4A (Expenses $ 89447478 including grants of $ 23390) (Revenue $ 118205450)
SAN LUIS VALLEY HEALTH WAS FORMED JULY 1, 2013. PRIOR TO THE MERGER THAT CREATED SAN LUIS VALLEY HEALTH, THE HOSPITAL OPERATED AS AN INDEPENDENT, NOT FOR PROFIT HOSPITAL FOR OVER 83 YEARS. THE MERGER BROUGHT TOGETHER SAN LUIS VALLEY REGIONAL MEDICAL CENTER AND CONEJOS COUNTY HOSPITAL. PRIOR TO THE MERGER, CONEJOS COUNTY HOSPITAL HAD BEEN MANAGED BY SAN LUIS VALLEY REGIONAL MEDICAL CENTER SINCE 2003. SLV HEALTH SERVES THE SIX COUNTIES OF THE SAN LUIS VALLEY WITH A POPULATION OF JUST UNDER 50,000 AND AN AREA OF OVER 8,200 SQUARE MILES; LARGER THAN THE STATE OF NEW JERSEY. SLV HEALTH EMPLOYS OVER 650 EMPLOYEES AND IS THE LARGEST EMPLOYER IN THE SAN LUIS VALLEY. THE TRUSTEES, PROVIDERS AND STAFF OF SLV HEALTH ARE UNDERSTANDABLY PROUD OF THEIR TRADITION FOR PROVIDING CARE AND SERVICE TO OUR COMMUNITIES. SERVING OUR LOW-INCOME COMMUNITY MEANS THAT WE HAVE A CHALLENGING PAYER MIX WITH HIGH MEDICAID, UNINSURED AND RELATIVELY LOW COMMERCIAL PERCENTAGES. THIS HAS LED TO OUR ORGANIZATION BEING RESOURCEFUL, CREATIVE AND INNOVATIVE IN ORDER TO CONTINUE SERVICE WITH POSITIVE OPERATING MARGINS. OVER THE LAST TEN YEARS, OUR GROSS REVENUE HAS INCREASED FROM $20M TO IN EXCESS OF $200M AND THE NUMBER OF PATIENTS SERVED HAS EXPANDED SEVERAL FOLD. NEW SERVICES HAVE BEEN ADDED IN MEDICATION ONCOLOGY, INPATIENT REHABILITATION, SLEEP DISORDERS, WOMEN'S IMAGING CENTER, FIXED WING MEDICAL TRANSPORTATION, GENETIC COUNSELING, BEHAVIORAL HEALTH, CARDIOLOGY, CHIROPRACTIC, ONCOLOGY/INFUSION THERAPY, UROLOGY, AND MORE.

SCHEDULE H, PART V, SECTION B, LINE 5
INPUT FROM REPRESENTATIVES OF THE COMMUNITY: SLVH LEADERSHIP REPRESENTATIVES, IN COLLABORATION WITH COLORADO RURAL HEALTH CENTER, CONDUCTED A SURVEY OF INTERESTED SAN LUIS VALLEY RESIDENTS. THE SURVEY INCLUDED 44 QUESTIONS ON A VARIETY OF HEALTH AND PROVIDER ISSUES. THE HEALTH QUESTIONNAIRE FOR SLVH WAS DISTRIBUTED BY THE HOSPITAL AND THE COMMUNITY GROUP MEMBERS USING PAPER AND WEB-BASED SURVEYS. THEY WERE GIVEN TO THE COMMUNITY GROUP FOLLOWING THE FIRST MEETING AND PARTICIPANTS WERE ENCOURAGED TO HAVE THEIR COLLEAGUES, FRIENDS, AND FAMILY COMPLETE THE SURVEY AS WELL. TO AID LEADERSHIP REPRESENTATIVES IN THE ASSESSMENT OF THE COMMUNITY'S HEALTH NEEDS, THE COMMUNITY GROUP WAS COMPRISED OF INTERESTED AGENCIES AND ORGANIZATIONS SERVING HEALTH, EDUCATION, COMMERCIAL AND GOVERNMENT INTERESTS IN THE SAN LUIS VALLEY. - ADAMS STATE UNIVERSITY - ADAMS STATE UNIVERSITY VETERANS PROGRAM - BLUE PEAKS DEVELOPMENTAL SERVICES - CITY OF ALAMOSA AND CITY COUNCIL - CITY OF MONTE VISTA AND CITY COUNCIL - RIO GRANDE COUNTY PUBLIC HEALTH - SAN LUIS VALLEY BEHAVIORAL HEALTH GROUP - SAN LUIS VALLEY DEVELOPMENT RESOURCE GROUP - SAN LUIS VALLEY PUBLIC HEALTH PARTNERSHIPS - SAN LUIS VALLEY SMALL BUSINESS DEVELOPMENT CENTER - VALLEY WIDE HEALTH SYSTEMS - VALLEY WIDE HEALTH SYSTEMS, NURSE - FAMILY PARTNERSHIPS

