SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
BETH ISRAEL DEACONESS MEDICAL CENTER
 
Employer identification number

04-2103881
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    31,731,737 12,251,277 19,480,460 0.890 %
b Medicaid (from Worksheet 3, column a) . . . . .     250,287,430 221,333,877 28,953,553 1.320 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     282,019,167 233,585,154 48,434,013 2.210 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     11,639,579 2,282,189 9,357,390 0.430 %
f Health professions education (from Worksheet 5) . . .     97,381,431 28,925,256 68,456,175 3.130 %
g Subsidized health services (from Worksheet 6) . . . .     52,877,366 25,250,882 27,626,484 1.260 %
h Research (from Worksheet 7) .     307,298,416 241,917,383 65,381,033 2.990 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     9,262,458 47,264 9,215,194 0.420 %
j Total. Other Benefits . .     478,459,250 298,422,974 180,036,276 8.230 %
k Total. Add lines 7d and 7j .     760,478,417 532,008,128 228,470,289 10.440 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     384,124 5,000 379,124 0.020 %
9 Other     54,241 0 54,241 0 %
10 Total     438,365 5,000 433,365 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
12,152,530
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
576,908,003
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
622,806,728
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-45,898,725
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 BETH ISRAEL DEACONESS MEDICAL CENTER
330 BROOKLINE AVENUE
BOSTON,MA02215
WWW.BIDMC.ORG
VL42 		X X   X   X X   TERTIARY CARE ACADEMIC MEDICAL CENTER  
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
BETH ISRAEL DEACONESS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART VI
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
BETH ISRAEL DEACONESS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SUPPLEMENTAL INFORMATION
b
SEE SUPPLEMENTAL INFORMATION
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
BETH ISRAEL DEACONESS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
BETH ISRAEL DEACONESS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
BETH ISRAEL DEACONESS MEDICAL CENTER PART V, SECTION B, LINE 5: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H, PART V, SECTION B PLEASE SEE SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION
BETH ISRAEL DEACONESS MEDICAL CENTER PART V, SECTION B, LINE 11: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H, PART V, SECTION B PLEASE SEE SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address Type of Facility (describe)
1 1 - BETH ISRAEL DEACONESS HEALTHCARE LEXIN
482 BEDFORD STREET
LEXINGTON,MA02420 		OUTPATIENT MEDICAL CARE
2 2 - BETH ISRAEL DEACONESS HEALTHCARE CHELS
1000 BROADWAY
CHELSEA,MA02150 		OUTPATIENT MEDICAL CARE
3 3 - BOWDOIN STREET HEALTH CENTER
230 BOWDOIN STREET
DORCHESTER,MA02122 		OUTPATIENT MEDICAL CARE
4 4 - CHESTNUT HILL AMBULATORY CARE
200 BOYLSTON STREET
NEWTON,MA02467 		OUTPATIENT MEDICAL CARE
5 5 - BETH ISRAEL DEACONESS CANCER CENTER
148 CHESTNUT STREET
NEEDHAM,MA02492 		OUTPATIENT MEDICAL CARE
6 6 - WILLIAM ARNOLD-CAROL A WARFIELD
1 BROOKLINE PLACE
BROOKLINE,MA02445 		OUTPATIENT MEDICAL CARE
7
8
9
10
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSBETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) AFFILIATIONBETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A MEMBER OF BETH ISRAEL LAHEY HEALTH (BILH). THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.BIDMC COMMUNITY BENEFITS MISSION STATEMENT THE MISSION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS TO PROVIDE EXTRAORDINARY CARE, WHERE THE PATIENT COMES FIRST, SUPPORTED BY WORLD-CLASS EDUCATION AND RESEARCH. BIDMC'S MISSION IS SUPPORTED BY A COMMITMENT TO PERSONALIZED, EXCELLENT PATIENT CARE; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT AND COLLABORATION; AND A COMMITMENT TO MAINTAINING THE INSTITUTION'S FINANCIAL HEALTH. BIDMC IS COMMITTED TO BEING ACTIVE IN THE COMMUNITY AS WELL. SERVICE TO COMMUNITY IS AT THE CORE AND AN IMPORTANT PART OF OUR MISSION. BIDMC HAS A COVENANT TO CARE FOR THE UNDERSERVED AND TO WORK TO CHANGE DISPARITIES IN ACCESS TO CARE. BIDMC'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING BIDMC'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY; ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN BIDMC'S SERVICE AREA THAT ARE GEARED TOWARD IMPROVING THE CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES; PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, BIDMC PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $18,572,584 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE BIDMC COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY A TEAM OF COMMUNITY BENEFITS SENIOR LEADERS INCLUDING THE VICE PRESIDENT AND DIRECTOR OF COMMUNITY BENEFITS. THE VICE PRESIDENT OF COMMUNITY BENEFITS HAS DIRECT ACCESS TO AND IS ACCOUNTABLE TO THE BIDMC PRESIDENT AND ALSO REPORTS DIRECTLY TO THE BILH CHIEF DIVERSITY, EQUITY AND INCLUSION OFFICER. THESE LEADERS ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF HISTORICALLY UNDERSERVED POPULATIONS ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. ADDITIONALLY, BIDMC'S BOARD OF TRUSTEES IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS SERVICE AREA AND BEYOND. WORLD-CLASS CLINICAL EXPERTISE, EDUCATION AND RESEARCH ALONG WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY ARE THE PRIMARY TENETS OF THE MISSION OVERSEEN BY THE BOARD OF TRUSTEES. COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. BIDMC COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2019. THAT CHNA WAS APPROVED BY THE BIDMC'S BOARD OF TRUSTEES ON SEPTEMBER 18, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 18, 2019, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF BIDMC'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA (CBSA) WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BIDMC ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BIDMC, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.
2019 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATION AS NOTED ABOVE, BIDMC COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHIC FOCUS OF BIDMC'S MOST RECENTLY COMPLETED 2019 CHNA ENCOMPASSES THE BOSTON NEIGHBORHOODS OF ALLSTON/BRIGHTON, BOWDOIN/GENEVA, CHINATOWN, FENWAY/KENMORE, MISSION HILL, AND ROXBURY, AND THE CITIES OF CHELSEA, BROOKLINE, LEXINGTON, NEEDHAM, AND NEWTON (CHESTNUT HILL). IN AUGUST 2021, BIDMC OPENED TWO NEW LICENSED SITES IN BURLINGTON AND PEABODY; THESE TWO MUNICIPALITIES ARE NOW PART OF BIDMC'S CBSA. THESE MUNICIPALITIES ARE NOT INCLUDED IN THE FY 19 CHNA OR CURRENT FY 20-22 IMPLEMENTATION STRATEGY BUT ARE INCLUDED IN BIDMC'S 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. BIDMC'S FY19 CHNA, ON WHICH THIS REPORT IS BASED, SHOWS THAT LOW-INCOME AND RACIALLY/ETHNICALLY DIVERSE POPULATIONS LIVING IN BOSTON'S NEIGHBORHOODS OF ALLSTON/BRIGHTON, BOWDOIN/GENEVA, CHINATOWN, FENWAY/KENMORE, MISSION HILL, AND ROXBURY, AS WELL AS THE ADJACENT CITY OF CHELSEA, FACE THE GREATEST HEALTH DISPARITIES AND ARE MOST AT RISK. AS A RESULT, THESE BOSTON NEIGHBORHOODS AND THE CITY OF CHELSEA HAVE BEEN IDENTIFIED AND PRIORITIZED AS THE FOCUS FOR BIDMC'S COMMUNITY HEALTH EFFORTS. BIDMC'S TARGET POPULATIONS FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES, AS FOLLOWS: YOUTH AND ADOLESCENTS OLDER ADULTS LOW RESOURCE INDIVIDUALS AND FAMILIES LGBTQ POPULATION RACIALLY AND ETHNICALLY DIVERSE POPULATIONS/NON-ENGLISH SPEAKERS TARGET POPULATIONS FOR BIDMC'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS, AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. RATHER THAN CONDUCTING A SINGLE ASSESSMENT, BIDMC'S COMMUNITY BENEFITS STAFF CONDUCTED THEIR OWN ASSESSMENT AND CO-LED AND/OR PARTICIPATED IN A SERIES OF ADDITIONAL, CONCURRENT AND COMPREHENSIVE ASSESSMENTS THAT WERE THEN AGGREGATED TO CREATE THE 2019 CHNA REPORT. THESE CONCURRENT ASSESSMENTS WERE CONDUCTED BY ORGANIZATIONS OR COLLECTIVES OF ORGANIZATIONS IN BOSTON AND CHELSEA WITH WHICH BIDMC PARTNERS ON A REGULAR BASIS (BOSTON CHNA-CHIP COLLABORATIVE, NORTH SUFFOLK INTEGRATED CHNA, BILH AND OTHER HOSPITAL CHNAS). BIDMC ALSO INTEGRATED ITS EXTENSIVE COMMUNITY ENGAGEMENT AND PLANNING WORK FROM ITS MASSACHUSETTS DETERMINATION OF NEED NEW INPATIENT BUILDING COMMUNITY-BASED HEALTH INITIATIVE. INVOLVEMENT IN THESE FOUR EFFORTS ALLOWED BIDMC TO LEVERAGE RESOURCES AND CREATE A ROBUST AND INCLUSIVE CHNA AND IMPLEMENTATION STRATEGY. THE COLLABORATIVE PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM 4,219 SURVEYS, 74 KEY INFORMANT INTERVIEWS, 35 FOCUS GROUPS AND 5 COMMUNITY MEETINGS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE CITIES OF BOSTON, CHELSEA, REVERE AND WINTHROP THAT COMPRISE THE NORTH SUFFOLK REGION AND WITH A RANGE OF PEOPLE REPRESENTING DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., OLDER ADULTS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 1,085 PEOPLE.BIDMC CONDUCTS ITS CHNAS IN THREE PHASES, WHICH ALLOWED BIDMC TO: COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA; ENGAGE AND INVOLVE KEY STAKEHOLDERS, BIDMC CLINICAL AND ADMINISTRATIVE STAFF AND THE COMMUNITY AT-LARGE; DEVELOP A REPORT AND DETAILED STRATEGIC PLAN; AND COMPLY WITH ALL COMMONWEALTH ATTORNEY GENERAL AND FEDERAL IRS COMMUNITY BENEFITS REQUIREMENTS.DATA SOURCES INCLUDED A BROAD ARRAY OF PUBLICLY AVAILABLE SECONDARY DATA, KEY INFORMANT INTERVIEWS, AND FOUR COMMUNITY FORUMS.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSBIDMC RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT ITS CBSA. BIDMC COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT BIDMC LEVERAGED INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017) BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, 2017 MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017 AND 2018-2019) FBI UNIFORM CRIME REPORTS (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY13-FY17) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2017) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018)2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BIDMC'S CHNA WAS INFORMED BY 74 KEY INFORMANT INTERVIEWS THAT ENGAGED INSTITUTIONAL, ORGANIZATIONAL AND COMMUNITY LEADERS AND FRONT-LINE STAFF ACROSS SECTORS. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX C OF THE CHNA REPORT THAT IS POSTED ON BIDMC'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN BIDMC'S CBSA. INTERVIEWS WERE CONDUCTED IN PERSON AND ON THE PHONE USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING MAJOR HEALTH ISSUES, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS, AND TARGET POPULATIONS.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)BIDMC PARTICIPATED IN 35 COMMUNITY FOCUS GROUPS IN ITS' SERVICE AREA TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS WERE ORGANIZED IN COLLABORATION WITH THE BOSTON CHNA-CHIP COLLABORATIVE, NORTH SUFFOLK INTEGRATED CHNA, AND OTHER BILH HOSPITALS.BIDMC HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BIDMC'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IMPLEMENTATION STRATEGY PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY SENT OUT AS PART OF THE BOSTON CHNA-CHIP COLLABORATIVE'S CHNA WAS ADMINISTERED ONLINE AND VIA HARD COPY IN SEVEN LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, WAITING ROOMS, BOSTON PUBLIC LIBRARY NEIGHBORHOOD BRANCHES, COMMUNITY EVENTS AND LARGE APARTMENT BUILDINGS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. AS AN EXAMPLE OF BIDMC'S EXTENSIVE AND SUCCESSFUL COMMUNITY OUTREACH, NEARLY HALF (45%) OF FOCUS GROUP PARTICIPANTS IDENTIFIED AS BLACK OR AFRICAN-AMERICAN AND 34% IDENTIFIED AS HISPANIC/LATINO.THE BIDMC COMMUNITY BENEFITS COMMITTEE WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE COMMUNITY BENEFITS COMMITTEE MET QUARTERLY DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE.
