THE POPULATION OF KODIAK ISLAND IS 13,621 PEOPLE.BEING THE ONLY ACUTE CARE HOSPITAL ON KODIAK ISLAND, THE COMMUNITIES SERVED BY THE HOSPITAL ARE DEFINED AS THE ISLAND OF KODIAK INCLUSIVE OF THE FOLLOWING COMMUNITIES. COMMUNITY DEMOGRAPHICS BASED ON THE US CENSUS, THE TOTAL POPULATION OF THE KODIAK ISLAND BOROUGH IS 13,621 PEOPLE. THE AGE DEMOGRAPHICS ARE THE FOLLOWING:- 27.9% YOUTH (0-19 YEARS)- 36.3% YOUNG ADULTS (20-44 YEARS) 24.8% OLDER ADULTS (45-64 YEARS) 11.1% SENIORS (65 YEARS AND OLDER). THE FOLLOWING 2019 KODIAK COMMUNITY SURVEY DATA REPRESENT RESIDENTS' ACCESS TO AND UTILIZATION OF HEALTH CARE SERVICES:- 22% OF ADULTS UNDER THE AGE 65 ARE UNINSURED (US CENSUS: SMALL AREA HEALTH INSURANCE ESTIMATES)- 8% OF ADULTS OF ALL AGES ARE UNINSURED- 11% INDICATE USING THE EMERGENCY ROOM FOR MAIN SOURCE OF HEALTH CARE- 12% REPORT BEING UNABLE TO RECEIVE NEEDED HEALTH CARE IN THE LAST 12 MONTHSTHE FOLLOWING 2019 KODIAK COMMUNITY SURVEY DATA REPRESENT THE HEALTH AND WELLBEING OF COMMUNITY RESIDENTS: - 65% OF ADULTS ARE OVERWEIGHT OR OBESE- 22% OF SURVEY RESPONDENTS INDICATED THEY HAVE A CHRONIC DISEASE, AND OF THOSE, 25% DO NOT HAVE THE RESOURCES NEEDED TO MANAGE THEIR CHRONIC DISEASE- 25% OF SURVEY RESPONDENTS ENGAGED IN BINGE DRINKING IN THE PAST 30 DAYS- 14% OF RESPONDENTS INDICATED THAT THEY EXPERIENCED DEPRESSION IN THE PAST 12 MONTHS- 5% OF SURVEY RESPONDENTS INDICATED THAT THEY HAD THOUGHT ABOUT COMMITTING SUICIDE AT SOME POINT IN THE PAST 12 MONTHS. HEALTH PROFESSIONS SHORTAGE AREATHE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). THE MUNICIPALITY OF ANCHORAGE SERVICE AREAS WITHIN IT THAT HAVE BEEN IDENTIFIED AS MENTAL HEALTH, PRIMARY CARE AND DENTAL HEALTH PROFESSIONS SHORTAGE AREAS.MEDICAL UNDERSERVED AREA MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL ""UNDER SERVICE.""MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY.THE MUNICIPALITY OF ANCHORAGE IS IDENTIFIED AS A MEDICALLY UNDERSERVED AREA. OTHER HOSPITALS IN SERVICE AREA:ANCHORAGE, AK1) ALASKA REGIONAL HOSPITAL2)ALASKA NATIVE MEDICAL CENTERKODIAK, AK PROVIDENCE KODIAK ISLAND MEDICAL CENTER IS THE ONLY HOSPITAL ON KODIAK ISLANDTHE RELATIONSHIP BETWEEN HIGHER LEVELS OF ECONOMIC WEALTH AND OPTIMAL HEALTH, AND LOWER LEVELS OF ECONOMIC WEALTH AND POOR HEALTH, ARE WELL DOCUMENTED. INCOME IS THE INDICATOR THAT MOST DIRECTLY MEASURES MATERIAL RESOURCES AND CAN INFLUENCE HEALTH BY ITS DIRECT EFFECT ON LIVING STANDARDS; SPECIFICALLY, ACCESS TO BETTER QUALITY FOOD, HOUSING AND HEALTHCARE SERVICES. - IN 2019, THE MEDIAN HOUSEHOLD INCOME IN SPOKANE COUNTY WAS $59,974 COMPARED TO $78,687 FOR WASHINGTON STATE. THE MEDIAN HOUSEHOLD INCOME IN SPOKANE COUNTY HAS INCREASED BY 24% SINCE 2015.