SCHEDULE H, PART V, SECTION B, LINE 7A & 10A
DIRECT URL TO CHNA AND IMPLEMENTATION STRATEGY: www.sanluisvalleyhealth.org/documents/files/2022-Community-Health-Needs-As smnt.pdf

SCHEDULE H, PART V, SECTION B, LINE 11
"San Luis Valley Health (SLVH) completed their Community Health Needs Assessment in the spring/summer of 2022. The following priorities were identified as pressing community health needs for the San Luis Valley (SLV) region: 1. Access to Care a. As an integrated health care organization, SLVH aspires to achieve the quadruple aim in meeting the health care needs of patients. This includes: 1) enhancing access and patient satisfaction; 2) improving outcomes; 3) reducing cost, and 4) improving provider and staff satisfaction. SLVH monitors Patient Experiences of Care (PEC) through participation in innovative primary care transformation models focused on the whole person, in a patient-centered model. Clinic measures include Timely Appointments, Care, and Information; How Well Providers Communicate; Attention to Care From Other Providers; Providers Support Patient in Taking Care of Own Health; and Patient Rating of Provider and Care. In addition, SLVH participates in analytics and strategic advisory solutions through Press Ganey and includes several measures as strategic priorities, reviewed quarterly by SLVH departments, Leadership, Senior Team, and the Governing Board. To promote advancement toward organizational goals and objectives, measures that fall below organizational goals are identified for performance and process improvements. b. SLVH has developed processes to increase access to patient care by optimizing clinic schedules and staffing patterns so that patients are scheduled with their primary care provider (PCP) as a first choice or another provider on their health care team as a second choice, or offered an acute care visit with the acute care provider. Primary care clinics have also extended weekday hours of operation weekdays. In response to the COVID-19 pandemic, SLVH telehealth and telemedicine services were implemented using a secure, Health Insurance Portability and Accountability Act (HIPAA) platform. Telehealth services provide an important method to stay connected to some of the organization's most vulnerable patient populations while accounting for social distancing for patients and staff. This group of patients includes those with serious health care conditions, including cancer, diabetes, cardiac, and prenatal conditions, as well as those who have significant social barriers including transportation, financial, and other social emotional issues. The service quickly met or exceeded patients' expectations of convenient and quality. Telehealth aims to provide an alternative visit option for patients, as part of best practices encouraged through Team Based Care and Alternative Payment Model best practices. By making visits more convenient and accessible, SLVH expects to better-address population health through enhancing care plan adherence. SLVH also opened a dedicated Respiratory Clinic at the onset of the pandemic for acute respiratory conditions, including COVID. This helped segregate patient populations seeking medical care. c. SLVH continues to evaluate and assess potential service lines to benefit the health needs of our patient population. Nephrology service days have recently been increased, and Cardiology service expansions are under consideration. Monitor clinic access and measure 3rd next available appointments within 3 days of demand. (According to research, 3rd next available national average for hospital-owned clinics is 3 days per MGMA, but best practice/the ultimate goal is 0 days for primary care.) SLVH's goal is an average of 3 days among its primary care clinic sites (including women's health and pediatric clinics. Primary care provider (PCP) schedules also allow access for post-hospital and emergency department follow up to ensure patients connect to their PCP for continuity of care. Providers also maintain two acute, same day appointments. SLVH is currently able to offer the next available appointment within 3.75 days. Primary care provider recruitment efforts have an increased focus due to provider vacancies and continued higher demands for care. d. On March 10, 2020, in response to the global COVID-19 pandemic, SLVH leadership initiated it's Hospital Emergency Incident Command System. Organizational objectives were: caring for our community by providing essential health care services; and, ensuring the safety and wellbeing of our team. Overall community support included participation on the SLV Health Care Coalition, establishing a nurse telephone triage system to help direct and guide patients appropriately, and establishing telemed and virtual visits for patients to maintain