2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS. IDENTIFY BIDMC'S COMMUNITY BENEFITS PRIORITY POPULATIONS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE BIDMC'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2016 CHNA AND SUBSEQUENT IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY BIDMC DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015). DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018).2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSTHE KEY PRIORITY POPULATIONS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2019, WERE: YOUTH AND ADOLESCENTS OLDER ADULTS LOW-RESOURCE INDIVIDUALS AND FAMILIES LESBIAN, GAY, BISEXUAL, TRANSGENDER AND QUEER OR QUESTIONING (LGBTQ) INDIVIDUALS RACIALLY AND ETHNICALLY DIVERSE POPULATIONS AND NON-ENGLISH SPEAKERSBIDMC'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, SURVEY, FOCUS GROUPS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW-INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, HOUSING, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY INTEGRATION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEAD FINDING, BUT A CLOSE SECOND WAS THE PROFOUND IMPACT OF BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE USE AND MENTAL HEALTH) ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN BIDMC'S CBSA. DEPRESSION/ANXIETY, SUICIDE, ALCOHOL USE, OPIOID AND PRESCRIPTION DRUG USE AND MARIJUANA USE ARE MAJOR HEALTH ISSUES AND ARE HAVING A SIGNIFICANT IMPACT ON THE POPULATION AS WELL AS BURDENING THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID USE AND THE IMPACTS OF TRAUMA. HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN BIDMC'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES, THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN FOR THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH. LIMITED ACCESS TO PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, BEHAVIORAL HEALTH, AND ORAL HEALTH CARE SERVICES FOR LOW-INCOME, FOREIGN BORN, THOSE COVERED BY MEDICAID, UNINSURED, AND OTHER VULNERABLE POPULATIONS FACING HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE AND THE COMMUNITIES THAT MAKE UP BIDMC'S CBSA HAVE STRONG, ROBUST SAFETY NET SYSTEMS, THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW-INCOME, MEDICAID COVERED, UNINSURED AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL, BEHAVIORAL AND ORAL HEALTH SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE AND IMPROVE THE QUALITY OF PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, BEHAVIORAL HEALTH AND ORAL HEALTH SERVICES. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM BIDMC'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022.COMMUNITY HEALTH NEEDS ASSESSMENTMAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEBIDMC STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY. AS NOTED ABOVE, BIDMC COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE BIDMC WEBSITE AT: HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/CHNA-REPORT93019FINAL.PDF IN ADDITION TO THE CHNA, BIDMC COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE BIDMC WEBSITE AT: HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/IMPLEMENTATION-STRATEGY-2020-2022.PDF IN ADDITION, AS NOTED ABOVE, BIDMC COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015. THAT CHNA IS AVAILABLE ON THE BIDMC WEBSITE AT: HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/BIDMC-2016-CHNA-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING BIDMC'S FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015) IS AVAILABLE ON THE BIDMC WEBSITE AT: HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-IMPLEMENTATION-PLAN.PDF EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, BIDMC'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THAT CHNA AND IMPLEMENTATION STRATEGY (IS) INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF BIDMC FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, AND WILL CONTINUE TO INFORM THE HOSPITAL'S COMMUNITY BENEFITS MISSION AND ACTIVITIES FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2022.A SUMMARY OF BIDMC'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, BIDMC HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW. PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH GOAL 1: PROMOTE HEALTHY NEIGHBORHOODS (HEALTHY EATING, ACTIVE LIVING, OTHER HEALTHY BEHAVIORS, HEALTH-RELATED PROGRAMS/POLICIES) GOAL 2: PROMOTE VIOLENCE PREVENTION (SAFE NEIGHBORHOODS AND COMMUNITY COHESION) GOALS 3 AND 4: PROMOTE AFFORDABLE HOUSING AND PROMOTE HOME OWNERSHIP GOAL 5: SUPPORT WORKFORCE DEVELOPMENT AND CREATION OF EMPLOYMENT OPPORTUNITIES GOAL 6: PROMOTE ENVIRONMENTAL SUSTAINABILITY PRIORITY AREA 2: CHRONIC / COMPLEX CONDITIONS & THEIR RISK FACTORS GOAL 1: IMPROVE CHRONIC DISEASE MANAGEMENT GOAL 2: REDUCE CANCER DISPARITIES (ACCESS TO SCREENING AND TREATMENT) GOAL 3: SUPPORT OLDER ADULTS TO AGE IN PLACE PRIORITY AREA 3: ACCESS TO CARE GOAL 1: INCREASE ACCESS TO QUALITY MEDICAL SERVICES, INCLUDING PRIMARY CARE, OB/GYN, AND SPECIALTY CARE AS WELL AS URGENT, EMERGENT AND TRAUMA CARE GOAL 2: INCREASE ACCESS TO QUALITY ORAL HEALTH SERVICES GOAL 3: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS GOAL 4: PROMOTE GREATER HEALTH EQUITY AND REDUCE DISPARITIES IN ACCESS FOR LGBTQ POPULATIONS PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE GOAL 1: INCREASE ACCESS TO QUALITY MENTAL HEALTH CARE AND SUBSTANCE USE SERVICES GOAL 2: REDUCE BURDEN OF OPIOID USE GOAL 3: PROMOTE BEHAVIORAL HEALTH WORKFORCE DEVELOPMENT AND INCREASE CAPACITY COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)BIDMC HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES BIDMC OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG THEIR TARGET POPULATIONS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS.BIDMC HAS BEEN A LEADER IN CREATING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE THE BIDMC CENTER FOR VIOLENCE PREVENTION AND RECOVERY (CVPR), JOB CREATION AND CAREER ADVANCEMENT OPPORTUNITIES THROUGH BIDMC'S OFFICE OF WORKFORCE DEVELOPMENT, DEVELOPMENT OF INSTITUTIONAL METRICS TO MEASURE BIDMC'S SHRINKING CARBON FOOTPRINT, AND TRANSPORTATION RESOURCES TO IMPROVE ACCESS TO HEALTHCARE. THROUGH CVPR, BIDMC HAS LED THE WAY IN DEVELOPING A CONTINUUM OF EDUCATION, OUTREACH, AND TREATMENT INTERVENTIONS TO RESPOND TO VICTIMS OF INTERPERSONAL, SEXUAL, COMMUNITY VIOLENCE, AND HOMICIDE BEREAVEMENT. IT IS ALSO ONE OF THE LEADERS IN DEVELOPING PROGRAMMING TO ADDRESS SECONDARY TRAUMATIC STRESS AMONG DOMESTIC VIOLENCE AND MEDICAL SERVICE PROVIDERS. IN FY21, BIDMC PROVIDED EMERGENCY MEDICAL CARE TO 27 SEXUAL ASSAULT SURVIVORS IN THE EMERGENCY DEPARTMENT. TO FURTHER ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, BIDMC IS COMMITTED TO MAKING EMPLOYMENT OPPORTUNITIES AVAILABLE TO COMMUNITY RESIDENTS AND CREATING CAREER ADVANCEMENT OPPORTUNITIES FOR BIDMC EMPLOYEES WHO ARE SEEKING ADDITIONAL SKILLS AND HIGHER INCOMES. IN FY21 BIDMC'S OFFICE OF WORKFORCE DEVELOPMENT OFFERED 4 DIFFERENT CAREER PIPELINE PROGRAMS THAT SERVED 37 PEOPLE. ADDITIONALLY, 31 YOUTH WERE EMPLOYED IN PAID SUMMER JOBS AT BIDMC. OTHER EXAMPLES OF SUCCESS ARE LISTED IN THE SUBSEQUENT SCHEDULE H IMPLEMENTATION STRATEGY UPDATE. BIDMC IS ROOTED IN PROVIDING HEALTHCARE TO POPULATIONS WHO HAVE HISTORICALLY NOT HAD ADEQUATE ACCESS TO CARE. BIDMC CONTINUES TO EXPAND ACCESS THROUGHOUT THEIR CBSA BY SUPPORTING AND LEADING THE COMMUNITY CARE ALLIANCE (CCA), ENSURING THAT RESIDENTS HAVE ACCESS TO QUALITY COMMUNITY HEALTH CENTERS (CHCS) SERVING THE NEEDS OF THE MOST VULNERABLE IN WAYS THAT ARE CULTURALLY RESPONSIVE AND ACCESSIBLE. BIDMC IS COMMITTED TO STRENGTHENING THE CAPACITY OF ITS FIVE AFFILIATED CHCS INCLUDING: BOWDOIN STREET HEALTH CENTER (BSHC), THE DIMOCK HEALTH CENTER, FENWAY HEALTH, CHARLES RIVER COMMUNITY HEALTH, AND SOUTH COVE COMMUNITY HEALTH CENTER. THE PARTNERSHIP TAKES MANY FORMS: RECRUITMENT, RETENTION, FINANCIAL SUPPORT AND CREDENTIALING OF PHYSICIANS AND MID-LEVEL PROVIDERS, BIDMC ADMITTING PRIVILEGES AND ACCESS TO MANAGED CARE CONTRACTS, HARVARD MEDICAL SCHOOL APPOINTMENTS AND TEACHING OPPORTUNITIES, BIDMC-SPONSORED EDUCATIONAL PROGRAMS, AND ACCESS TO UP-TO-DATE (A CLINICAL SUPPORT RESOURCE). WHILE OUTER CAPE HEALTH SERVICES REMAINS A CLINICAL AFFILIATE AND BIDMC COLLABORATOR AND COMMUNITY PARTNER, THE HEALTH CENTER IS LONGER A MEMBER OF CCA. BIDMC HAS FOCUSED ITS EFFORTS ON CREATING TARGETED PROGRAMS THAT ADDRESS CHRONIC DISEASES SUCH AS CANCER, DIABETES, AND HIV. THESE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO BSHC'S FITNESS IN THE CITY AND CANCER PATIENT NAVIGATORS AT BIDMC. TO SUPPORT CANCER PATIENTS WHEN SPECIALTY CARE OR INPATIENT HOSPITALIZATIONS ARE NECESSARY, BIDMC OFFERS THE SERVICES OF BILINGUAL AND BICULTURAL CANCER PATIENT NAVIGATORS WHO BRIDGE THE GULF BETWEEN COMMUNITY PROVIDERS AND THE MEDICAL CENTER. ONE PATIENT NAVIGATOR SPECIALIZES IN SERVING THE LATINO COMMUNITY AND THE OTHER SPECIALIZES IN SERVING THE CHINESE COMMUNITY, THOUGH THEY ALSO SERVE PATIENTS FROM OTHER ETHNIC GROUPS. DETAILS OF OTHER BIDMC PROGRAMS, SUCH AS BOWDOIN STREET HEALTH CENTER'S FITNESS IN THE CITY, ADDRESSING CHRONIC DISEASE MANAGEMENT ARE INCLUDED IN THE IMPLEMENTATION STRATEGY UPDATE BELOW.AMONG THE MANY WAYS BIDMC AND ITS PARTNERS ADDRESS BEHAVIORAL HEALTH NEEDS IS BY EXPANDING BEHAVIORAL HEALTH INTEGRATION AT ITS AFFILIATED HEALTH CENTERS AS WELL AS SCREENING PATIENTS AT BIDMC AND CONNECTING THEM TO APPROPRIATE SERVICES. FOR EXAMPLE, BSHC CONTINUES TO INTEGRATE BEHAVIORAL HEALTH SERVICES INTO THEIR PRIMARY CARE CLINIC. A BEHAVIORAL HEALTH CARE MANAGER IS ON-SITE TO PROVIDE MENTAL HEALTH ASSESSMENT, INTERVENTION, AND CONSULTATION TO PATIENTS AND PROVIDERS DURING PRIMARY CARE VISITS. RESULTS OF THE BEHAVIORAL HEALTH INTEGRATION SHOW THAT MORE HIGH-RISK PATIENTS ARE ACCESSING MENTAL HEALTH SERVICES, AN INCREASE IN APPOINTMENTS KEPT BY PATIENTS WHO RECEIVE A "WARM-HAND OFF" BY THEIR PROVIDER TO THERAPISTS, AND REDUCED WAIT TIME FOR MENTAL HEALTH APPOINTMENTS. BIDMC ALSO CONTINUED TO DEDICATE SIGNIFICANT TIME AND RESOURCES TO RESPOND TO NEEDS RELATED TO COVID-19, SUCH AS FOOD INSECURITY, HOUSING INSTABILITY, AND ACCESS TO CARE. FOR EXAMPLE, BIDMC CONTINUED TO OFFER ACCESS TO COVID-19 TESTING AT ITS CHELSEA LOCATION. IN RESPONSE TO FOOD INSECURITY CAUSED AND/OR EXACERBATED BY COVID-19, BIDMC PARTNERED WITH ITS' LICENSED AND AFFILIATED HEALTH CENTERS AND OTHER ORGANIZATIONS TO IMPROVE FOOD ACCESS. BOWDOIN STREET HEALTH CENTER DELIVERED BI-WEEKLY FOOD BOXES FOR HEALTH CENTER PATIENTS WHO IDENTIFIED AS FOOD INSECURE. THE DIMOCK CENTER ADDRESSED FOOD INSECURITY AMONG PATIENTS AND COMMUNITY RESIDENTS THROUGH A GIFT-CARD BASED PROGRAM, PROVIDING A FLEXIBLE MECHANISM FOR INDIVIDUALS TO PURCHASE NECESSARY FOOD AND HOUSEHOLD ITEMS. A FULL UPDATE ON BIDMC'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.