-THE UNEMPLOYMENT RATE IN SPOKANE COUNTY WAS 6.3% IN 2019 COMPARED TO 4.6% STATEWIDE.HOUSING IS A BASIC HUMAN NEED. WHEN AN INDIVIDUAL IS WORRIED ABOUT MEETING THIS NEED, THEY CANNOT PURSUE OTHER AREAS OF THEIR LIFE, SUCH AS EDUCATION, WORK, AND FAMILY DEVELOPMENT. FROM A HEALTH PERSPECTIVE, THERE IS A CLEAR LINK BETWEEN HOUSING AVAILABILITY AND QUALITY, AND HEALTH. POOR-QUALITY HOUSING IS ASSOCIATED WITH MULTIPLE NEGATIVE HEALTH OUTCOMES, INCLUDING CHRONIC DISEASE, INJURY, AND POOR MENTAL HEALTH. LOW-INCOME FAMILIES AND RACIAL AND ETHNIC MINORITIES MAY BE MORE LIKELY TO LIVE IN POOR-QUALITY HOUSING AND SUFFER ADVERSE HEALTH OUTCOMES AS A RESULT. THE AVAILABILITY OF AFFORDABLE HOUSING CHOICES FOR SPOKANE COUNTY RESIDENTS IS CURRENTLY LOW. MAKING HOUSING MORE AFFORDABLE AND AVAILABLE TO ALL RESIDENTS HAS BEEN IDENTIFIED AS A TOP PRIORITY IN PREVIOUS SPOKANE COUNTY NEEDS ASSESSMENTS.COVID-19 HAS HAD A SIGNIFICANT IMPACT ON THE WORLD OVER THE PAST YEAR. IN SPOKANE COUNTY, PACIFIC ISLANDER, LATINO/A AND BLACK COMMUNITIES EXPERIENCED SIGNIFICANTLY HIGHER RATES OF CASES, DEATHS AND HOSPITALIZATIONS ASSOCIATED WITH COVID-19 THAN WHITE COMMUNITIES. AS OF AUGUST 25, 2021, SPOKANE COUNTY RECORDED 55,083 CASES AND 727 DEATHS."

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NEEDS ASSESSMENT:PROVIDENCE ALASKA MEDICAL CENTER AND ALASKA SPECIALTY HOSPITAL (ST. ELIAS)IN ADDITION TO CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, ALASKA MEDICAL CENTER LEADERSHIP PARTICIPATE IN COMMUNITY BOARDS THAT ENABLE IT TO UNDERSTAND EMERGING COMMUNITY NEEDS. IN ADDITION, THE HEALTH AND WELLBEING MONITOR WILL BE DEPLOYED ANNUALLY IN LOW INCOME COMMUNITIES TO HAVE ANNUAL FEEDBACK LOOP ON COMMUNITY NEEDS IN THEIR MARGINALIZED AND UNDERSERVED COMMUNITIES.PROVIDENCE ST. PETER HOSPITAL & CENTRALIA HOSPITALEVERY THREE YEARS, PROVIDENCE CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA IS CONDUCTED TO DISCERN THE NEEDS OF THOSE WE SERVE AND TO CREATE PARTNERSHIPS THAT RESPOND EFFECTIVELY. WE HAVE COMMUNITY AND FOUNDATION BOARDS. THE CIVIC LEADERS THAT SERVE ON PROVIDENCE BOARDS HELP PROVIDE A LOCAL PERSPECTIVE ON COMMUNITY NEEDS.PROVIDENCE REGIONAL MEDICAL CENTER COLBY & PACIFICTHE CHNA PROCESS IS BASED UPON THE UNDERSTANDING THAT HEALTH AND WELLNESS HAPPEN ACROSS OUR COMMUNITIES, NOT JUST IN MEDICAL FACILITIES. IN GATHERING INFORMATION ON THE COMMUNITIES SERVED BY THE HOSPITAL, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, AND HEALTH BEHAVIORS. WE ALSO INVITED KEY STAKEHOLDERS AND COMMUNITY MEMBERS TO PROVIDE ADDITIONAL CONTEXT TO THE DATA THROUGH COMMUNITY SURVEYS AND COMMUNITY FORUMS. PRMCE UTILIZED A THREE-STEP APPROACH TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS. NEEDS IDENTIFIED IN THE SNOHOMISH HEALTH DISTRICT CHNA WERE EVALUATED IN THE FIRST PHASE OF