access to medical services. Vaccination PODS (point of distribution) were implemented to administer vaccinations to large groups of the eligible population, eventually transitioning vaccination delivery in to day-to-day operations within clinic settings. e. Transportation issues and barriers often deter maximal health care utilization. SLVH provided a $25,000 donation toward the purchase of a transport vehicle that is specially equipped to accommodate patients in wheelchairs. The new van was purchased by Valley-Wide Health Systems, Inc., and adds to the fleet of vehicles offered by the ""Valley-Wide Ride"" program to help address transportation needs for medical and non-medical appointments for the SLV population 2. Chronic Disease Management a. SLVH has worked to improve communication through appropriate exchange of information through the continuum of care to support overall health care management. Emphasis has been placed on the use of care coordination to ensure patients and their information follows them at all care levels. In October 2020, SLVH transitioned their electronic health record to a comprehensive and integrated system that supports availability of information at every level of care within SLVH including all functions of health care services, billing, data and analysis to support appropriate utilization, evaluation, and performance improvement processes. Focusing on the identification of patients' PCP will help drive chronic disease management while improving patient/provider relationships and experiences, access, continuity of care, transitions of care, and communication among providers. b. SLVH continues to organize, participate, and contribute to local food banks and helps assemble and distribute food boxes during the holidays. 3. Mental Health Prevention and Improvement a. In order to improve patient safety, advance integrated behavioral health (BH) services and screenings in Emergency Departments (ED) help identify high-risk patients, SLVH has continued to develop its BH department and hired an additional Licensed Clinical Social Worker to provide direct therapy services. The department is working to expand behavioral health services and increase a Behavior Health Consultant FTE to work in the inpatient setting to provide brief interventions, warm hand-offs and referrals into ambulatory care. SLVH has expanded Medication Assisted Therapy (MAT) in clinic settings, and continues to partner with external agencies to implement and/or support behavioral health resources within the organization as well as within the community. Behavioral health workforce shortages challenge recruitment and retention organizationally as well as among community partners. In addition, COVID has limited the role of community partners providing in-person crisis-level evaluations. b. SLVH standardized screenings in EDs to be more effective in addressing and providing protective factors during clinical visits. This begins with general screening during nurse triage to identify patients at risk, followed by more intense screening, following the evidence-based Columbia Suicide Severity Rating Scale. SLVH has also updated its policy and procedures for patients who are at risk for self-destructive behavior to provide, as best as possible, a safe environment, appropriate medical screening, and crisis behavioral health care services. i. September 2020, SLVH participated in National Suicide Prevention Month through SLV Voices, a local podcast discussion, to help listeners learn more about tools and strategies to cope with stress and life challenges, and services available to help. ii. SLVH has initiated a system-wide approach to suicide prevention through the Zero Suicide initiative. During the month of February 2022, SLVH will offer Question, Persuade, and Refer (QPR) train the trainer coursework for approximately 20 staff, who will then proceed training other care providers within the organization. c. SLVH continues efforts to improve transitions of care through safe discharge planning, coordinated access to BH services in primary care settings, connecting patients to community-based services and resources, and ensuring follow up at appropriate intervals. d. SLVH participates with a practice improvement initiative to improve Integrated Care for Women and Babies (June 2020), expanding the number of providers inducting patients into MAT t"

SCHEDULE H, PART V, SECTION B, LINE 16A
URL where FAP is made widely available on a website: https://www.sanluisvalleyhealth.org/documents/Financial-Assitance-Policy-S LVH-Update-02242023.pdf The financial assistance policy can also be found by going to the home page of organization's website, under quick links click on get financial assistance and there will be a Financial Assistance policy hyperlink.