FY20 SCHEDULE H IMPLEMENTATION STRATEGY UPDATE KEY: BASELINE-2020, YEAR 1-2021, YEAR 2-2022PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM BIDMC'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW-INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT AND COMMUNITY INTEGRATION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. THE IMPACT OF RACISM, BARRIERS TO CARE, AND DISPARITIES IN HEALTH OUTCOMES THAT THESE POPULATIONS FACE ARE WIDELY DOCUMENTED. THERE ARE A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. THE UNDERLYING ISSUE IS NOT ONLY RACE/ETHNICITY, FOREIGN BORN STATUS, OR LANGUAGE BUT RATHER A BROAD ARRAY OF INTERRELATED ISSUES INCLUDING ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION. GOAL 1: PROMOTE HEALTHY NEIGHBORHOODS (HEALTHY EATING, ACTIVE LIVING, OTHER HEALTHY BEHAVIORS, HEALTH-RELATED PROGRAMS/POLICIES) PROGRAMMATIC OBJECTIVES1.1 INCREASE THE NUMBER OF CHILDREN IN CCA CLINICS WHO ARE SCREENED FOR BMI1.2 INCREASE THE NUMBER OF CHILDREN, YOUTH, AND ADULTS WHO ARE PHYSICALLY ACTIVE1.3 DEVELOP AND UPDATE ANNUALLY A STRATEGIC PROGRAM PLAN FOR BOWDOIN STREET WELLNESS CENTER1.4 INCREASE ACCESS TO HEALTHY AND AFFORDABLE FOODS IN THE COMMUNITY1.5 IMPROVE NUTRITIONAL QUALITY OF THE FOOD SUPPLY1.6 DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITY1.7 PROVIDE OPPORTUNITIES FOR NEIGHBORHOODS TO IDENTIFY AND ADDRESS UNIQUE NEIGHBORHOOD NEEDSCOMMUNITY OBJECTIVES / STRATEGIES PROMOTE UNIVERSAL SCREENING FOR BMI ALONG WITH APPROPRIATE COUNSELING FOR PHYSICAL ACTIVITY AND NUTRITION SUPPORT AND PROMOTE THE DEVELOPMENT OF WALKING AND OTHER PHYSICAL ACTIVITY GROUPS IN SCHOOLS, COMMUNITY-BASED AND PRIMARY CARE-BASED SETTINGS (E.G., BOWDOIN STREET WELLNESS CENTER) SUPPORT AND COLLABORATE WITH BPHC AND COMMUNITY-BASED ORGANIZATIONS (E.G., DAILY TABLE, GBFB, ETC.) TO PROMOTE ACCESSIBLE/AFFORDABLE HEALTHY FOOD INCLUDING RX FOOD PRESCRIPTION, AND FARMERS MARKETS SUPPORT HEALTHY CHAMPIONS, A GROUP OF TEENAGERS, IN HEALTHY COOKING AND EDUCATION WORKSHOPS SUPPORT THE FITNESS IN THE CITY PROGRAM AT BSHC SELECT NEIGHBORHOOD COLLECTIVES TO IDENTIFY AND ADDRESS UNIQUE NEIGHBORHOOD NEEDSMETRICS AND STATUS UPDATE: NUMBER OF CHILDREN 3-17 AT AFFILIATED HEALTH CENTERS WHO ARE SCREENED FOR BMI AND COUNSELED FOR PHYSICAL ACTIVITY AND NUTRITION (FY20: 7,137 FY21: 5,694) PERCENTAGE OF CHILDREN SEEN AT AFFILIATED HEALTH CENTERS THAT WERE SCREENED FOR BMI AND COUNSELED FOR NUTRITION AND PHYSICAL ACTIVITY (FY20: 73%; FY21: 62%) NUMBER OF SCHOOLS PARTICIPATING IN WALKING PROGRAMS AND OTHER PHYSICAL ACTIVITY GROUPS (FY20: 8 PUBLIC SCHOOLS; FY21: PROGRAM ENDED IN FY20) NUMBER OF PARTICIPANTS IN THE FITNESS IN THE CITY PROGRAM (FY20: 73; FY21: 56) NUMBER OF BOWDOIN GENEVA FARMERS' MARKETS AND OTHER FARMERS MARKETS HELD (FY20: 0 - DID NOT TAKE PLACE DUE TO COVID-19; FY21: PROGRAM ENDED DUE TO FUNDING CHANGES AND REDIRECTION DUE TO COVID-19) POUNDS OF PRODUCE SOLD AT BOWDOIN GENEVA FARMERS' MARKETS (FY20: 0 - DID NOT TAKE PLACE DUE TO COVID-19; FY21: PROGRAM ENDED DUE TO FUNDING CHANGES AND REDIRECTION DUE TO COVID-19) NUMBER OF FOOD BOXES BSHC PROVIDED (FY21: 2,925 BOXES TO 125 UNIQUE FAMILIES) NUMBER OF PATIENTS REFERRED TO BSHC COMMUNITY HEALTH WORKERS FOR SUPPORT (FY20: 183; FY21: 438) NUMBER OF INTERVENTION CALLS BSHC COMMUNITY HEALTH WORKERS RESPONDED TO (FY20: 118; FY21: 85) NUMBER OF PATIENTS EACH BSHC COMMUNITY HEALTH WORKER PROVIDES SUPPORT/ INTERVENTION TO (FY20: 48; FY21: 74)GOAL 2: PROMOTE VIOLENCE PREVENTION (SAFE NEIGHBORHOODS AND COMMUNITY COHESION)PROGRAMMATIC OBJECTIVES1.1 INCREASE ACCESS TO MENTAL HEALTH SERVICES AT BSHC FOR AFFECTED VICTIMS1.2 INCREASE PARTICIPATION IN ADVOCATE EDUCATION AND SUPPORT PROJECT1.3 PROVIDE COUNSELING AND OTHER MEDICAL SERVICES TO RAPE VICTIMS1.4 PROVIDE GRIEVING SUPPORT ACTIVITIES1.5 CONDUCT NEIGHBORHOOD CAMPAIGNS TO ENGAGE COMMUNITY AND CREATE GREATER COMMUNITY COHESION1.6 INCREASE ACCESS TO CARE AND SUPPORT TO NEIGHBORHOODS IMPACTED BY TRAUMA THROUGH THE NEIGHBORHOOD TRAUMA TEAMCOMMUNITY ACTIVITIES / STRATEGIES SUPPORT AND ORGANIZE COMMUNITY MEETINGS WHERE RESIDENTS SHARE THEIR CONCERNS AND DISCUSS POSSIBLE ACTION STEPS (VIP/ VILLAGE IN PROGRESS CALL TO ACTION) IDENTIFY AND EMPOWER COMMUNITY LEADERS THROUGH OUTREACH ACTIVITIES TO BUILD COMMUNITY COHESION SUPPORT PROGRAMS IN BSHC THAT INTEGRATE SERVICES PROVIDED BY BEHAVIORAL HEALTH SPECIALISTS AND MONITOR, ASSESS, AND TREAT THOSE EXPERIENCING TRAUMA FROM VIOLENCE HOLD HEALING SERVICES WHEN APPROPRIATE FOR COMMUNITY RESIDENTS PARTICIPATE IN COMMUNITY INTERVENTIONS THAT RAISE AWARENESS ABOUT VIOLENCE, ENGAGE THE COMMUNITY, ADDRESS FACTORS ASSOCIATED WITH VIOLENCE AND PROMOTE A SENSE OF COMMUNITY SUPPORT AND PROMOTE THE IMPLEMENTATION OF TRAINING PROGRAMS, SUPPORT GROUPS FOR ADVOCATES AND AFFECTED COMMUNITY MEMBERS PROVIDE OVERNIGHT STAYS FOR DOMESTIC VIOLENCE AND/OR SEXUAL ASSAULT VICTIMS WITHOUT SAFE SHELTER CONDUCT PUBLIC POLICY ADVOCACY FOR SAFE SHELTERS AND LONG-TERM HOUSING SUPPORT EMPOWER YOUTH TO DEVELOP LEADERSHIP SKILLS, PREVENT VIOLENCE, AND CREATE CHANGE IN THEIR COMMUNITY THROUGH THE YOUTH LEADERSHIP PROGRAM AT BOWDOIN STREET HEALTH CENTER RESPOND TO ALL INCIDENTS OF HOMICIDE OR VIOLENCE WITHIN CATCHMENT AREA THAT MEET CRITERIA AS ESTABLISHED BY THE BPHC (VIP AND NTT)METRICS AND STATUS UPDATES NUMBER OF SEXUAL ASSAULT VICTIMS RECEIVING SERVICES (FY20: PROVIDED SERVICES, INCLUDING COUNSELING TO 56 SEXUAL ASSAULT VICTIMS. PROVIDED POST-HIV EXPOSURE PROPHYLAXIS MEDICATIONS TO 34 SEXUAL ASSAULT VICTIMS; FY21: PROVIDED SERVICES, INCLUDING COUNSELING TO 27 SEXUAL ASSAULT VICTIMS.) NUMBER OF SAFE BED OVERNIGHT STAYS (FY20: 34; FY21:11) NUMBER OF HEALTH CENTERS, COLLEGES AND UNIVERSITIES, AND COMMUNITY GROUPS RECEIVING EDUCATIONAL PROGRAMMING AROUND SEXUAL ASSAULT, INTERPERSONAL VIOLENCE, COMMUNITY VIOLENCE AND SECONDARY TRAUMATIC STRESS (FY20:17; FY21: 41) NUMBER OF HEALING CIRCLES HELD WITH WOMEN, MEN, AND CHILDREN (FY20: 86 HEALING CIRCLES, SERVING OVER 1,130 MEMBERS OF THE COMMUNITY; FY21: 64 HEALING CIRCLES, SERVING OVER 715 MEMBERS OF THE COMMUNITY) NUMBER OF INCIDENTS OF HOMICIDE OR VIOLENCE RESPONDED TO (FY20: 43; FY21: 36) NUMBER OF BOWDOIN/GENEVA YOUTH PARTICIPATING IN THE BSHC YOUTH LEADERSHIP PROGRAM (FY20: 30; FY21: 22)GOAL 3: PROMOTE AFFORDABLE HOUSING AND GOAL 4: PROMOTE HOME OWNERSHIP PROGRAMMATIC OBJECTIVES1.1 INCREASE ACCESS TO AFFORDABLE HOUSING1.2 INCREASE HOME OWNERSHIP1.3 REDUCE RISK OF HOMELESSNESSCOMMUNITY ACTIVITIES / STRATEGIES FUND COMMUNITY-BASED ORGANIZATIONS THAT ARE WORKING ON AFFORDABLE HOUSING AND HOME OWNERSHIP INITIATIVES THROUGH BIDMC'S NEW INPATIENT BUILDING COMMUNITY-BASED HEALTH INITIATIVE (CHI) CONDUCT PUBLIC POLICY AND ADVOCACY THAT AIMS TO INCREASE: ACCESS TO AFFORDABLE HOUSING, HOUSING STABILITY, AND HEALTHY LIVING CONDITIONS (INCLUDING SAFETY) AND IMPROVE HOUSING QUALITY PROVIDE ACCESS TO HOUSING STABILITY SERVICES SUCH AS LEGAL AID PROVIDE RESOURCES TO MITIGATE FINANCIAL "CLIFF EFFECTS" PROVIDE HOUSING OPPORTUNITIES FOR LGBTQIA+ YOUTH AND HOMELESS YOUTH AND YOUNG ADULTS BUILD CAPACITY OF RESIDENTS TO ADVOCATE AND ORGANIZE AGAINST UNJUST EVICTIONS AND FORECLOSURES SUPPORT HOME BUYING AND FINANCIAL LITERACY EDUCATION SUPPORT HOMEOWNERSHIP PROGRAMSMETRICS AND STATUS UPDATES RELEASED A REQUEST FOR PROPOSALS IN AUGUST 2020 TO FUND EVIDENCE-BASED AND/OR EVIDENCE-INFORMED STRATEGIES IN THE AREAS OF HOMELESSNESS, RENTAL ASSISTANCE, AND HOME OWNERSHIP TO ADDRESS HOUSING AFFORDABILITY THROUGH BIDMC'S CHI, 7 ORGANIZATIONS WERE FUNDED TO ADDRESS HOUSING AFFORDABILITY EACH CHI GRANTEE CREATED A LOGIC MODEL TO OUTLINE PROJECT ACTIVITIES AND GOALS CHI GRANTEES PARTICIPATED IN 7 EVALUATION LEARNING COLLABORATIVES TO BUILD THEIR EVALUATION CAPACITY IN FY21, THE BIDMC SOCIAL WORK DEPARTMENT PROVIDED HOUSING SUPPORT TO 74 PATIENTS IN NEED OF SHORT- OR LONG-TERM HOUSING
GOAL 5: SUPPORT WORKFORCE DEVELOPMENT AND CREATION OF EMPLOYMENT OPPORTUNITI PROGRAMMATIC OBJECTIVES1.1 INCREASE MENTORSHIP, TRAINING, AND EMPLOYMENT OPPORTUNITIES FOR YOUTH, YOUNG ADULTS, AND ADULTS RESIDING IN THE BIDMC CBSA AS WELL AS BIDMC EMPLOYEES1.2 PROMOTE WORKFORCE DEVELOPMENT AND CAPACITY BUILDINGCOMMUNITY ACTIVITIES / STRATEGIES ORGANIZE AND SUPPORT PIPELINE PROGRAMS TO ENHANCE SKILLS AND CAREER ADVANCEMENT PROVIDE OPPORTUNITIES THROUGH EMPLOYEE CAREER INITIATIVE (ECI) FOR COLLEGE-LEVEL COURSES AS WELL AS COUNSELING OFFER ESOL CLASSES, GED CLASSES, A BASIC COMPUTER SKILLS COURSE, CITIZENSHIP CLASSES, AND A FINANCIAL LITERACY CLASS PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR COMMUNITY RESIDENTS PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR MIDDLE AND HIGH SCHOOL STUDENTS FUND COMMUNITY-BASED ORGANIZATIONS THROUGH THE NEW INPATIENT BUILDING COMMUNITY-BASED HEALTH INITIATIVE TO ADDRESS JOBS AND FINANCIAL SECURITY PROVIDE SUPPORT FOR BI-LINGUAL/BI-CULTURAL PROVIDERS PROVIDE PAID WORKFORCE DEVELOPMENT OPPORTUNITIES FOR LATINX, ENGLISH LANGUAGE LEARNERS, AND IMMIGRANT YOUTHMETRICS AND STATUS UPDATES NUMBER OF PIPELINE PROGRAMS OFFERED (FY20: 6; FY21: 4) NUMBER OF PARTICIPANTS IN PIPELINE PROGRAM (FY20: 34; FY21: 37) NUMBER OF PARTICIPANTS WHO GRADUATED FROM PIPELINE PROGRAMS (FY20: 28; FY21:16) NUMBER OF EMPLOYEES RECEIVING ECI SERVICES (FY20: 551; FY21: 398) NUMBER OF EMPLOYEES ENROLLED IN ESOL CLASSES (FY20: 24; FY21: 18) NUMBER OF ADULT INTERNS PLACED (FY20: 14; FY21: 0 (COVID)) NUMBER OF ADULT INTERNS HIRED AFTER INTERNSHIPS (FY20: 6; FY21: 0) NUMBER OF REFERRALS/RECOMMENDATIONS BY COMMUNITY PARTNERS FOR BIDMC TO HIRE (FY20: 202; FY21: 310) NUMBER OF HIRES FROM REFERRALS FROM COMMUNITY PARTNERS (FY21: 40) NUMBER OF SUMMER JOB OPPORTUNITIES PROVIDED (FY20: 22; FY21: 31) NUMBER OF SCHOOL INTERNS HOSTED (FY20: 1; FY21: 0) NUMBER OF BOSTON PUBLIC SCHOOL STUDENTS HOSTED FOR PIC'S ANNUAL JOB SHADOW DAY (FY20: 0 (DID NOT TAKE PLACE DUE TO COVID-19); FY21: PIC HAS DISCONTINUED OFFERING THIS EVENT TO BPS KIDS NUMBER OF HIGH SCHOOL STUDENTS HOSTED IN SUMMER HEALTH CORPS PROGRAM (FY20: 0 (DID NOT RUN DUE TO COVID-19); FY21: 20) NUMBER OF EMPLOYEES PARTICIPATING IN COMPUTER SKILLS, CITIZENSHIP, AND FINANCIAL LITERACY CLASSES (FY20: 36 EMPLOYEES PARTICIPATED IN A COMPUTER SKILLS CLASS, 17 ATTENDED CITIZENSHIP CLASSES, AND 155 ATTENDED A FINANCIAL LITERACY CLASS; FY 21: 91 ATTENDED A COMPUTER SKILLS CLASS, 12 ATTENDED CITIZENSHIP CLASSES AND 151 ATTENDED FINANCIAL LITERACY CLASSES) NUMBER OF YOUTH THAT GRADUATED