PRIORITIZATION. THE SECOND PHASE INCLUDED EVALUATING THE DATA BASED ON THE NEED FOR IMPROVEMENT, DISPROPORTIONATE IMPACT ON SUB-POPULATIONS, AND THE LEVEL OF COMMUNITY RESOURCES DEDICATED TO IMPROVING THE INDICATOR. AND FINALLY, THE THIRD PHASE INCLUDED A WEIGHTED SCORING BASED ON THE LINKAGE TO OUR STRATEGIC PLAN, THE AMOUNT OF RESOURCES RELATIVE TO COMMUNITY NEED, AND THE CONFIDENCE IN OUR ABILITY TO HAVE AN IMPACT ON THE HEALTH ISSUE. PROVIDENCE ST. MARY MEDICAL CENTER (PSMMC)PSMMC REPRESENTATIVES PARTICIPATE IN BLUE MOUNTAIN REGIONAL COMMUNITY HEALTH PARTNERSHIP (BMRCHP) MEETINGS AND ARE INCLUDED IN BMRCHP CHIP PLANNING DISCUSSIONS AND MEETINGS, PARTICIPATE IN REACH OUT WALLA WALLA MEETINGS AND INITIATIVES, AND HAVE AN EFFECTIVE AND COLLABORATIVE WORKING RELATIONSHIP WITH WALLA WALLA COUNTY DEPARTMENT OF HEALTH.KODIAK MEDICAL CENTERIN ADDITION TO CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEAR, KODIAK MEDICAL CENTER LEADERSHIP PARTICIPATE IN COMMUNITY BOARDS THAT ENABLE IT TO UNDERSTAND EMERGING COMMUNITY NEEDS. IN ADDITION, THE HEALTH AND WELLBEING MONITOR WILL BE DEPLOYED ANNUALLY IN LOW INCOME COMMUNITIES TO HAVE ANNUAL FEEDBACK LOOP ON COMMUNITY NEEDS IN THEIR MARGINALIZED AND UNDERSERVED COMMUNITIES.PROVIDENCE SACRED HEART MEDICAL CENTER AND CHILDREN'S HOSPITAL AND HOLY FAMILYEVERY THREE YEARS, PROVIDENCE CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA IS CONDUCTED TO DISCERN THE NEEDS OF THOSE WE SERVE AND TO CREATE PARTNERSHIPS THAT RESPOND EFFECTIVELY. WE HAVE COMMUNITY AND FOUNDATION BOARDS.THE CIVIC LEADERS WHO SERVE ON PROVIDENCE BOARDS HELP PROVIDE A LOCAL PERSPECTIVE ON COMMUNITY NEEDS.PROVIDENCE MT. CARMEL HOSPITAL AND PROVIDENCE ST. JOSEPH'S HOSPITALWE RECOGNIZE THAT CARING FOR THE POOR AND VULNERABLE IS NOT A TASK WE CAN DO ON OUR OWN. ON A ROUTINE BASIS WE CONDUCT A FORMAL COMMUNITY ASSESSMENT TO DETERMINE WHO IN OUR COMMUNITIES IS EXPERIENCING THE GREATEST NEED. THIS OUTREACH CONNECTS US TO MANY NOT-FOR-PROFITS AND SOCIAL SERVICE AGENCIES AS WELL AS CARE PROVIDERS AND THEIR CLIENTS IN THE COMMUNITIES. TO ENSURE THAT WE CONDUCT A COMPREHENSIVE ASSESSMENT, OUR PROCESS INCLUDES RESEARCH, MEETINGS, INTERVIEWS, FOCUS GROUPS AND SURVEYS. ADDITIONALLY, PROVIDENCE MINISTRIES HAVE COMMUNITY AND FOUNDATION BOARDS. THE CIVIC LEADERS THAT SERVE ON PROVIDENCE BOARDS CONNECT OUR MISSION WITH A LOCAL PERSPECTIVE ON COMMUNITY NEEDS.ST. LUKE'S REHABILITATION CENTEREVERY THREE YEARS, PROVIDENCE CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA IS CONDUCTED TO DISCERN THE NEEDS OF THOSE WE SERVE AND TO CREATE PARTNERSHIPS THAT RESPOND EFFECTIVELY. WE HAVE COMMUNITY AND FOUNDATION BOARDS. THE CIVIC LEADERS WHO SERVE ON PROVIDENCE BOARDS HELP PROVIDE A LOCAL PERSPECTIVE ON COMMUNITY NEEDS.