SCHEDULE H, PART V, SECTION B, LINE 16B
"URL where FAP application form is made widely available on a website: https://www.sanluisvalleyhealth.org/documents/charity_care_application.pdf THE FAP APPLICATION FORM CAN ALSO BE FOUND BY GOING TO THE HOME PAGE OF ORGANIZATION'S WEBSITE, UNDER QUICK LINKS CLICK ON ""GET FINANCIAL ASSISTANCETHERE WILL BE AN ""APPLICATION"" HYPERLINK. ASSISTANCETHERE WILL BE AN ""APPLICATION"" HYPERLINK."

SCHEDULE H, PART V, SECTION B, LINE 16C
"URL WHERE THE PLAIN LANGUAGE SUMMARY OF THE FAP IS MADE WIDELY AVAILABLE: https://www.sanluisvalleyhealth.org/documents/plain_language_summary.pdf THE PLAIN LANGUAGE SUMMARY CAN ALSO BE FOUND BY GOING TO THE HOME PAGE OF ORGANIZATION'S WEBSITE, UNDER QUICK LINKS CLICK ON ""GET FINANCIAL ASSISTANCETHERE WILL BE A ""PLAIN LANGUAGE SUMMARY"" HYPERLINK."

SCHEDULE H, PART I, LINE 3C
DESCRIPTION OF FACTORS USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES THE FOLLOWING ELIGIBILITY CRITERIA ARE ALSO USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY MEDICAL INDIGENCY, INSURANCE STATUS AND UNDERINSURANCE STATUS.

SCHEDULE H, PART I, LINE 7
THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A,7B AND 7C. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE INFORMATION FOR LINES 7E THROUGH 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS.

SCHEDULE H, PART II, LINES 1 - 10
EACH ACTIVITY AND EXPENSE IN THIS CATEGORY IS RELATED TO THE LOCAL COMMUNITY BY PROMOTING OR SUPPORTING HABITAT FOR HUMANITY, PLAYGROUND CONSTRUCTION, SERVING AT THE LOCAL HOMELESS SHELTER, VOLUNTEERING AT THE LOCAL FOOD BANK, RAISING FUNDS FOR SCHOOL SUPPLIES, TRAUMA PREPARATION, WORKFORCE DEVELOPMENT, AND SAFETY OF FAMILIES AND CHILDREN THROUGH A BIKE/HELMET SAFETY EVENT.

SCHEDULE H, PART III, SECTION A, LINE 2
THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

SCHEDULE H, PART III, SECTION A, LINE 3
THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.

SCHEDULE H, PART III, SECTION B, LINE 8
ALL OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE HOSPITALS ARE REQUIRED TO TREAT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A RURAL HOSPITAL IN SOUTHERN COLORADO, SAN LUIS VALLEY HEALTH, IS CRITICAL TO PROVIDING HEALTHCARE IN AN AREA THAT HAS LIMITED ACCESS TO SPECIALTY CARE. ACCESSIBLE, HIGH-QUALITY HEALTHCARE IS NEEDED FOR THE OVERALL HEALTH OF THE RESIDENTS OF THE SAN LUIS VALLEY EVEN IF MEDICARE REIMBURSEMENT DOES NOT MEET THE COST OF PROVIDING THAT CARE. RURAL HEALTHCARE IS OFTEN MORE COSTLY AS PATIENTS TEND TO HAVE A HIGHER THAN AVERAGE ACUITY AND LENGTH OF STAY DUE TO LIMITED SPECIALTY CARE IN THE TREATMENT AND PATIENT CARE FOLLOW PROCESS. THE MEDICARE SHORTFALL REFLECTS THE EXCESS OF COSTS CONSISTENTLY DRIVEN UP BY REGULATORY REQUIREMENTS, SKILLED LABOR SHORTAGES AND EVOLVING MEDICAL AND INFORMATION TECHNOLOGY, ABOVE NON-NEGOTIABLE PAYMENTS BASED ON UPDATES THAT HAVE FALLEN BEHIND ACTUAL HEALTHCARE COST INFLATION. THE MEDICARE COST REPORT WAS USED TO DETERMINE THE COST OF CARE REPORTED.