BSHC YOUTH LEADERSHIP PROGRAM (FY20: 12; FY21: 10) RELEASED A REQUEST FOR PROPOSALS IN AUGUST 2020 TO FUND EVIDENCE-BASED AND/OR EVIDENCE-INFORMED STRATEGIES IN THE AREAS OF EDUCATION/WORKFORCE DEVELOPMENT, EMPLOYMENT OPPORTUNITIES, AND INCOME/FINANCIAL SUPPORTS TO CREATE JOBS AND INCREASE FINANCIAL SECURITY THROUGH BIDMC'S CHI, 6 ORGANIZATIONS WERE FUNDED TO ADDRESS JOBS & FINANCIAL SECURITY EACH CHI GRANTEE CREATED A LOGIC MODEL TO OUTLINE PROJECT ACTIVITIES AND GOALS CHI GRANTEES PARTICIPATED IN 7 EVALUATION LEARNING COLLABORATIVES TO BUILD THEIR EVALUATION CAPACITYGOAL 6: PROMOTE ENVIRONMENTAL SUSTAINABILITY PROGRAMMATIC OBJECTIVES1.1 CREATE A HEALTHY FUTURE FOR OUR PATIENTS, THEIR FAMILIES, AND OURSELVES BY CONSERVING NATURAL RESOURCES, REDUCING OUR CARBON FOOTPRINT, AND FOSTERING CULTURE OF SUSTAINABILITYCOMMUNITY ACTIVITIES / STRATEGIES PROMOTE RECYCLING, COMPOSTING, AND OTHER PROGRAMS TO DIVERT WASTE FROM INCINERATION INCREASE BIDMC'S SPEND ON HEALTHY BEVERAGES AND LOCAL AND SUSTAINABLE FOOD REDUCE CONSUMPTION OF WATER, ENERGY, AND GREENHOUSE GASESMETRICS AND STATUS UPDATES PERCENT OF DOLLARS EXPENDED IN LOCAL & SUSTAINABLE FOOD (FY20: 15%; FY21:16%) PERCENT REDUCTION OF GREENHOUSE GAS EMISSIONS (FY20: NOT MEASURED DUE TO COVID-19; FY21: 6%) NUMBER OF TAXI OR CHAIR CAR VOUCHERS PROVIDED TO PATIENTS BY BIDMC (FY20: 2,062 RIDE SHARE/TAXI RIDES AND 3 CHAIR CARS; FY21: 3,779 RIDE SHARE/TAXI RIDES AND 5 CHAIR CARS) PERCENT DECREASE IN GREENHOUSE GAS EMISSIONS RELATED TO EMPLOYEE COMMUTING DUE TO TRANSITIONING TO SUPPORT REMOTE WORK AND DECREASE IN SINGLE-OCCUPANCY VEHICLES DURING COVID-19 (FY20: 29% DECREASE; FY21: 43% INCREASE AS STAFF RETURNS TO WORK)PRIORITY AREA 2: CHRONIC / COMPLEX CONDITIONS & THEIR RISK FACTORS HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA SHOWS THAT MANY COMMUNITIES IN BIDMC'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN FOR THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH. LIMITED ACCESS TO CANCER SCREENING FOR RACIAL/ETHNIC DIVERSITY AND OTHER AT-RISK POPULATIONS. MANY OF THE COMMUNITIES THAT ARE PART OF BIDMC'S CBSA HAVE HIGH CANCER MORTALITY RATES. THIS IS PARTICULARLY TRUE FOR CERTAIN CANCERS IN SPECIFIC COMMUNITIES IN BOSTON NEIGHBORHOODS SUCH AS ROXBURY, DORCHESTER, AND CHINATOWN. AT THE ROOT OF ADDRESSING HIGH MORTALITY IS SCREENING, EARLY DETECTION, AND ACCESS TO TIMELY TREATMENT. HIGH RATES OF THE LEADING HEALTH RISK FACTORS (E.G., LACK OF NUTRITIONAL FOOD AND PHYSICAL ACTIVITY, ALCOHOL/ILLICIT DRUG USE, AND TOBACCO USE) ARE ONE OF THE LEADING FINDINGS FROM THE ASSESSMENT IS THAT MANY COMMUNITIES AND/OR POPULATION SEGMENTS IN BIDMC'S CBSA HAVE HIGH RATES OF CHRONIC PHYSICAL AND BEHAVIORAL HEALTH CONDITIONS. IN SOME PEOPLE, THESE CONDITIONS UNDERLYING GENETIC ROOTS THAT ARE HARD TO COUNTER. HOWEVER, FOR MOST PEOPLE THESE CONDITIONS ARE WIDELY CONSIDERED PREVENTABLE OR MANAGEABLE. ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF A SOUND CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGY. GOAL 1: IMPROVE CHRONIC DISEASE MANAGEMENT PROGRAMMATIC OBJECTIVES1.1 INCREASE THE NUMBER OF ADULTS WHO RECEIVE EDUCATION AND COUNSELING REGARDING RISK FACTORS, HEALTHY BEHAVIORS TO INCREASE CHRONIC DISEASE HEALTH LITERACY1.2 INCREASE THE NUMBER OF ADULTS SCREENED FOR DIABETES, HYPERTENSION, HIV/AIDS, AND ASTHMA 1.3 INCREASE THE NUMBER OF ADULTS WITH DIABETES, HYPERTENSION, HIV/AIDS, AND PERSISTENT ASTHMA WHO RECEIVE EVIDENCE-BASED COUNSELING/ COACHING AND TREATMENT1.4 INCREASE THE NUMBER OF ADULTS WITH DIABETES, HYPERTENSION, HIV/AIDS, AND PERSISTENT ASTHMA WHOSE CONDITIONS ARE MONITORED AND CONTROLLEDCOMMUNITY ACTIVITIES / STRATEGIES SUPPORT PROGRAMS IN CCA CLINICS INCLUDING LIVE AND LEARN DIABETES AT CRCH THAT EDUCATE AND SCREEN PATIENTS FOR DIABETES, HYPERTENSION, AND PERSISTENT ASTHMA PROVIDE EVIDENCED-BASED COUNSELING/COACHING AND TREATMENT, AS WELL AS APPROPRIATE REFERRALS FOR SPECIALTY CARE SERVICES FOR THOSE WHO SCREEN POSITIVE FOR DIABETES, HYPERTENSION, HIV/AIDS, AND ASTHMA PROVIDE SCREENING, EDUCATION/COUNSELING, AND TREATMENT SERVICES HIV/AIDS AND HIV/HCV CO-INFECTION SUPPORT GROUPS FOR MEN AND WOMEN LIVING WITH HIV/AIDS SUPPORT PRIMARY CARE PROVIDER EDUCATION AT CRCH IN THE AREA OF DIABETES MANAGEMENTMETRICS AND STATUS UPDATES: NUMBER OF CRCH PATIENTS PARTICIPATING IN THE CRCH DISEASE MANAGEMENT PROGRAM LIVE AND LEARN DIABETES (FY20: 24 PATIENTS AND 25 APPOINTMENTS; FY21: 94 PATIENTS AND 71 APPOINTMENTS) NUMBER OF BSHC PATIENTS PARTICIPATING IN DISEASE MANAGEMENT PROGRAMS (FY20: 50; FY21: PROGRAM ENDED IN FY20) PERCENTAGE OF CCA FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AND OUTER CAPE HEALTH SERVICES PATIENTS WITH DIABETES WITH HBA1C < 9 (FY20: 80%; FY21: 72%) PERCENTAGE OF CCA FQHC AND OUTER CAPE HEALTH SERVICES PATIENTS WITH HYPERTENSION WHO HAD A BLOOD PRESSURE < 140/90.(FY20: 71%; FY21: 60%) PERCENTAGE OF CCA FQHC AND OUTER CAPE HEALTH SERVICES PERSISTENT ASTHMATIC PATIENTS WITH PHARMACOLOGICAL THERAPY (FY20: 75%; FY21: METRIC NO LONGER MEASURED BY UNIFORM DATA SYSTEM (UDS))
GOAL 2: REDUCE CANCER DISPARITIES (ACCESS TO SCREENING AND TREATMENT) PROGRAMMATIC OBJECTIVES1.1 INCREASE THE NUMBER OF LOW INCOME AND RACIAL/ETHNIC DIVERSE ADULTS EDUCATED AND SCREENED FOR CANCER1.2 INCREASE THE NUMBER OF ADULTS WHO SCREEN POSITIVE FOR CANCER WHO ARE REFERRED FOR EDUCATION, COUNSELING AND TREATMENT1.3 INCREASE THE NUMBER OF ADULTS WHO SCREEN POSITIVE FOR CANCER WHO ARE LINKED TO A CANCER NAVIGATOR1.4 INCREASE THE NUMBER OF ADULTS WHO PARTICIPATE IN CANCER SUPPORT GROUPSCOMMUNITY ACTIVITIES / STRATEGIES SUPPORT ACCESS TO CANCER SCREENING AND TREATMENT FOR LOW INCOME, UNINSURED ADULTS (BREAST, PROSTATE, COLON, AND LUNG, CANCERS), INCLUDING MAMMOGRAMS, COLORECTAL SCREENING, AND CT SCANS SUPPORT AND PROMOTE THE CITY-WIDE CANCER NAVIGATORS PROGRAM LINK PATIENTS SCREENED POSITIVE FOR CANCER TO CANCER PATIENT NAVIGATORS SUPPORT THE IMPLEMENTATION OF CANCER SUPPORT GROUPS SUPPORT SURVIVOR SELF-PORTRAIT AND TESTIMONIES ACTIVITIES TO REDUCE STIGMA IN COMMUNITIES (FACES OF FAITH ANNUAL EXHIBIT)METRICS AND STATUS UPDATES INCREASE ACCESS TO PATIENT NAVIGATORS NUMBER OF UNIQUE PATIENTS SERVED BY THE LATINX AND CHINESE PATIENT NAVIGATORS (FY20: 147; FY21: 421) NUMBER OF CHINESE PATIENT NAVIGATOR ENCOUNTERS (FY20: 1,640; FY21: 1,790) NUMBER OF LATINX PATIENT NAVIGATOR ENCOUNTERS (FY21: 68) NUMBER OF PEOPLE PARTICIPATING IN CANCER SUPPORT GROUPS AT BIDMC (FY20: 52; FY21: 65) NUMBER OF MAMMOGRAMS PROVIDED FOR LOW-INCOME PATIENTS AT FENWAY, OUTER CAPE, AND SOUTH COVE COMMUNITY HEALTH CENTERS.(FY20: 1,949; FY21: 1,106) NUMBER OF COLON CANCER SCREENINGS PROVIDED AT BIDMC FOR LOW-INCOME PATIENTS (FY20: 928; FY21: 1,331) NUMBER OF BIDMC PATIENTS SCREENED FOR LUNG CANCER (FY20: 643; FY21:1,616) NUMBER OF MEDICALLY UNDERSERVED PATIENTS WITH BREAST CANCER IDENTIFIED AND ENROLLED IN THE SOCIAL NEEDS ASSESSMENT PROGRAM AT BIDMC (FY20: 68; FY21: 104)GOAL 3: SUPPORT OLDER ADULTS TO AGE IN PLACE PROGRAMMATIC OBJECTIVES1.1 REDUCE INAPPROPRIATE READMISSIONS FOR OLDER ADULTS1.2 REDUCE ELDERLY FALLS1.3 REDUCE SOCIAL ISOLATIONCOMMUNITY ACTIVITIES / STRATEGIES VIP WORK WITH THE ELDER BUILDINGS TO SUPPORT ELDER RESIDENT GROUP PROVIDING THEM RESOURCES, ADDRESS ISSUES (55+)METRICS AND STATUS UPDATES NO METRICS RELATED TO ACTIVITIES TO SUPPORT OLDER ADULTS AGING IN PLACE IN FY20PRIORITY AREA 3: ACCESS TO CARE LIMITED ACCESS TO PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH CARE SERVICES FOR LOW-INCOME, MEDICAID INSURED, UNINSURED, AND OTHER VULNERABLE POPULATIONS FACING HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE AND THE COMMUNITIES THAT MAKE UP BIDMC'S CBSA HAVE STRONG, ROBUST SAFETY NET SYSTEMS, THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW-INCOME, MEDICAID INSURED, UNINSURED, AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND ORAL HEALTH SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH SERVICES.BARRIERS TO ACCESS AND DISPARITIES IN HEALTH OUTCOMES CONTINUE TO CHALLENGE THREE SPECIFIC POPULATIONS (INFANTS/MOTHERS/FATHERS, FRAIL OLDER ADULTS, AND LESBIAN, GAY, BI-SEXUAL, AND TRANSGENDER (LGBT) POPULATIONS. BASED ON INFORMATION GATHERED PRIMARILY FROM INTERVIEWS AND COMMUNITY FORUMS, THE ASSESSMENT IDENTIFIED A NUMBER OF SPECIAL POPULATIONS THAT FACE BARRIERS TO CARE AND DISPARITIES IN ACCESS. MORE SPECIFICALLY, INFANTS/MOTHERS/FATHERS, FRAIL OLDER ADULTS, AND THE LESBIAN, GAY, BI-SEXUAL, AND TRANSGENDER (LGBT) POPULATIONS FACE DISPARITIES IN ACCESS AND OUTCOME AND ARE PARTICULARLY AT-RISK. IF THESE DISPARITIES ARE GOING TO BE ADDRESSED, THEN CARE NEEDS TO BE TAKEN TO TAILOR IDENTIFICATION/SCREENING AND PREVENTIVE SERVICES AS WELL AS ACUTE AND CHRONIC DISEASE MANAGEMENT SERVICES FOR THESE SPECIAL POPULATIONS. GOAL 1: INCREASE ACCESS TO QUALITY MEDICAL SERVICES, INCLUDING PRIMARY CARE, OB/GYN, AND SPECIALTY CARE AS WELL AS URGENT, EMERGENT AND TRAUMA CARE PROGRAMMATIC OBJECTIVES1.1 INCREASE ACCESS TO PRIMARY MEDICAL CARE SERVICES, INCLUDING OB/GYN SERVICES, AT BIDMC'S CCA CLINIC SITES AND BIDMC'S CHELSEA SERVICE SITE, AS WELL AS AT ITS APG AND HCA PRACTICES1.2 INCREASE THE NUMBER OF PATIENTS RECEIVING SPECIALTY CARE MEDICAL SERVICES1.3 INCREASE THE NUMBER OF UNINSURED OR UNDERINSURED PATIENTS RECEIVING NEEDED MEDICATIONS1.4 INCREASE ACCESS TO APPROPRIATE, TIMELY, URGENT, EMERGENT, AND TRAUMA CARE SERVICES1.5 INCREASE THE NUMBER OF RESIDENTS WHO ARE SCREENED AND ENROLLED FOR HEALTH INSURANCE1.6 INCREASE PATIENT SATISFACTION1.7 CONTINUE TO SUPPORT HSN TRUST FUND1.8 ADVOCATE FOR POLICIES SUPPORTING PUBLIC HEALTH, MENTAL HEALTH AND SUBSTANCE ABUSE AND ANTI-POVERTY PROGRAMSCOMMUNITY ACTIVITIES / STRATEGIES SUPPORT PRIMARY MEDICAL CARE SERVICES, INCLUDING OB/GYN SERVICES AT BIDMC'S CCA CLINIC SITES AND BIDMC'S CHELSEA SERVICE SITE, AS WELL AS AT BIDMC'S APG AND HCA PRACTICES SUPPORT RESIDENT ROTATIONS INTO CCA CLINIC SITES FACILITATE REFERRALS TO SPECIALTY CARE THROUGH CARE CONNECTION'S INPATIENT DISCHARGE FOLLOW UP PROGRAM PROVIDE FREE PHARMACY MEDICATIONS TO ELIGIBLE, LOW INCOME PATIENTS SUPPORT THE PROVISION OF APPROPRIATE, TIMELY URGENT CARE SERVICES AT BIDMC URGENT CARE LOCATIONS IN CHELSEA, CHESTNUT HILL, AND THE BOWDOIN/GENEVA NEIGHBORHOOD OF BOSTON, AS WELL AS AT SOME OF BIDMC'S APG PRACTICES SUPPORT MEDFLIGHT AND COORDINATED EMS IN BOSTON SUPPORT THE COMMONWEALTH'S HEALTH SAFETY NET (HSN) SUPPORT ACTIVITIES OF THE BOSTON HEALTHY START INITIATIVE (BHSI), ADMINISTERED AT BOWDOIN STREET HEALTH CENTER (BSHC), INCLUDING CASE MANAGEMENT, NUTRITION COUNSELING, PRENATAL EDUCATION, AND PARENTING SUPPORT SUPPORT CLINICAL OPERATIONS AT CCA CLINICS CONDUCT "MYSTERY SHOPPING" TO ADDRESS QUALITY IMPROVEMENT SUPPORT CARE INTEGRATION THROUGH INFORMATION SHARING, INCLUDING PARTICIPATION IN MASS HIWAY AND HEALTH INFORMATION EXCHANGE INTEGRATE SOCIAL JUSTICE TOPICS INTO RESIDENT CURRICULUM SUPPORT INSTITUTIONAL AND COMMUNITY EMERGENCY PREPAREDNESSMETRICS AND STATUS UPDATES NUMBER OF REFERRALS MADE THROUGH CARE CONNECTION CALL CENTER (FY20: 801; FY21:1,058) NUMBER OF PREGNANT MOTHERS AND FAMILIES FROM BSHC PROVIDED CASE MANAGEMENT THROUGH THE BHSI PROGRAM (FY20: SERVED 56 PREGNANT CLIENTS AND 62 INTERCONCEPTION/PARENTING CLIENTS; FY21:140 TOTAL PATIENTS INCLUDING 49 PRENATAL MOTHERS, 41 POSTNATAL MOTHERS, AND 50 CHILDREN) NUMBER OF BIDMC PATIENTS SCREENED FOR ENTITLEMENT ELIGIBILITY (FY20: 9,892; FY21: 161,593) NUMBER OF BIDMC PATIENTS ENROLLED IN ENTITLEMENT PROGRAMS (FY20: 7,463; FY21: 16,942) NUMBER OF UNIQUE PATIENTS SUPPORTED THROUGH HSN (FY20: 1317; FY21: 7,279) NUMBER OF MEDICAL RESIDENTS PLACED AT CCA HEALTH CENTERS (FY20: 28; FY21: 37) NUMBER OF PRIMARY CARE TRACK RESIDENTS AT CCA HEALTH CENTERS (FY20: 7; FY21: 10) NUMBER OF BIDMC SPECIALISTS THAT PRACTICE AT ALL CCA HEALTH CENTERS (FY20: 26; FY21: 31) NUMBER OF PATIENTS SERVED AT FQHC CCA HEALTH CENTERS AND OUTER CAPE HEALTH SERVICES (FY20: 115,634; FY21: 135,636) NUMBER OF VISITS PROVIDED AT FQHC CCA HEALTH CENTERS AND OUTER CAPE HEALTH SERVICES (FY20: 579,163; FY21: 535,082) NUMBER OF PATIENTS WITHOUT INSURANCE SERVED AT FQHC CCA HEALTH CENTERS (FY20: 9,664; FY21:8,137) NUMBER OF MYSTERY SHOPPING SURVEYS COMPLETED (FY20: 28; FY21: 48) NUMBER OF PRESCRIPTIONS FILLED FOR INDIGENT PATIENTS (FY20: 33,431; FY21: 31,095)GOAL 2: INCREASE ACCESS TO QUALITY ORAL HEALTH SERVICES PROGRAMMATIC OBJECTIVES1.1 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY DENTAL CARE SERVICES AT CCA CLINICCOMMUNITY ACTIVITIES / STRATEGIES SUPPORT CLINICAL OPERATIONS AT CCA CLINICS SUPPORT HSNMETRICS AND STATUS UPDATES NUMBER OF DENTAL PATIENTS AT FQHC CCA HEALTH CENTERS (FY20: 25,675; FY21: 16,687) NUMBER OF UNIQUE DENTAL VISITS AT FQHC CCA HEALTH CENTERS (FY20: 76,363; FY21: 39,832)
GOAL 3: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO FACE CULTURAL AND GOAL 3: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS PROGRAMMATIC OBJECTIVES1.1 MAINTAIN OR INCREASE THE NUMBER OF NON-ENGLISH SPEAKING PATIENTS OR RESIDENTS SERVED BY THE INTERPRETER SERVICES PROGRAM1.2 EDUCATE STAFF/CLINICIANS IN HEALTH EQUITY PRINCIPLES1.3 PROMOTE HEALTH EQUITY, HEALTH LITERACY, CULTURAL HUMILITY ACROSS CCA CLINICSCOMMUNITY ACTIVITIES / STRATEGIES INCREASE UNDERSTANDING OF CULTURAL IMPACTS ON HEALTH CARE DELIVERY, HEALTH STATUS AND HEALTH OUTCOMES MAKE AVAILABLE TOOLS AND RESOURCES TO FACILITATE CROSS-CULTURAL COMMUNICATION INCREASE ACCESS TO INTERPRETER SERVICESMETRICS AND STATUS UPDATES NUMBER OF LEP ENCOUNTERS AND LANGUAGES AT BIDMC (FY20: 222,396 ENCOUNTERS (PERSON, TELEPHONE AND VIDEO) IN 76 LANGUAGES; FY21: 271,357 ENCOUNTERS (PERSON, TELEPHONE AND VIDEO) IN 67 LANGUAGES) NUMBER OF HIGH-VOLUME, BIDMC CUSTOM MATERIALS, TRANSLATED INTO SIX LANGUAGES; SPANISH, PORTUGUESE, RUSSIAN, TRADITIONAL CHINESE, HAITIAN CREOLE, AND SIMPLIFIED CHINESE (FY20: 6; FY21: 0) NUMBER OF PATIENTS BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH AT FQHC CCA HEALTH CENTERS AND OUTER CAPE HEALTH SERVICES (FY20: 48,422; FY21:45,625) NUMBER OF PATIENTS OF DIVERSE RACE/ETHNICITY SERVED AT FQHC CCA HEALTH CENTERS AND OUTER CAPE HEALTH SERVICES (FY20: 79,788; FY21:66,522)GOAL 4: PROMOTE GREATER HEALTH EQUITY AND REDUCE DISPARITIES IN ACCESS FOR LGBTQ POPULATIONS PROGRAMMATIC OBJECTIVES1.1 REDUCE DISPARITIES1.2 PROMOTE HEALTH EQUITYCOMMUNITY ACTIVITIES / STRATEGIES WORK TO IMPLEMENT SOGI APPROPRIATE POLICIES AND PROCEDURES COLLABORATE WITH FENWAY ON JOINT RESIDENCY PROGRAM SUPPORT PRIDE CELEBRATION SUPPORT EFFORTS ACHIEVE HEALTH CARE QUALITY INDEX RECOGNITION (E.G., SIGNAGE AND PATIENT SELF-IDENTIFICATION OF SEXUAL ORIENTATION)METRICS AND STATUS UPDATES IMPLEMENTED TRAINING FOR BIDMC STAFF ON SEXUAL ORIENTATION AND GENDER IDENTITY (SOGI) IN FY20 NUMBER OF BIDMC STAFF THAT COMPLETED THE SOGI TRAINING (FY20: 7,557; FY21: 2,564) IMPLEMENTED SOGI CAPTURE IN WEBOMR AND PATIENT-SITE IN FY20 NUMBER OF FQHC CCA PATIENTS THAT IDENTIFY AS OTHER THAN STRAIGHT: (FY20: 19,009; FY21:15,960) NUMBER OF FQHC CCA PATIENTS THAT IDENTIFY AS TRANSGENDER: (FY20: 3,047; FY21: 2,719)PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY, AND STRESS). IF THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEADING FINDING OF THE CHNA, A CLOSE SECOND WAS THE PROFOUND IMPACT THAT BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE USE AND MENTAL HEALTH) ARE HAVING ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN BIDMC'S CBSA. DEPRESSION/ANXIETY, SUICIDE, OPIOID AND PRESCRIPTION DRUG DEPENDENCY, AND ALCOHOL AND MARIJUANA USE, PARTICULARLY IN YOUTH, ARE MAJOR HEALTH ISSUES AND ARE HAVING A TREMENDOUS IMPACT ON THE POPULATION AS WELL AS A BURDEN ON THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID ABUSE IN THE COMMONWEALTH.LIMITED ACCESS TO BEHAVIORAL HEALTH SERVICES, PARTICULARLY FOR LOW-INCOME, MEDICAID INSURED, UNINSURED, AND THOSE WITH COMPLEX, MULTI-FACETED ISSUES. DESPITE THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON ALL SEGMENTS OF THE POPULATION, THERE IS AN EXTREMELY LIMITED SERVICE SYSTEM AVAILABLE TO MEET THE NEEDS THAT EXIST FOR THOSE WITH ALL MILD TO MODERATE EPISODIC ISSUES OR THOSE WITH MORE SERIOUS AND COMPLEX, CHRONIC CONDITIONS. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE (INCLUDING STIGMA), AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALIZED BEHAVIORAL HEALTH SERVICES.GOAL 1: INCREASE ACCESS TO QUALITY MENTAL HEALTH CARE AND SUBSTANCE USE SERVICES PROGRAMMATIC OBJECTIVES1.1 INCREASE PATIENT AWARENESS AND KNOWLEDGE OF BEHAVIORAL HEALTH SERVICES1.2 INCREASE THE NUMBER OF PATIENTS RECEIVING INTEGRATED MENTAL HEALTH AND SUBSTANCE USE SERVICES AT BIDMC'S CCA CLINIC SITES AND BIDMC'S CHELSEA SERVICE SITE, AS WELL AS AT BIDMC'S APG AND HCA PRACTICES 1.3 INCREASE ACCESS TO BEHAVIORAL HEALTH INPATIENT SERVICES AT BIDMC INPATIENT LOCATIONS1.4 ADVOCATE FOR HEALTH POLICY THAT PROMOTES PRIMARY CARE AND BEHAVIORAL HEALTH INTEGRATION1.5 REDUCE STIGMA AROUND BEHAVIORAL HEALTH1.6 INCREASE CAPACITY OF LOCAL ORGANIZATIONS TO PROVIDE CULTURALLY-INFORMED BEHAVIORAL HEALTH CARECOMMUNITY ACTIVITIES / STRATEGIES SUPPORT PRIMARY CARE MEDICAL AND BEHAVIORAL HEALTH INTEGRATION AT BIDMC'S CCA CLINIC SITES AND BIDMC'S CHELSEA SERVICE SITE, AS WELL AS AT BIDMC'S APG AND HCA PRACTICES CONTINUE TO PROVIDE CASE MANAGEMENT SUPPORT SERVICES FOR CCA PATIENTS WITH COMPLEX PHYSICAL AND BEHAVIORAL HEALTH ISSUES ADVOCATE FOR HEALTH POLICY THAT PROMOTES INTEGRATION SUPPORT TELEPHONIC AND ONSITE PSYCHIATRIC CONSULTATION FOR PRIMARY CARE PROVIDERS SERVING THOSE WITH BEHAVIORAL HEALTH (BH) CONDITIONS PROVIDE OB/GYN SERVICES FOR WOMEN WITH CHRONIC SUBSTANCE ABUSE ISSUES PROVIDE CULTURALLY APPROPRIATE MENTAL HEALTH SERVICES FOR THE HISPANIC/LATINO COMMUNITY SUPPORT EDUCATIONAL OPPORTUNITIES ON CULTURAL PSYCHIATRY FOR SPANISH SPEAKING MENTAL HEALTH PROVIDERS CONTINUE SBIRT IN BIDMC'S EMERGENCY DEPARTMENT PROVIDE TRAINING FOR CLINICAL PROVIDERS ON HOW TO BETTER INTEGRATE AND COORDINATE BEHAVIORAL HEALTH SERVICES ACROSS THE SYSTEM FUND COMMUNITY-BASED ORGANIZATIONS THROUGH THE NEW INPATIENT BUILDING COMMUNITY-BASED HEALTH INITIATIVE TO ADDRESS BEHAVIORAL HEALTH SUPPORT EVIDENCE-BASED, COMMUNITY-BASED PROGRAMS AIMED AT REDUCING STIGMA AROUND BEHAVIORAL HEALTH SUPPORT EVIDENCE-BASED BEHAVIORAL HEALTH INTERVENTIONS PROVIDED IN COMMUNITY SETTINGSMETRICS AND STATUS UPDATES PERCENT INCREASE OF MENTAL HEALTH VISITS IN PATIENTS SERVED BY SOCIAL WORK DEPARTMENT (FY20: 16.2%; FY21:11%) NUMBER OF PATIENTS SERVED BY BEHAVIORAL HEALTH CARE MANAGER AT BSHC (FY20: 608; FY21: 736) NUMBER OF PATIENTS ACCESSING BH SERVICES IN FQHC CCA HEALTH CENTERS (FY20: 11,966; FY21: 9,268) NUMBER OF INTEGRATED BEHAVIORAL HEALTH CONSULTATIONS PROVIDED IN BSHC PRIMARY CARE CLINIC (FY20: 184; FY21:71) RELEASED A REQUEST FOR PROPOSALS IN AUGUST 2020 TO FUND EVIDENCE-BASED AND/OR EVIDENCE-INFORMED STRATEGIES TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE THROUGH BIDMC'S COMMUNITY-BASED HEALTH (CHI) INITIATIVE, 7 ORGANIZATIONS WERE FUNDED TO ADDRESS BEHAVIORAL HEALTH EACH CHI GRANTEE CREATED A LOGIC MODEL TO OUTLINE PROJECT ACTIVITIES AND GOALS CHI GRANTEES PARTICIPATED IN 7 EVALUATION LEARNING COLLABORATIVES TO BUILD THEIR EVALUATION CAPACITY
GOAL 2: REDUCE BURDEN OF OPIOID USE PROGRAMMATIC OBJECTIVES1.1 INCREASE THE NUMBER OF ADULTS WITH SUBSTANCE ISSUES WHO ARE APPROPRIATELY MONITORED, ASSESSED, AND TREATED IN CCA CLINICS1.2 INCREASE THE NUMBER OF PATIENTS RECEIVING INPATIENT DETOX SERVICESCOMMUNITY ACTIVITIES / STRATEGIES SUPPORT THE DEVELOPMENT OF A BIDMC EMERGENCY DEPARTMENT BUPRENORPHINE PATHWAY TO PROMOTE ACCESS TO SERVICES FOR THOSE IDENTIFIED WITH SUBSTANCE USE DISORDERS IN THE HOSPITAL SETTING CONTINUE THE SUBOXONE CLINICS IN HEALTHCARE ASSOCIATES AND THE EMERGENCY DEPARTMENT BUPRENORPHINE PATHWAY FOR NON-HCA PATIENTSMETRICS AND STATUS UPDATES HIRED A SECOND ATTENDING PSYCHIATRIST IN FY20 FOR THE DIVISION OF ADDICTION PSYCHIATRY, ENSURING THAT BIDMC PATIENTS CAN BE SEEN IN THE LINK CLINIC FOR OPIOID USE DISORDER CARE 5 DAYS A WEEK CONTINUED TO CONDUCT BUPRENORPHINE WAIVER TRAININGS, ALLOWING MORE PHYSICIANS TO OBTAIN THEIR BUPRENORPHINE X-WAIVERS ADDED INJECTABLE BUPRENORPHINE TO THE FORMULARY AS ANOTHER MEDICATION OPTION FOR BIDMC PATIENTS IN FY20 TRANSLATED PATIENT EDUCATION MATERIALS IN MULTIPLE LANGUAGES PARTICIPATED IN THE OPIOID USE DISORDER INITIATIVE THROUGH THE MASS PERINATAL QUALITY COLLABORATIVE (MPQC) CREATED GUIDELINE FOR TREATING PATIENTS' PAIN WHILE ON BUPRENORPHINE/ NALOXONE (SUBOXONE) WORKED ON AN OPIOID PRESCRIBING DASHBOARD UPDATED OPIOID EDUCATION FOR TRAINEES IN FY21 ROLLED OUT OPIOID PRESCRIBING DASHBOARD IN FY21 IN THE PROCESS OF DEVELOPING PATHWAYS FOR NEW STRATEGIES TO PROVIDE ADDICTION TREATMENTGOAL 3: PROMOTE BEHAVIORAL HEALTH WORKFORCE DEVELOPMENT AND INCREASE CAPACITY PROGRAMMATIC OBJECTIVES1.1 PROMOTE BEHAVIORAL HEALTH WORKFORCE DEVELOPMENT AND INCREASE CAPACITY COMMUNITY