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COMMUNICATION TO THE PUBLIC:PROVIDENCE HOSPITALS POST NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME UNINSURED PATIENTS. THESE NOTICES ARE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE HOSPITAL SUCH AS ADMITTING/REGISTRATION, BILLING OFFICE, EMERGENCY DEPARTMENT AND OTHER OUTPATIENT SETTINGS.EVERY POSTED NOTICE REGARDING FINANCIAL ASSISTANCE POLICIES CONTAINS BRIEF INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE OR A DISCOUNTED PAYMENT. THE NOTICES ALSO INCLUDE A CONTACT TELEPHONE NUMBER THAT A PATIENT OR FAMILY MEMBER CAN CALL TO OBTAIN MORE INFORMATION.PROVIDENCE ENSURES THAT APPROPRIATE STAFF MEMBERS ARE KNOWLEDGEABLE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES. TRAINING IS PROVIDED TO STAFF MEMBERS (I.E., BILLING OFFICE, FINANCIAL DEPARTMENT, ETC.) WHO DIRECTLY INTERACT WITH PATIENTS REGARDING THEIR HOSPITAL BILLS.WHEN COMMUNICATING TO PATIENTS REGARDING THEIR FINANCIAL ASSISTANCE POLICIES, PROVIDENCE ATTEMPTS TO DO SO IN THE PRIMARY LANGUAGE OF THE PATIENT, OR HIS/HER FAMILY, IF REASONABLY POSSIBLE, AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.PROVIDENCE SHARES THEIR FINANCIAL ASSISTANCE POLICIES WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST SUCH PATIENTS.

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AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE HEALTH CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:- PROVIDENCE ACROSS SEVEN WESTERN STATES- COVENANT HEALTH IN WEST TEXAS- PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA- HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA- KADLEC IN SOUTHEAST WASHINGTON- PACIFIC MEDICAL CENTERS IN SEATTLE, WA.- SWEDISH HEALTH SERVICES IN SEATTLE, WA.2021 WAS A YEAR MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.

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PROVIDENCE MT. CARMEL & ST. JOSEPH'S HOSPITALWE RECOGNIZE THAT CARING FOR THE POOR AND VULNERABLE IS NOT A TASK WE CAN DO ON OUR OWN. ON A ROUTINE BASIS WE CONDUCT A FORMAL COMMUNITY ASSESSMENT TO DETERMINE WHO IN OUR COMMUNITIES IS EXPERIENCING THE GREATEST NEED. THIS OUTREACH CONNECTS US TO MANY NOT-FOR-PROFITS AND SOCIAL SERVICE AGENCIES AS WELL AS CARE PROVIDERS AND THEIR CLIENTS IN THE COMMUNITIES. TO ENSURE THAT WE CONDUCT A COMPREHENSIVE ASSESSMENT, OUR PROCESS INCLUDES RESEARCH, MEETINGS, INTERVIEWS, FOCUS GROUPS AND SURVEYS.ADDITIONALLY, PROVIDENCE MINISTRIES HAVE COMMUNITY AND FOUNDATION BOARDS. THE CIVIC LEADERS THAT SERVE ON PROVIDENCE BOARDS CONNECT OUR MISSION WITH A LOCAL PERSPECTIVE ON COMMUNITY NEEDS.OUR ASSESSMENT FINDINGS ARE ASSEMBLED TO MAKE CERTAIN WE UNDERSTAND AND RESPOND TO LOCAL AND REGIONAL NEEDS, WHICH OFTEN VARY FROM ONE CITY OR COUNTY TO ANOTHER. IDENTIFIED AREAS OF NEED NOT ONLY GUIDE OUR COMMUNITY BENEFIT GIVING, BUT ALSO GUIDE OUR STRATEGIC PLANNING. WE BELIEVE MEANINGFUL COMMUNITY NEEDS ASSESSMENT PROVIDES INSIGHT INTO THE COMPLETE COMMUNITY BENEFIT THAT IS REQUIRED, BEYOND JUST FREE AND DISCOUNTED CARE.PROVIDENCE KODIAK ISLAND MEDICAL CENTEREVERY