SCHEDULE H, PART III, SECTION C, LINE 9B
FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, THE COLLECTION PROCESS FOLLOWS THESE STEPS: A. PATIENTS ARE CONTACTED BY BROCHURE, MAIL AND PHONE CALLS FROM A FINANCIAL COUNSELOR, OR THE PATIENT ACCESS MANAGER. LETTERS SENT, BROCHURES GIVEN AND OUTBOUND PHONE CALLS AND RESPONSES ARE NOTED IN PATIENT NOTES IN THE PATIENT'S PROFILE. B. PATIENTS WHO QUALIFY FOR ASSISTANCE WILL PRESENT INFORMATION TO THE FINANCIAL COUNSELORS WHO WILL UPDATE THE REGISTRATION SECTION OF THE PATIENT PROFILE. BILINGUAL COUNSELORS OR INTERPRETERS ARE AVAILABLE. C. PATIENTS WILL BE INFORMED OF THEIR RESPONSIBILITY TO PAY CO PAYMENTS OR OTHER SLIDING FEE PATIENT RESPONSIBILITY AMOUNTS. THEY WILL BE INFORMED IN PERSON AND BY PHONE WHENEVER POSSIBLE. PAYMENT PLANS ARE ALWAYS OFFERED FOR PATIENTS WHO CANNOT AFFORD THEIR PORTION. D. PATIENTS WHO DO NOT PAY THEIR PORTION OR CO-PAYMENT WILL RECEIVE AN INVOICE, PRINTED IN ENGLISH AND SPANISH, DIRECTING THEM TO PAY OR TO CALL. IF THE PATIENT CALLS AND REQUESTS ASSISTANCE FROM THE FINANCIAL COUNSELOR, THEY WILL BE DIRECTED TO THE CUSTOMER SERVICE PHONE NUMBER. E. PATIENTS WILL RECEIVE UP TO 3 LETTERS AND 2 PHONE CALLS FROM A CONTRACTED, 3RD PARTY VENDOR WHO HAVE BILINGUAL SPECIALISTS. WHEN 90 DAYS HAVE PASSED WITHOUT ANY RESPONSE FROM THE PATIENT, THE ACCOUNT WILL BE REVIEWED BY THE PATIENT ACCESS MANAGER AS WELL AS THE PATIENT ACCOUNT MANAGER-CASH POSTING, BOTH MEMBERS OF THE BUSINESS REVENUE CYCLE TEAM. F. UPON REVIEW, IF THE PORTION IS DEEMED TO BE THE RESPONSIBILITY OF THE PATIENT, THE PROCESS TOWARD COLLECTIONS WILL BEGIN. A LETTER IS SENT TO THE PATIENT FROM THE THIRD PARTY COMPANY. THE THIRD PARTY COLLECTION COMPANY FOLLOWS LEGAL PROCEEDINGS AT THIS POINT.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT: SLV HEALTH SUBMITS MANY GRANTS EVERY YEAR TO IMPROVE COMMUNITY HEALTH. EACH GRANT INCLUDES A SUMMARY OF KNOWN HEALTH DATA TO JUSTIFY THE NEED FOR THE FUNDS. AS A CONSEQUENCE WE ARE VERY ATTUNED TO OUR COMMUNITY HEALTH NEEDS. THROUGH COMMUNICATION WITH PROVIDERS AND COMMUNITY NON PROFITS, THIS NEED IS ADDRESSED AS REQUIRED. SAMPLE CURRENT AND PAST PROGRAMMING HAVE INCLUDED FREE COLONOSCOPIES, BREAST HEALTH RELATED TESTING, PSA TESTING AND MUCH MORE.

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SLV HEALTH PROVIDES A PATIENT FINANCIAL COUNSELOR WHO IDENTIFIES RESOURCES AND ELIGIBILITY ASSESSMENT FOR PROGRAMS THROUGH FEDERAL AND STATE GOVERNMENT PROGRAMS, AS WELL AS GRANT FUNDED PROGRAM. WE ALSO PROVIDE A SLIDING FEE SCALE FOR SERVICE FOR THOSE SELF PAY PATIENTS NOT FITTING WITHIN ANY OF THESE PROGRAMS. PAY PLANS ARE ALSO SET UP FOR SELF PAY PATIENTS.

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM: SLV HEALTH HAS A PROFESSIONAL AFFILIATION WITH CENTURA HEALTH SYSTEMS TO COORDINATE CARE FOR OUR SHARED PATIENTS.