ACTIVITIES / STRATEGIES FUND COMMUNITY-BASED ORGANIZATIONS THROUGH THE NEW INPATIENT BUILDING COMMUNITY-BASED HEALTH INITIATIVE TO ADDRESS BEHAVIORAL HEALTHMETRICS AND STATUS UPDATES RELEASED A REQUEST FOR PROPOSALS IN AUGUST 2020 TO FUND EVIDENCE-BASED AND/OR EVIDENCE-INFORMED STRATEGIES IN THE AREAS OF MENTAL HEALTH AND SUBSTANCE USE, INCLUDING BUILDING BEHAVIORAL HEALTH PROVIDER CAPACITYCOMMUNITY PARTNERSBIDMC IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE:FY21 PARTNERSA BETTER CITY CANCER CARE HMS DIVERSITY AFFILIATES OPPORTUNITY COMMUNITIESA ROOM TO GROW CASA MYRNA HOSPITALITY HOMES OPERATION P.E.A.C.E.ABOUT FRESH CHADD MENTORING COURSE, HMS JANE DOE INC. OUTER CAPE HEALTH SERVICESADCARE TREATMENT CENTER CHARLES RIVER COMMUNITY HEALTH JEWISH COMMUNITY CENTER (JCC) OF GREATER BOSTON PARTNERS FOR WORLD HEALTHAIDS ACTION COMMITTEE CIRCLE OF HOPE JEWISH FAMILY AND CHILDREN'S SERVICES PEER HEALTH EXCHANGEAIDS SUPPORT GROUP OF CAPE COD CITY OF BOSTON EMERGENCY MANAGEMENT OFFICE JEWISH VOCATIONAL SERVICES PINE STREET INN ALZHEIMER'S ASSOCIATION OF MA (WALTHAM) CITY OF BOSTON'S GREEN RIBBON COMMISSION JOE ANDRUZZI CANCER FUND PRACTICE GREEN HEALTHAMERICAN CHINESE CHRISTIAN EDUCATION & SOCIAL SERVICES, INC. CITY LIFE/VIDA URBANA JOSLIN DIABETES CENTER PRIVATE INDUSTRY COUNCILASIAN AMERICAN CIVIC ASSOCIATION CONFERENCE OF BOSTON TEACHING HOSPITALS (COBTH) JUSTICE RESOURCE INSTITUTE (JRI) IN BOSTON RIA, INC.ASIAN COMMUNITY DEVELOPMENT CORPORATION COMMUNITY RESEARCH INITIATIVE LA ALIANZA HISPANA RYAN WHITE DENTAL PROGRAM AUDUBON CIRCLE NEIGHBORHOOD COMMUNITY SERVINGS LEUKEMIA & LYMPHOMA SOCIETY SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAMATRIUS HEALTH CRADLES TO CRAYONS LOUIS D. BROWN PEACE INSTITUTE SEXUAL ASSAULT UNIT OF DISABLED PERSONS PROTECTION COMMISSIONBAGLY, INC. DANA FARBER CANCER INSTITUTE MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION (MASSDEP) SOCIEDAD LATINA BROCKTON AREA MULTI SERVICE INC. (BAMSI) DORCHESTER CATHOLIC PARISHES MASSACHUSETTS DEPARTMENT OF TRANSPORTATION (MASSDOT) SOUTH COVE COMMUNITY HEALTH CENTERBOSTON AREA RAPE CRISIS CENTER (BARCC) DORCHESTER FOOD CO-OP MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SPORTSMEN TENNIS AND ENRICHMENT CENTERBETH ISRAEL DEACONESS HEALTHCARE ELLIE FUND MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH COVID-19 PANDEMIC RESPONSE ST. PETER'S TEEN CENTERBETH ISRAEL DEACONESS HEALTHCARE CHELSEA ENGLISH FOR NEW BOSTONIANS MASSACHUSETTS HEALTH INFORMATION HIGHWAY ST. MARY'S CENTER FOR WOMEN AND CHILDRENBOSTON CHILDREN'S HOSPITAL EVERSOURCE MAINSPRING TASTY BURGERBOSTON CHINATOWN NEIGHBORHOOD CENTER FAIR FOODS (BOSTON) MEDICAL ACADEMIC AND SCIENTIFIC COMMUNITY ORGANIZATION (MASCO) THE FAMILY VANBOSTON ELDER SERVICES FAMILY NURTURING CENTER MASS COLLEGE OF ART AND DESIGN THE DIMOCK CENTERBOSTON EMERGENCY MEDICAL SERVICES FATHER BILL'S MASSACHUSETTS INSURANCE COMMISSION THE LATINO MEDICAL STUDENT ASSOCIATIONBOSTON FIRE DEPARTMENT FATHERS' UPLIFT MASSACHUSETTS COMMISSION FOR THE BLIND THE NETWORK/LA REDBOSTON GREEN ACADEMY FENWAY ALLIANCE MASSACHUSETTS COMMISSION FOR THE DEAF AND HARD OF HEARING THE PARTNERSHIP, INC.BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM FENWAY CIVIC ASSOCIATION MASSACHUSETTS DEPARTMENT OF CHILDREN AND FAMILIES THE STUDENT NATIONAL MEDICAL ASSOCIATION, NATIONAL AND NE CHAPTERBOSTON HOSPITAL COLLABORATION FOR COMMUNITY VIOLENCE FENWAY COMMUNITY CENTER MASSACHUSETTS DEPARTMENT OF TRANSITIONAL ASSISTANCE TRAINING, INC.BOSTON LIVING CENTER FENWAY HEALTH MASSACHUSETTS GENERAL HOSPITAL TRUSTEES OF RESERVATIONSBOSTON MEDICAL CENTER FOUND IN TRANSLATION MASSACHUSETTS HIV DRUG ASSISTANCE PROGRAM TUFTS MEDICAL CENTERBOSTON MEDFLIGHT FRIENDS OF GENEVA CLIFFS MASSACHUSETTS IMMIGRANT AND REFUGEE ADVOCACY COALITION (MIRA) UP ACADEMY DORCHESTER SCHOOLBOSTON PRIVATE INDUSTRY COUNCIL (PIC) FRIENDS OF RONAN PARK MASSACHUSETTS INSTITUTE OF TECHNOLOGY U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA)BOSTON POLICE DEPARTMENT GLAAD MASSACHUSETTS STATE POLICE UNITED CEREBRAL PALSY (WATERTOWN) BOSTON PUBLIC HEALTH COMMISSION GREATER BOSTON CHINESE GOLDEN AGE CENTER MEDICAL INTELLIGENCE CENTER VICTIM RIGHTS LAW CENTERBOSTON UNIVERSITY SCHOOL OF PUBLIC HEALTH GREATER BOSTON FOOD BANK MEETINGHOUSE HILL CIVIC ASSOCIATION VICTORY PROGRAMS BRIGHAM AND WOMEN'S HOSPITAL GREATER FOUR CORNERS ACTION COALITION METRO HOUSING|BOSTON VIRIDIAN APARTMENTSBOWDOIN STREET HEALTH CENTER HALLKEEN MANAGEMENT MOUNT AUBURN HOSPITAL WILMERHALE LEGAL SERVICES (ALSO KNOWN HAS THE LEGAL SERVICE CENTER) CAMBRIDGE HEALTH ALLIANCE HEALTH CARE FOR ALL NEW ENGLAND AIDS EDUCATION AND TRAINING CENTER WONDERFUND OF MASSACHUSETTSCAPE VERDEAN ASSOCIATION OF BOSTON HEALTHCARE WITHOUT HARM NORTHEASTERN UNIVERSITY YMCA OF GREATER BOSTON
FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BIDMC CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H,10.45% OF BIDMC'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITSANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, BIDMC'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 , AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S OFFICE WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://WWW.BIDMC.ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT BIDMC FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BIDMC IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, RESEARCH HOSPITAL AND TEACHING HOSPITAL, PROVIDING 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBIDMC'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $19,480,460 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, BIDMC IS ONE OF TEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $71,673,934 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BIDMC ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BIDMC GENERATED $221,333,877 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BIDMC FOR SUCH SERVICES BY $28,953,553 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 18.7% OR 170,993OF BIDMC'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 43.9% OR 400,692 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND BIDMC PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BIDMC GENERATED $576,980,003 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY 45,826,725. OF THESE AMOUNTS, REVENUE OF $25,250,882 IS RELATED TO THE PROVISION OF PSYCHIATRY INPATIENT, BOWDOIN STREET HEALTH CENTER, CHESTNUS HILL UC, AND CHELSEA UC AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $27,626,484. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH BIDMC CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, BIDMC HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 2.21%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BIDMC ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $12,152,530 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.
EMERGENCY CARE ACCESS BETH ISRAEL DEACONESS MEDICAL CENTER IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. THE ED'S MISSION, ALIGNED WITH BIDMC'S MISSION, IS TO DISTINGUISH ITSELF FROM OTHER PROVIDERS THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, RESEARCH AND THROUGH IMPROVED HEALTH IN THE COMMUNITIES SERVED. BIDMC'S DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).THE BIDMC DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE BIDMC IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM BIDMC AS WELL AS PROVIDERS WHO FOLLOW BIDMC'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN BIDMC AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW BIDMC'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. BIDMC DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2017 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 1, 2017, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICYTRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1,000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, RUSSIAN, PORTUGUESE, VIETNAMESE, FRENCH, HAITIAN CREOLE, HINDI, ITALIAN, JAPANESE, CAPE VERDEAN, AND ARABIC. (SCHEDULE H PART V SECTION B QUESTION 16I)
FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITY COPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.BIDMC.ORG/PATIENT-AND-VISITOR-INFORMATION/PATIENT-INFORMATION/YOUR-HOSPITAL-BILL/FINANCIAL-ASSISTANCE IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE BIDMC FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, SPANISH, FRENCH, HAITIAN CREOLE, HINDI, ITALIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, RUSSIAN, PORTUGUESE, VIETNAMESE, JAPANESE, ARABIC, CAPE VERDEAN, CAN BE FOUND ON THE BIDMC WEBSITE AT: HTTPS://WWW.BIDMC.ORG/PATIENT-AND-VISITOR-INFORMATION/PATIENT-INFORMATION/YOUR-HOSPITAL-BILL/FINANCIAL-ASSISTANCE LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE.
FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCH AS PREVIOUSLY NOTED IN THIS FORM 990, PART III, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,800 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,400 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 260 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES: ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE EMERGENCY MEDICINE MEDICINE O ALLERGY AND INFLAMMATIONO CARDIOVASCULAR MEDICINEO CENTER FOR VASCULAR BIOLOGY RESEARCHO CENTER FOR VIROLOGY AND VACCINE RESEARCHO CLINICAL INFORMATICSO CLINICAL NUTRITIONO ENDOCRINOLOGYO EXPERIMENTAL MEDICINEO GASTROENTEROLOGYO GENERAL MEDICINE AND PRIMARY CAREO GENETICSO GERONTOLOGYO HEMATOLOGY AND ONCOLOGYO HEMOSTASIS AND THROMBOSISO IMMUNOLOGYO INFECTIOUS DISEASEO INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGYO MOLECULAR AND VASCULAR MEDICINEO NEPHROLOGYO PULMONOLOGYO RHEUMATOLOGYO SIGNAL TRANSDUCTIONO TRANSLATIONAL RESEARCHO TRANSPLANT IMMUNOLOGY NEONATOLOGY NEUROLOGY OBSTETRICS AND GYNECOLOGY ORTHOPAEDIC SURGERY PATHOLOGY PSYCHIATRY RADIOLOGY SURGERY O CARDIAC SURGERYO CENTER FOR MINIMALLY INVASIVE SURGERYO NEUROSURGERYO PLASTIC AND RECONSTRUCTIVE SURGERYO VASCULAR SURGERY TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $241,917,383 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 2.99% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $307,298,416 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS ON SCHEDULE H, PART I LINE 7H COLUMN D, WHICH, IF INCLUDED IN SCHEDULE H, PART I, LINE 7H COLUMN E CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 2.21%.