THREE YEARS, PROVIDENCE KODIAK ISLAND MEDICAL CENTER CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE KODIAK ISLAND BOROUGH. THE CHNA IS AN EVALUATION OF KEY HEALTH INDICATORS OF THE COMMUNITY. IN 2019, WIPFLI LLP WAS ENGAGED BY PROVIDENCE TO COLLECT AND AGGREGATE PRIMARY AND SECONDARY DATA IN THE FORM OF A CHNA REPORT.A COMMUNITY SURVEY WAS MADE AVAILABLE ONLINE AND ADMINISTERED IN HARD COPY THROUGHOUT THE COMMUNITY BY THE ADVISORY COMMITTEE, COMMUNITY VOLUNTEERS AND PSMCC STAFF. THE SURVEY WAS BASED ON THE PRIOR KODIAK ASSESSMENT SURVEY TO ENABLE TRACKING AND DEMONSTRATION OF HEALTH TRENDS, BUT WAS ALSO AUGMENTED BASED ON INPUT FROM THE KODIAK CHNA ADVISORY GROUP TO CAPTURE INFORMATION ABOUT UNIQUE AND/OR TIMELY HEALTH-RELATED ISSUES WITHIN THE KODIAK COMMUNITY.SECONDARY DATA WAS COLLECTED FROM THE FOLLOWING MAJOR SOURCES:- ALASKA BUREAU OF VITAL STATISTICS- ALASKA YOUTH RISK BEHAVIOR SURVEY- COUNTY HEALTH RANKINGS- ESRI, 2015 (BASED ON US CENSUS DATA)- MEDICAID.GOV- NATIONAL CENTER FOR HEALTH STATISTICSTHE SECONDARY DATA INCLUDES A VARIETY OF SERVICE AREAS IN ADDITION TO STATE AND NATIONAL MEASURES TO PRESENT A COMMUNITY PROFILE, BIRTH AND DEATH CHARACTERISTICS, ACCESS TO HEALTH CARE, CHRONIC DISEASES, SOCIAL ISSUES, AND OTHER DEMOGRAPHIC CHARACTERISTICS. DATA WAS COLLECTED AND PRESENTED AT THE SERVICE AREA LEVEL AND WHEREVER POSSIBLE, COMPARED TO ALASKA AND NATIONAL BENCHMARKS.COUNTY HEALTH RANKINGS DATA IS AGGREGATED FROM THE FOLLOWING NATIONAL DATA SOURCES:- THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)- NATIONAL CENTER FOR HEALTH STATISTICS- US CENSUS BUREAU'S SMALL AREA HEALTH INSURANCE ESTIMATES PROGRAMKEY STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS IN THE KODIAK COMMUNITY. THESE INDIVIDUALS WERE IDENTIFIED BY THE CHNA ADVISORY COMMITTEE BASED ON THEIR QUALIFICATIONS TO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED. GENERALLY, THE INTERVIEWEES INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AND THOSE WHO REPRESENT AND/OR SERVE THE MEDICALLY UNDERSERVED, MINORITY AND VULNERABLE POPULATIONS. INTERVIEWEES WERE INVITED TO PARTICIPATE IN THE INFORMATIONAL INTERVIEWS.PROVIDENCE SHMC & CHILDREN'S HOSPITAL AND PROVIDENCE HOLY FAMILY HOSPITALAS HEALTH CARE CONTINUES TO EVOLVE, PROVIDENCE IS RESPONDING WITH DEDICATION TO ITS MISSION AND A CORE STRATEGY TO CREATE HEALTHIER COMMUNITIES, TOGETHER. PARTNERING WITH COMMUNITY ORGANIZATIONS, WE CONDUCT A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT TO LEARN ABOUT THE GREATEST NEEDS AND ASSETS FROM THE PERSPECTIVE OF SOME OF THE MOST MARGINALIZED GROUPS OF PEOPLE IN COMMUNITIES WE SERVE. THIS ASSESSMENT HELPS US DEVELOP COLLABORATIVE SOLUTIONS TO FULFILL UNMET NEEDS AND GUIDES OUR COMMUNITY BENEFIT INVESTMENTS, NOT ONLY FOR OUR OWN PROGRAMS BUT ALSO FOR MANY PARTNERS. DOZENS OF PARTICIPANTS PROVIDED FEEDBACK. SIGNIFICANT CONTRIBUTORS INCLUDE PRIORITY SPOKANE, A CIVIC LEADERSHIP GROUP MADE UP OF LOCAL GOVERNMENT, BUSINESSES, NONPROFIT ORGANIZATIONS AND LOCAL FUNDERS; THE SPOKANE REGIONAL HEALTH DISTRICT; AND THE SPOKANE HOMELESS COALITION.