SCHEDULE H, PART VI, LINE 7
DESCRIPTION OF STATE FILINGS: SLV HEALTH FILES A COMMUNTIY BENEFIT REPORT ANNUALLY WITH COLORADO.

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: LOCATED IN SOUTH-CENTRAL COLORADO, THE SAN LUIS VALLEY (SLV) IS THE LARGEST AND HIGHEST VALLEY IN NORTH AMERICA, SURROUNDED BY THREE MOUNTAIN RANGES THAT EFFECTIVELY ISOLATE THE VALLEY FROM OTHER MEDICAL RESOURCES. THE SLV CONSISTS OF THREE RURAL AND THREE FRONTIER COUNTIES COVERING 8194 SQUARE MILES (2,000,000 ACRES), LARGER THAN THE STATE OF CONNECTICUT. FRONTIER AREAS, DEFINED AS COUNTIES HAVING A POPULATION DENSITY OF SIX OR FEWER PEOPLE PER SQUARE MILE, FACE CHALLENGES IN PROVIDING ACCESS TO HEALTH AND HUMAN SERVICES WHICH ARE EVEN GREATER THAN THE CHALLENGES FACED BY OTHER RURAL COMMUNITIES. FIVE OF THE SIX COUNTIES ARE FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA (AREAS/POPULATIONS THAT LACK ACCESS TO PRIMARY CARE SERVICES) AND ALL SIX COUNTIES ARE FEDERALLY DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS (SHORTAGES OF PRIMARY MEDICAL CARE, DENTAL OR MENTAL HEALTH PROVIDERS). THE SLV HAS A DIVERSE POPULATION OF 47,049, WITH 45% WHO IDENTIFY WITH A HISPANIC, LATINO, OR SPANISH ORIGIN [STATE DEMOGRAPHY OFFICE]. ADDITIONALLY, THERE IS A LARGE POPULATION OF INDIGENT AND MIGRANT FARM WORKERS. PREDOMINANTLY AGRICULTURAL IN NATURE, THE SLV IS ONE OF THE POOREST AREAS IN COLORADO (CO) WITH 19% LIVING IN POVERTY, COMPARED TO 9.6% FOR THE ENTIRE STATE, AND THE MEDIAN HOUSEHOLD INCOME IS $39,773, COMPARED TO $68,811 FOR CO [US CENSUS 2014-2018]. CENSUS DATA ALSO STATES FIVE OF THE SIX SLV COUNTIES HAVE THE HIGHEST PERCENT OF RESIDENTS THAT SPEAK A LANGUAGE OTHER THAN ENGLISH (OVER 33%), COMPARED TO CO AT 17%. THE SLV'S UNINSURED RATE IS 13% COMPARED TO 8% FOR CO, AND 43% OF SLV RESIDENTS ARE ON MEDICAID, COMPARED TO 24% OF COLORADOANS [COLORADO HEALTH INSTITUTE].

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH: SLVH IS ACTIVE IN THE COMMUNITY AND SUPPORTS STAFF WHO PROVIDE COMMUNITY RESOURCES IN AREAS THAT INCLUDE HEALTH EDUCATION AND INFORMATION, PROMOTING SAFETY AND WELLNESS TO THE GENERAL POPULATION, AND SPONSORS BEHAVIORAL HEALTH SUPPORT GROUPS. HOSPITAL LEADERSHIP AND CLINICAL PROVIDERS CONDUCT HEALTH EDUCATION INFORMATION IN THE AREAS OF ADOLESCENT HEALTH, ARE FOR PATIENTS WITH DEMENTIA, SKIN CARE, AND WOMEN'S HEALTH. SLVH STAFF ALSO PARTICIPATE IN COMMUNITY HEALTH INITIATIVES SUCH AS ADOLESCENT PREVENTION COALITIONS, OPIOID USE/ABUSE TASK FORCE, A NEONATAL TASK FORCE, COORDINATION OF HEALTH CARE SERVICES ACROSS THE CONTINUUM, AND WORKFORCE DEVELOPMENT ISSUES. PATIENT AND FAMILY ADVISORY COUNCILS HAVE ALSO BEEN ESTABLISHED TO BRING THE VOICE OF PATIENTS AND THEIR FAMILIES INTO PROGRAM DESIGN AND IMPROVEMENT PROCESSES.