RESEARCH ENGAGED IN AT THE MEDICAL CENTER THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. COVID-19 VACCINE RESEARCHTHE PERIOD COVERED BY THIS FILING IS THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, DURING WHICH THE COVID-19 PANDEMIC CONTINUED TO DISRUPT LIFE IN THE UNITED STATES AND ACROSS THE GLOBE. RESEARCH CONDUCTED AT BIDMC DURING THIS FISCAL PERIOD HIGHLIGHTS BIDMC'S CONTINUING NATIONAL LEADERSHIP DURING THIS ONGOING PUBLIC HEALTH CRISIS.AS OF LATE JULY, 2021, ABOUT 48.5 PERCENT OF AMERICANS, OR ABOUT 159 MILLION PEOPLE, WERE FULLY VACCINATED AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19. BIDMC IMMUNOLOGIST DAN BAROUCH, MD, PHD, PLAYED AN INSTRUMENTAL ROLE IN DESIGNING AND DEVELOPING ONE OF THE FIRST THREE COVID-19 VACCINES TO COME TO MARKET IN THE UNITED STATES. AS DIRECTOR OF BIDMC'S CENTER FOR VIROLOGY AND VACCINE RESEARCH (CVVR), DR. BAROUCH AND HIS COLLEAGUES BEGAN WORKING ON A COVID-19 VACCINE ON JANUARY 10, 2020, THE SAME NIGHT THAT CHINESE SCIENTISTS RELEASED THE SARS-COV-2 VIRUS'S GENOME. DR. BAROUCH'S TEAM QUICKLY DESIGNED A SERIES OF VACCINE CANDIDATES, EVALUATED IN CLINICAL STUDIES LED BY PRIMARY INVESTIGATOR KATHRYN E. STEPHENSON, MD, MPH, DIRECTOR OF THE CLINICAL TRIALS UNIT AT CVVR.DR. BAROUCH'S INNOVATIVE VACCINE DESIGN NOW THE BASIS OF THE JOHNSON & JOHNSON SINGLE SHOT VACCINE USES A COMMON-COLD VIRUS, CALLED THE ADENOVIRUS, TO DELIVER A SMALL BIT OF THE COVID-19 DNA INTO HOST CELLS, WHERE IT STIMULATES THE BODY TO RAISE IMMUNE RESPONSES AGAINST THE VIRUS. SHOWN TO BE SAFE AND EFFECTIVE, THE COVID-19 VACCINE WAS GRANTED EMERGENCY USE APPROVAL BY THE U.S. FDA IN FEBRUARY, 2021.SINCE THEN, BAROUCH AND COLLEAGUES HAVE CONTINUED TO STUDY THE VIRUS' IMPACT ON THE IMMUNE SYSTEM AND HOW THE VACCINES AND THERAPIES DEVELOPED TO PROTECT AGAINST THE ORIGINAL STRAIN OF SARS-COV-2 ARE HOLDING UP AGAINST THE EMERGING VARIANTS. FOLLOWING IS A SUMMARY OUTLINING RESEARCH FROM FISCAL YEAR 2021.A STUDY LED BY BAROUCH AND COLLEAGUES SHED MORE LIGHT ON HOW MOLECULES OF THE IMMUNE AND VASCULAR SYSTEMS INTERACT TO PRODUCE THE EXTENSIVE DAMAGE TO THE LUNG AND VASCULAR TISSUES SEEN IN PATIENTS WITH SEVERE DISEASE. RESEARCHERS CONDUCTED COMPREHENSIVE ANALYSES OF TISSUE AND BLOOD SAMPLES FROM HUMANS AND FROM NON-HUMAN PRIMATES INFECTED WITH COVID-19. THE TEAM'S FINDINGS, PUBLISHED IN THE JOURNAL CELL, HELP DEFINE THE PATHWAYS BY WHICH COVID-19 INDUCES VASCULAR DISEASE AND ALSO POINT TO POTENTIAL THERAPEUTIC TARGETS. "OVERALL, OUR DATA REVEAL THE KEY BIOLOGICAL PROCESSES INVOLVED IN TRIGGERING THE CLOTTING AND VASCULAR DAMAGE OBSERVED WITH SARS-COV-19 INFECTION," SAID BAROUCH. "OUR RESULTS SUGGEST A MODEL IN WHICH CRITICAL INTERACTIONS BETWEEN INFLAMMATORY AND CLOTTING PATHWAYS LEAD TO SEVERE VASCULAR INJURY SEEN IN CRITICALLY ILL PATIENTS WITH COVID-19." IN A PAPER IN THE JOURNAL NATURE, BAROUCH, AND COLLEAGUES ELUCIDATED THE ROLE OF ANTIBODIES AND IMMUNE CELLS IN PROTECTION AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19, IN RHESUS MACAQUES. "IN THIS STUDY, WE DEFINE THE ROLE OF ANTIBODIES VERSUS T CELLS IN PROTECTION AGAINST COVID-19 IN MONKEYS. WE REPORTTHAT A RELATIVELY LOW ANTIBODY TITER (THE CONCENTRATION OF ANTIBODIES IN THE BLOOD) IS NEEDED FOR PROTECTION," SAID BAROUCH. "SUCH KNOWLEDGE WILL BE IMPORTANT IN THE DEVELOPMENT OF NEXT GENERATION VACCINES, ANTIBODY-BASED THERAPEUTICS, AND PUBLIC HEALTH STRATEGIES FOR COVID-19." IN ANOTHER STUDY IN NATURE, BAROUCH AND COLLEAGUES ALSO TESTED JOHNSON & JOHNSON'S COVID-19 VACCINE IN RHESUS MACAQUES CHALLENGED WITH THE VIRAL VARIANT B.1.351 AND IN RHESUS MACAQUES CHALLENGED WITH THE ORIGINAL STRAIN IDENTIFIED, DESIGNATED WA1/2020. BAROUCH AND COLLEAGUES WHO HELPED DEVELOP JOHNSON & JOHNSON'S SINGLE-SHOT VIRAL VECTOR VACCINE, CALLED AD26.COV2.S REPORT THAT THE VACCINE PRODUCES ROBUST PROTECTION AGAINST BOTH. THE FINDINGS HAVE IMPORTANT IMPLICATIONS FOR THE VACCINE CONTROL OF SARS-COV-2 VARIANTS OF CONCERN. "THE EMERGENCE OF SARS-COV-2 VARIANTS THAT PARTIALLY EVADE NEUTRALIZING ANTIBODIES POSES A THREAT TO THE EFFICACY OF CURRENT COVID-19 VACCINES," SAID BAROUCH, SENIOR AUTHOR OF THE STUDY AND DIRECTOR OF VACCINE AND VIROLOGY RESEARCH AT BIDMC. "HERE WE SHOW THAT THE AD26.COV2.S VACCINE ELICITS HUMORAL AND CELLULAR IMMUNE RESPONSES THAT CROSS-REACT WITH THE B.1.351 VARIANT AND PROTECTS AGAINST THE B.1.351 CHALLENGE IN RHESUS MACAQUES." IN FINDINGS PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE, BAROUCH'S TEAM REPORTED ON THE DURABILITY OF JOHNSON & JOHNSON'S AD26.COV2.S VACCINE IN HUMANS. THE SINGLE-SHOT VIRAL VECTOR VACCINE DEVELOPED IN PART BY BAROUCH AND COLLEAGUES AT BIDMC WAS ALSO EVALUATED FOR ITS COVERAGE AGAINST THE ALPHA, BETA, GAMMA, DELTA, EPSILON AND KAPPA SARS-COV-2 VARIANTS. "OUR DATA SHOW THAT THE AD26.COV2.S VACCINE ELICITED DURABLE IMMUNE RESPONSES WITH MINIMAL DECLINE FOR AT LEAST EIGHT MONTHS, THE TIMEFRAME EXAMINED, FOLLOWING IMMUNIZATION," SAID BAROUCH, CORRESPONDING AUTHOR OF THE PAPER AND ALSO PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. "WE ALSO SHOWED GOOD NEUTRALIZATION COVERAGE OF THE DELTA VARIANT AS WELL AS OTHER VARIANTS." LAST SUMMER, BAROUCH'S TEAM WAS AWARDED $4.9 MILLION IN ANNUAL FUNDING OVER THE NEXT FIVE YEARS TO FIND A CURE FOR HIV. BAROUCH WAS ONE OF TEN PRIMARY INVESTIGATORS TO RECEIVE A 2021 NATIONAL INSTITUTES OF HEALTH (NIH) MARTIN DELANEY COLLABORATORIES FOR HIV CURE RESEARCH AWARD, WHICH AIMS TO EXPEDITE HUMAN IMMUNODEFICIENCY VIRUS (HIV) CURE RESEARCH BY BRINGING TOGETHER RESEARCH PARTNERS IN ACADEMIA, GOVERNMENT, THE PRIVATE SECTOR AND THE COMMUNITY; COORDINATING COMPLEX RESEARCH STUDIES, AND MENTORING THE NEXT GENERATION OF HIV CURE RESEARCHERS. BAROUCH AND COLLEAGUES WILL FOCUS ON UNDERSTANDING THE VIRAL RESERVOIR DORMANT HIV-INFECTED IMMUNE CELLS THAT REMAIN IN THE BODY DESPITE ANTI-RETROVIRAL THERAPY (ART) AND CAN SPRING BACK INTO ACTION IF ART IS INTERRUPTED AND ON DEVELOPING NEW IMMUNOLOGIC STRATEGIES TARGETING THE RESERVOIR TO CONTROL OR ERADICATE HIV INFECTION. WITH MORE THAN 35 MILLION PEOPLE WORLDWIDE LIVING WITH THE VIRUS AND NEARLY 2 MILLION NEW CASES EACH YEAR, HIV REMAINS A MAJOR GLOBAL EPIDEMIC. "THE LATENT VIRAL RESERVOIR IS THE CRITICAL BARRIER FOR THE DEVELOPMENT OF A CURE FOR HIV-1 INFECTION," SAID BAROUCH. "OUR OVERALL HYPOTHESIS IS THAT MULTIPLE IMMUNOLOGIC STRATEGIES WILL NEED TO BE EXPLORED AND COMBINED TO ACHIEVE LONG-TERM, ART-FREE VIROLOGIC CONTROL OR COMPLETE VIRUS ERADICATION. WE'RE VERY GRATEFUL FOR THIS GRANT AND TREMENDOUSLY EXCITED TO SEE THE PROGRESS WE CAN MAKE WITH THIS LONG-TERM SOURCE OF SUPPORT." DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW.
STUDY FINDS ENTIRE HOUSEHOLD AT INCREASED RISK WHEN POST-SURGICAL PATIENTS HOSPITALIZED PATIENTS WITH COVID-19 SIX TIMES MORE LIKELY TO DIE THAN PATIENTS HOSPITALIZED WITH INFLUENZA, RESEARCH FINDSCOVID-19 AND INFLUENZA ARE BOTH CONTAGIOUS RESPIRATORY VIRAL DISEASES THAT CAN LEAD TO PNEUMONIA AND ACUTE RESPIRATORY FAILURE IN SEVERE CASES. HOWEVER, DETAILED COMPARISON OF THE EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS OF COVID-19 AND THOSE OF INFLUENZA ARE LACKING. IN A PAPER PUBLISHED IN THE JOURNAL OF GENERAL INTERNAL MEDICINE, PHYSICIAN-RESEARCHERS AT BIDMC ASSESSED THE RELATIVE IMPACT OF COVID-19 ON PATIENTS HOSPITALIZED WITH THE VIRAL INFECTION IN MARCH AND APRIL 2020, VERSUS PATIENTS HOSPITALIZED WITH INFLUENZA DURING THE LAST FIVE FLU SEASONS AT THE MEDICAL CENTER. OVERALL, THE TEAM DEMONSTRATED THAT COVID-19 CASES RESULTED IN SIGNIFICANTLY MORE WEEKLY HOSPITALIZATIONS, MORE USE OF MECHANICAL VENTILATION AND HIGHER MORTALITY RATES THAN INFLUENZA. CORRESPONDING AUTHOR MICHAEL DONNINO, MD, A CRITICAL CARE AND EMERGENCY MEDICINE PHYSICIAN AT BIDMC, AND COLLEAGUES INCLUDED A TOTAL OF 1,634 HOSPITALIZED PATIENTS IN THEIR STUDY, 582 OF WHOM HAD LABORATORY-CONFIRMED COVID-19 AND 1,052 OF WHOM HAD CONFIRMED INFLUENZA. WHILE 174 PATIENTS WITH COVID-19 (OR 30 PERCENT) RECEIVED MECHANICAL VENTILATION DURING THE TWO-MONTH PERIOD, JUST 84 PATIENTS WITH INFLUENZA (OR 8 PERCENT) WERE PLACED ON VENTILATION OVER ALL FIVE SEASONS OF INFLUENZA. LIKEWISE, THE PROPORTION OF PATIENTS WHO DIED WAS MUCH HIGHER FOR COVID-19 THAN FOR INFLUENZA; 20 PERCENT OF ADMITTED PATIENTS WITH COVID-19 DIED IN THE TWO-MONTH PERIOD, COMPARED TO THREE PERCENT OF PATIENTS WITH INFLUENZA OVER FIVE SEASONS. FURTHER ANALYSIS REVEALED THAT HOSPITALIZED PATIENTS WITH COVID-19 TENDED TO BE YOUNGER THAN THOSE HOSPITALIZED WITH INFLUENZA. AMONG PATIENTS REQUIRING MECHANICAL VENTILATION, PATIENTS WITH COVID-19 WERE ON VENTILATION MUCH LONGER A MEDIAN DURATION OF TWO WEEKS COMPARED TO JUST OVER THREE DAYS FOR PATIENTS WITH INFLUENZA. MOREOVER, AMONG PATIENTS REQUIRING MECHANICAL VENTILATION, PATIENTS WITH COVID-19 WERE FAR LESS LIKELY TO HAVE HAD PRE-EXISTING MEDICAL CONDITIONS. "OUR DATA ILLUSTRATE THAT 98 PERCENT OF THE DEATHS OF PATIENTS HOSPITALIZED WITH COVID-19 ARE DIRECTLY OR INDIRECTLY RELATED TO THEIR COVID-19 ILLNESS, WHICH HELPS DEBUNK THE IDEA THAT THE HIGH NUMBER OF U.S. COVID-19 DEATHS ARE AN ARTIFACT OF THE WAY CAUSES OF DEATHS ARE BEING RECORDED," SAID DONNINO. "WE ALSO SHOWED THAT COVID-19 CAUSED A SUBSTANTIAL NUMBER OF PATIENTS WITHOUT MAJOR PRE-EXISTING CONDITIONS TO REQUIRE MECHANICAL VENTILATION, WHICH HAPPENS RARELY IN PATIENTS WITH INFLUENZA," SAID DONNINO. BIDMC RESEARCHERS DEVELOP MODEL TO ESTIMATE FALSE-NEGATIVE RATE FOR COVID-19 TESTS AS OF JUNE 2020, THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) HAD GRANTED EMERGENCY USE AUTHORIZATION FOR MORE THAN 85 DIFFERENT VIRAL DNA TEST KITS OR ASSAYS EACH WITH WIDELY VARYING DEGREES OF SENSITIVITY AND UNKNOWN RATES OF ACCURACY. HOWEVER, WITH NO EXISTING GOLD STANDARD TEST FOR COVID-19, THERE'S LITTLE DATA ON WHICH TO JUDGE THESE VARIOUS TESTS' USEFULNESS. RESEARCHERS AT BIDMC DEVELOPED A MATHEMATICAL MEANS OF ASSESSING TESTS' FALSE-NEGATIVE RATE. THE TEAM'S METHODOLOGY, WHICH ALLOWS AN APPLES-TO-APPLES COMPARISON OF THE VARIOUS ASSAYS' CLINICAL SENSITIVITY, IS PUBLISHED IN THE JOURNAL CLINICAL INFECTIOUS DISEASES. "WE FOUND THAT CLINICAL SENSITIVITIES VARY WIDELY, WHICH