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"TOTAL ANCHORAGE POPULATION IS 294,356:- 27.4% YOUTH (0-19 YEARS)- 37.1% ADULTS (20-44 YEARS)- 25.1% OLDER ADULTS (45-64 YEARS)- 10.5% SENIORS (65 YEARS AND OLDER)RACE AND ETHNICITY:- 64.5% WHITE/CAUCASIAN - 9.8% ASIAN- 9.2% WERE HISPANIC OR LATINO- 8.8% WERE ALASKA NATIVE OR AMERICAN INDIAN- 6.0% WERE AFRICAN AMERICAN OR BLACK- 2.6% WERE NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER- 8.2% WERE OF TWO OR MORE RACES. INCOME AND HOUSING:- $82,271 MEDIAN HOUSEHOLD INCOME- 4.9% UNEMPLOYMENT- 8.1% TOTAL POPULATION BELOW POVERTY- 12.3% CHILDREN LESS THAN 18 YEARS OLD BELOW POVERTY- 5.5% HOUSEHOLDS WITH PUBLIC ASSISTANCE INCOME- 4.3% HOMELESS STUDENTS SERVED BY ANCHORAGE SCHOOL DISTRICT OTHER HOSPITALS IN SERVICE AREAIN ADDITION TO ALASKA MEDICAL CENTER AND ALASKA SPECIALTY HOSPITAL ST. ELIAS, THE OTHER HOSPITALS IN ANCHORAGE INCLUDE ALASKA NATIVE MEDICAL CENTER, ALASKA REGIONAL HOSPITAL, ALASKA VETERANS ADMINISTRATION (VA) HEALTH CARE SYSTEM, AFMS-JOINT BASE ELMENDORF-RICHARDSON-673D MEDICAL GROUP AND ALASKA AREA NATIVE HEALTH SERVICES.PROVIDENCE MOUNT CARMEL HOSPITAL AND PROVIDENCE ST. JOSEPH HOSPITALPROVIDENCE MOUNT CARMEL HOSPITAL AND PROVIDENCE ST. JOSEPH HOSPITAL ARE LOCATED IN STEVENS COUNTY, WHICH HAS THE THIRD-HIGHEST POVERTY RATE IN WASHINGTON STATE. GEOGRAPHICALLY, THE COUNTY IS LOCATED ON THE EASTERN SIDE OF THE STATE BETWEEN FERRY AND PEND OREILLE COUNTIES, MAKING UP THE TRI COUNTY REGION. TOTAL POPULATION IS 45,030, WITH AN ANNUAL GROWTH RATE OF ABOUT 0.1 PERCENT IN 2017. AGE DEMOGRAPHICS ARE EVENLY DISTRIBUTED, WITH THE YOUNG ADULT AGE GROUP COMPRISING THE SMALLEST PROPORTION OF THE POPULATION. IN 2014 THE POPULATION COMPRISED: - 20.7 PERCENT YOUTH (0-17 YEARS)- 17 PERCENT YOUNG ADULTS (18-39 YEARS)- 39.1 PERCENT OLDER ADULTS (40-64 YEARS)- 23.2 PERCENT SENIORS (65 YEARS AND OLDER) AMONG STEVENS COUNTY RESIDENTS IN 2018, 89.2 PERCENT WERE WHITE, 0.4 PERCENT AFRICAN AMERICAN, 5.7 PERCENT NATIVE AMERICAN, 0.7 PERCENT ASIAN/PACIFIC ISLANDER, AND 3.7 PERCENT WERE OF TWO OR MORE RACES. IN 2017, THE MEDIAN HOUSEHOLD INCOME FOR STEVENS COUNTY WAS $53,245, AND THE UNEMPLOYMENT RATE WAS 7.3 PERCENT. AN INCREASE FROM 6.3 PERCENT FROM OUR LAST NEEDS ASSESSMENT. 29 PERCENT OF THE COMMUNITY HAS HOUSEHOLDS WITH INCOME BELOW THE FEDERAL POVERTY LEVEL, AND 17.2 PERCENT OF CHILDREN AND 8.8 PERCENT OF OLDER ADULTS LIVE AT OR BELOW THE POVERTY LEVEL. THE MEDIAN HOUSEHOLD INCOME HAS INCREASED AND PERCENTAGE OF THE POPULATION LIVING UNDER THE FEDERAL POVERTY LEVEL HAS INCREASED SINCE THE LAST NEEDS ASSESSMENT. IN STEVENS COUNTY, 1.6 PERCENT OF OCCUPIED HOUSING LACKED COMPLETE PLUMBING FACILITIES AND 1.8 PERCENT LACKED COMPLETE KITCHEN FACILITIES. COMPARED TO 0.4 PERCENT OF OCCUPIED HOUSING IN WASHINGTON STATE. 90 PERCENT OF OUR POPULATION 25 AND OLDER HAS A HIGH SCHOOL DEGREE OR EQUIVALENT OR MORE EDUCATION. STEVENS COUNTY HAS LESS OF THE POPULATION WITH BACHELOR'S DEGREES OR HIGHER THAN THE STATE AVERAGE. THE SHARE OF STEVENS COUNTY RESIDENTS WHO ARE UNINSURED WAS 10.3 PERCENT IN 2016. THIS IS A DECREASE FROM 15.3 PERCENT IN 2009. THIS IS SLIGHTLY HIGHER THAN THE OVERALL SHARE OF WASHINGTON STATE, AT 9.8 PERCENT. AMERICAN INDIAN/ALASKAN NATIVE POPULATIONS IN STEVENS COUNTY ARE MORE LIKELY TO BE UNINSURED THAN ELSEWHERE IN THE STATE. IN STEVENS COUNTY, 26 PERCENT OF YOUTH AND 40 PERCENT OF ADULTS ARE OVERWEIGHT OR OBESE. DURING 2016, THE TOP-FOUR CAUSES OF HOSPITALIZATIONS WERE: - 11.2% FOR UNINTENTIONAL INJURIES, INCREASING FROM 9.0% IN 2006. - 11.3% FOR HEART DISEASES, DECREASING FROM 13.8% IN 2006. - 10.7% FOR DIGESTIVE SYSTEM DISEASES, DECREASING FROM 11.2% IN 2006.- 8.9% FOR RESPIRATORY DISEASES, DECREASING FROM 13.2% IN 2006.HEALTH PROFESSIONS SHORTAGE AREA - STEVENS COUNTYTHE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). THE MAPS BELOW DEPICT THESE SHORTAGE AREAS RELATIVE TO PROVIDENCE MOUNT CARMEL HOSPITAL AND PROVIDENCE ST. JOSEPH HOSPITAL LOCATIONS. CLICK ON THE LINK BELOW FOR FULL SIZED VERSIONS. OVERALL, STEVENS COUNTY HAS SHORTAGES IN EACH OF THESE AREAS WITH BOTH PRIMARY CARE AND MENTAL HEALTH PROVIDERS NEEDED FOR THE GENERAL POPULATION AND THE LOW-INCOME POPULATION AND DENTAL PROVIDERS ARE NEEDED FOR THE LOW-INCOME POPULATION.OTHER HOSPITALS IN SERVICE AREAPROVIDENCE MOUNT CARMEL HOSPITAL AND PROVIDENCE ST. JOSEPH HOSPITAL ARE THE ONLY HOSPITALS IN STEVENS COUNTY. PROVIDENCE ST. MARY MEDICAL CENTERPSMMC SERVICE AREA IS IN WALLA WALLA COUNTY AND SERVES WALLA WALLA, COLUMBIA, AND UMATILLA COUNTIES WHICH INCLUDES A POPULATION OF APPROXIMATELY 144,442 PEOPLE. POPULATION AND AGEALMOST HALF OF THOSE LIVING IN WALLA WALLA COUNTY ARE AGES 18-54, WITH THE NEXT LARGEST AGE GROUP BEING THOSE 6-18, FOLLOWED BY AGES 65-84. THOSE AGES 6-54 ARE MORE LIKELY TO LIVE IN A HIGH NEED AREA, DEFINED BY LOWER LIFE EXPECTANCY AT BIRTH, LOWER HIGH SCHOOL GRADUATION RATES, AND MORE HOUSEHOLDS AT OR BELOW 200% FEDERAL POVERTY LEVEL (FPL) COMPARED TO CENSUS TRACTS ACROSS THE COUNTIES. THE MALE-TO-FEMALE RATIO IS PROPORTIONAL WITH SLIGHTLY MORE MALES THAN FEMALES. RACE AND ETHNICITYPER THE U.S. CENSUS, 2019, AMONG WALLA WALLA COUNTY RESIDENTS, 82.5% WERE WHITE, 1.1% AMERICAN INDIAN, 1.5% ASIAN, 2.2% BLACK, 0.3% PACIFIC ISLANDER, 8.9% OTHER RACE, 3.6% TWO OR MORE RACES. AMONG COLUMBIA COUNTY RESIDENTS, 89.5% WERE WHITE, 1.5% AMERICAN INDIAN, 1.3% ASIAN, 0.9% BLACK, 0.3% PACIFIC ISLANDER, 2.5% OTHER RACE, 4.0% TWO OR MORE RACES. AMONG UMATILLA COUNTY RESIDENTS, 76.1% WERE WHITE, 3.6% AMERICAN INDIAN, 1.0% ASIAN, 1.1% BLACK, 0.2% PACIFIC ISLANDER, 14.5% OTHER RACE, 3.6% TWO OR MORE RACES.OF THE OVER 144,442 PERMANENT RESIDENTS OF WALLA WALLA, COLUMBIA, AND UMATILLA COUNTIES ROUGHLY 50% LIVE IN THE ""HIGH NEED"" AREA, DEFINED BY LOWER LIFE EXPECTANCY AT BIRTH, LOWER HIGH SCHOOL GRADUATION RATES, AND MORE HOUSEHOLDS AT OR BELOW 200% FEDERAL POVERTY LEVEL (FPL) COMPARED TO CENSUS TRACTS ACROSS THE COUNTIES. INCOME AND HOUSINGTHE 2019 MEDIAN HOUSEHOLD INCOME IN WALLA WALLA COUNTY WAS $57,858 COMPARED TO 2017 RATE OF $54,157. THE MEDIAN INCOME IN THE HIGH NEED SERVICE AREA IS LESS THAN HALF OF THE MEDIAN INCOME IN WALLA WALLA COUNTY AND THE BROADER SERVICE AREA. THE PERCENT OF RENTER HOUSEHOLDS WITH SEVERE HOUSING COST BURDEN IS 24.5% IN WALLA WALLA COUNTY, 33.28% IN THE HIGH NEED SERVICE AREA, AND 13.97% IN THE BROADER SERVICE AREA. HEALTH PROFESSIONS SHORTAGE AREATHE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). PSMMC IS IN A PRIMARY CARE, MENTAL, AND DENTAL HEALTH HPSA. LARGE PORTIONS OF THE SERVICE AREA ARE DESIGNATED AS SHORTAGE AREAS. OTHER DESIGNATIONS WITHIN WALLA WALLA, COLUMBIA, AND UMATILLA COUNTIES INCLUDE FEDERALLY QUALIFIED HEALTH CENTERS (FQHC), CORRECTIONAL FACILITIES, AND LOW-INCOME, HOMELESS, AND/OR MIGRANT FARMWORKER POPULATIONS.OTHER HOSPITALS IN SERVICE AREAST. HELENA HOSPITAL ALSO SERVES WALLA WALLA WASHINGTON"