HAS CLEAR IMPLICATIONS FOR PATIENT CARE, EPIDEMIOLOGY AND THE SOCIAL AND ECONOMIC MANAGEMENT OF THE ONGOING PANDEMIC," SAID CO-CORRESPONDING AUTHOR JAMES E. KIRBY, MD, DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC. USING DATA FROM MORE THAN 27,000 TESTS FOR COVID-19 PERFORMED AT BETH ISRAEL LAHEY HEALTH HOSPITAL SITES FROM MARCH 26 TO MAY 2, 2020, KIRBY, AND CO-CORRESPONDING AUTHOR RAMY ARNAOUT, MD, DPHIL, ASSOCIATE DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC, AND COLLEAGUES FIRST DEMONSTRATED THAT VIRAL LOADS CAN BE DEPENDABLY REPORTED. "THIS HELPS DISTINGUISH POTENTIAL SUPERSPREADERS, AT ONE EXTREME, FROM CONVALESCENT PEOPLE, WITH ALMOST NO VIRUS, AND THEREFORE LOW LIKELIHOOD OF SPREADING THE INFECTION," ARNAOUT SAID. NEXT, THE RESEARCHERS ESTIMATED THE CLINICAL SENSITIVITY AND THE FALSE-NEGATIVE RATE FIRST FOR THE IN-HOUSE TEST WHICH WAS AMONG THE FIRST TO BE IMPLEMENTED NATIONWIDE AND CONSIDERED AMONG THE BEST IN CLASS. ANALYZING REPEAT TEST RESULTS FOR THE NEARLY 5,000 PATIENTS WHO TESTED POSITIVE ALLOWED THE RESEARCHERS TO DETERMINE THAT THE IN-HOUSE TEST PROVIDED A FALSE NEGATIVE IN ABOUT 10 PERCENT OF CASES, GIVING THE ASSAY A CLINICAL SENSITIVITY OF ABOUT 90 PERCENT. TO ESTIMATE THE ACCURACY OF OTHER ASSAYS, THE TEAM BASED THEIR CALCULATIONS ON EACH TESTS LIMIT OF DETECTION, OR LOD, DEFINED AS THE SMALLEST AMOUNT OF VIRAL DNA DETECTABLE THAT A TEST WILL CATCH 95 PERCENT OR MORE OF THE TIME. ARNAOUT, KIRBY, AND COLLEAGUES DEMONSTRATED THAT THE LIMIT OF DETECTION CAN BE USED AS A PROXY TO ESTIMATE A GIVEN ASSAY'S CLINICAL SENSITIVITY. BY THE TEAM'S CALCULATIONS, AN ASSAY WITH A LIMIT OF DETECTION OF 1,000 COPIES VIRAL DNA PER ML IS EXPECTED TO DETECT JUST 75 PERCENT OF PATIENTS WITH COVID-19, PROVIDING ONE OUT OF EVERY FOUR PEOPLE WITH A FALSE-NEGATIVE. THE TEAM ALSO SHOWED THAT ONE TEST AVAILABLE TODAY MISSES AS MANY AS ONE IN THREE INFECTED INDIVIDUALS, WHILE ANOTHER MAY MISS UP TO 60 PERCENT OF POSITIVE CASES. FIRST-OF-ITS-KIND STUDY FOUND INFANTS OF SOCIALLY VULNERABLE MOTHERS WERE AT HIGHEST RISK OF COVID-19 INFECTIONIN A STUDY PUBLISHED IN JAMA NETWORK OPEN, PHYSICIAN-RESEARCHERS FROM BIDMC, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON CHILDREN'S HOSPITAL AND MASSACHUSETTS GENERAL HOSPITAL REVEALED THAT, WHILE MOTHER-TO-NEWBORN TRANSMISSION OF THE VIRUS IS RARE, NEWBORNS OF EXPECTANT MOTHERS WITH COVID-19 CAN SUFFER INDIRECT ADVERSE HEALTH RISKS AS A RESULT OF WORSENING MATERNAL COVID-19 ILLNESS. EXAMINING NEONATAL OUTCOMES DURING THE FIRST MONTH OF LIFE FOR BABIES BORN AT 11 HOSPITALS THAT REPRESENT APPROXIMATELY 50 PERCENT OF ALL BIRTHS IN MASSACHUSETTS, THE TEAM IDENTIFIED 255 NEONATES DELIVERED BETWEEN MARCH 1 JULY 31, 2020, TO MOTHERS WITH A RECENT POSITIVE SARS-COV-2 TEST RESULT. THE RESEARCHERS USED THE AMERICAN ACADEMY OF PEDIATRICS' NATIONAL REGISTRY FOR SURVEILLANCE AND EPIDEMIOLOGY OF PERINATAL COVID-19 INFECTION COMPLEMENTED BY A MASSACHUSETTS-SPECIFIC REGISTRY. OUT OF THE 255 NEONATES STUDIED, 88.2 PERCENT WERE TESTED FOR SARS-COV-2, AND ONLY 2.2 PERCENT HAD POSITIVE RESULTS. HOWEVER, WHILE INFECTION RATES AMONG NEWBORNS WERE RELATIVELY LOW, WORSENING MATERNAL ILLNESS ACCOUNTED FOR 73.9 PERCENT OF PRETERM BIRTHS. PREMATURE BIRTH CAN OFTEN LEAD TO ACUTE AND CHRONIC COMPLICATIONS, INCLUDING RESPIRATORY DISTRESS, CHRONIC HEALTH PROBLEMS AND DEVELOPMENTAL DISABILITIES. NEWBORNS OF SOCIALLY VULNERABLE MOTHERS, AS DETERMINED USING A TOOL CREATED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION USING RESIDENTIAL ZIP-CODES, WERE AT AN INCREASED RISK FOR TESTING POSITIVE. THE SPECIFIC PATHWAYS BY WHICH SOCIAL VULNERABILITY MIGHT AFFECT MOTHER-TO-CHILD TRANSMISSION OF COVID-19 INCLUDE DIFFERENTIAL ACCESS TO CARE AND CLINICIAN BIAS. DISCRIMINATION MAY ALSO BE A FACTOR IN CHRONIC STRESS, WHICH CAN DIMINISH ANTIVIRAL IMMUNE RESPONSES. "THIS OBSERVATION THAT NEWBORNS OF SOCIALLY VULNERABLE MOTHERS WERE FIVE TIMES MORE LIKELY TO HAVE COVID-19 HIGHLIGHTS THAT HEALTH DISPARITIES ARE VERY COMPLEX AND EXTEND BEYOND RACE, ETHNICITY AND LANGUAGE STATUS," SAID CORRESPONDING AUTHOR ASIMENIA ANGELIDOU, MD, PHD, A NEONATOLOGIST AT BIDMC. "SOCIAL VULNERABILITY LIKELY AFFECTS HEALTH AND IMMUNITY AND OUR STUDY SUPPORTS FURTHER RESEARCH IN THIS AREA. REALLOCATION OF RESOURCES TO SOCIALLY VULNERABLE COMMUNITIES COULD GO A LONG WAY IN DECREASING HUMAN SUFFERING AND ECONOMIC LOSS DURING DISEASE OUTBREAKS." JANUARY 20, 2020SCIENTISTS CREATE FIRST-OF-ITS-KIND 3D ORGANOID MODEL OF THE HUMAN PANCREAS BECAUSE PANCREATIC CANCER IS HIDDEN DEEP WITHIN THE BODY AND OFTEN SYMPTOMLESS, IT'S FREQUENTLY DIAGNOSED AFTER THE DISEASE HAS PROGRESSED TOO FAR FOR SURGICAL INTERVENTION AND/OR HAS SPREAD THROUGHOUT THE BODY. RESEARCH INDICATES THAT EARLIER DETECTION OF PANCREATIC TUMORS COULD QUADRUPLE SURVIVAL RATES; HOWEVER, NO VALIDATED AND RELIABLE TESTS FOR EARLY DETECTION OF PANCREATIC CANCER CURRENTLY EXIST.
STUDY FINDS ENTIRE HOUSEHOLD AT INCREASED RISK WHEN POST-SURGICAL PATIENTS RESEARCHERS AT THE CANCER RESEARCH INSTITUTE AT BIDMC HAVE SUCCESSFULLY CREATED THE FIRST THREE-DIMENSIONAL (3D) ORGANOID MODELS OF THE PANCREAS FROM HUMAN STEM CELLS. UNLIKE PREVIOUS PLATFORMS FOR THE STUDY OF PANCREATIC CANCER, THIS FIRST-OF-ITS-KIND ORGANOID MODEL INCLUDES BOTH THE ACINAR AND DUCTAL STRUCTURES THAT PLAY A CRITICAL ROLE IN THE MAJORITY OF PANCREATIC CANCERS. THE NEW RESEARCH PLATFORM WHICH IS NOT EXPECTED TO GUIDE PATIENT CARE AT THIS TIME WILL SHED NEW LIGHT ON THE ORIGINS AND DEVELOPMENT OF PANCREATIC CANCER, AS WELL AS REVEAL POTENTIAL MEANS FOR DISCOVERING MARKERS OF EARLY DIAGNOSIS AND MONITORING THE DISEASE. THE TEAM'S REPORT APPEARS IN CELL STEM CELL. "WE THOUGHT, IF WE HAD A WAY TO USE HUMAN PANCREATIC CELLS TO FORWARD ENGINEER CANCER, WE COULD BEGIN TO UNDERSTAND THE EARLIEST STEPS IN THE DEVELOPMENT OF THIS DISEASE," SAID CORRESPONDING AUTHOR SENTHIL MUTHUSWAMY, PHD, DIRECTOR OF CELL BIOLOGY AT THE CANCER RESEARCH INSTITUTE AT BIDMC. "THIS MODEL COULD ALSO SERVE AS A PLATFORM TO POTENTIALLY DISCOVER BIOMARKERS MEASURABLE CHANGES LINKED TO DISEASE THAT WE HOPE TO USE IN THE CLINIC TO MONITOR CANCER DEVELOPMENT." THE PANCREAS IS A HORMONE-SECRETING ORGAN CONSISTING OF DUCTS AND ACINAR STRUCTURES, OR SACLIKE STRUCTURES THAT STORE PANCREATIC SECRETIONS. UNTIL NOW, SCIENTISTS HAVE NOT BEEN ABLE TO SUCCESSFULLY GROW AND MAINTAIN HUMAN ACINAR STRUCTURES IN THE LAB CHALLENGING THEIR ABILITY TO TEST THE HYPOTHESIS IN A MODEL. RESEARCHERS SUSPECT THAT THE MOST COMMON KIND OF PANCREATIC CANCER ARISES IN THE CELLS LINING ACINAR AND DUCTAL STRUCTURES.THE CULMINATION OF FIVE-PLUS YEARS' OF WORK, THE STUDY REPRESENTS THE FIRST TIME RESEARCHERS SUCCESSFULLY GENERATED HUMAN ACINAR CELLS IN CULTURE AND MAINTAINED THEM LONG ENOUGH TO BE ABLE TO USE THEM IN EXPERIMENTS. FINANCIAL BURDENS ASSOCIATED WITH CANCER CARE DISPROPORTIONATELY AFFECTS YOUNG, NON-WHITE PATIENTS WITH GYNECOLOGIC CANCERSTHE COST OF CANCER CARE IN UNITED STATES WAS AN ESTIMATED $183 BILLION IN 2015 AND IS PROJECTED TO RISE BY 30 PERCENT BY 2030, ACCORDING TO THE AMERICAN CANCER SOCIETY. WHILE PRIVATE AND GOVERNMENT INSURANCE MAY COVER MUCH OF THE COST OF CARE, EVEN PATIENTS WITH INSURANCE CAN STRUGGLE TO PAY FOR OFFICE VISIT CO-PAYMENTS, PRESCRIPTION MEDICATIONS OR OTHER CANCER-RELATED EXPENSES. YET LIMITED DATA DESCRIBES HOW FINANCIAL HARDSHIP IMPACTS PATIENT BEHAVIOR AND HOW THAT IN TURN MAY IMPACT PATIENTS' HEALTH. IN A STUDY DESIGNED TO PROVIDE A MORE COMPREHENSIVE PICTURE OF HOW A DIVERSE COHORT OF GYNECOLOGIC CANCER PATIENTS ARE AFFECTED BY FINANCIAL DISTRESS ALSO CALLED "FINANCIAL TOXICITY" IN ACKNOWLEDGMENT OF THE HEALTH HAZARD IT CAN POSE RESEARCHER-PHYSICIANS AT BIDMC AND THE UNIVERSITY OF ALABAMA (UAB) ANALYZED PREVIOUSLY COLLECTED SURVEY DATA OF GYNECOLOGIC ONCOLOGY PATIENTS FROM THEIR RESPECTIVE INSTITUTIONS. THEIR FINDINGS ARE REPORTED IN THE INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER. USING THE COMPREHENSIVE SCORE FOR FINANCIAL TOXICITY (COST) TO MEASURE THE ECONOMIC BURDEN EXPERIENCED BY PATIENTS WITH CANCER, CORRESPONDING AUTHOR KATHARINE M. ESSELEN, MD, MBA, OF THE DIVISION OF GYNECOLOGIC ONCOLOGY IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, AND COLLEAGUES ANALYZED PREVIOUSLY COLLECTED SURVEY DATA FROM 308 PATIENTS WITH GYNECOLOGIC CANCER 240 PATIENTS SURVEYED AT BIDMC AND 121 SURVEYED AT UAB. THEY FOUND THAT NEARLY HALF OF PATIENTS WITH GYNECOLOGIC CANCER REPORTED EXPERIENCING MODERATE TO SEVERE FINANCIAL TOXICITY. FURTHER ANALYSIS OF SURVEY DATA REVEALED THAT YOUNGER PATIENTS WERE AT GREATER RISK OF EXPERIENCING FINANCIAL TOXICITY FOR A VARIETY OF REASONS. YOUNGER PATIENTS ARE NOT ELIGIBLE FOR MEDICARE, AND DIAGNOSIS AND TREATMENT MAY IMPACT THEIR ABILITY TO WORK. THEY HAVE ALSO HAD FEWER EARNING YEARS TO ACCUMULATE A FINANCIAL SAFETY NET. PATIENTS REPORTING SEVERE FINANCIAL TOXICITY ACCOUNTED FOR 15 PERCENT OF THOSE SURVEYED. ESSELEN AND COLLEAGUES FOUND THIS GROUP MORE LIKELY TO REPORT CHANGING SPENDING HABITS AND BORROWING MONEY DUE TO THE COSTS OF CANCER CARE. MOST ALARMINGLY, THOSE REPORTING SEVERE FINANCIAL HARDSHIP WERE NEARLY FIVE TIMES MORE LIKELY TO ATTEMPT TO COPE WITH THE HIGH COST OF CARE THROUGH MEDICATION NON-COMPLIANCE. IMMUNOTHERAPY MAY BE EFFECTIVE FOR SUBSET OF PROSTATE CANCER IN RECENT YEARS, CANCER IMMUNOTHERAPY HAS BEEN EFFECTIVE IN TREATING PATIENTS WITH IMMUNOGENIC, OR SO-CALLED "HOT" TUMORS WITH INCREASED LEVELS OF INFLAMMATION AND THE PRESENCE OF IMMUNE CELLS IN AND AROUND THE TUMORS. PROSTATE CANCER, HOWEVER, IS CONSIDERED A "COLD" TUMOR, WITH FEW IMMUNE CELLS RECOGNIZING AND INFILTRATING PROSTATE MALIGNANCIES. ACCORDINGLY, PROSTATE CANCER HAS BEEN FOUND TO RESPOND POORLY TO THE CLASS OF IMMUNOTHERAPIES KNOWN AS IMMUNE CHECKPOINT INHIBITORS. IN PREVIOUS WORK, A TEAM LED BY MEDICAL ONCOLOGISTS AT BIDMC IDENTIFIED A SUBSET OF PROSTATE CANCERS THAT EXHIBITED CHARACTERISTICS MORE TYPICAL OF HOT CANCERS. IN A PAPER APPEARING IN THE JOURNAL CLINICAL CANCER RESEARCH, RESEARCHERS REPORT THAT ABOUT A QUARTER OF LOCALIZED PROSTATE CANCERS MAY DEMONSTRATE THESE IMMUNOLOGIC TRAITS, SUGGESTING THAT A SUBSTANTIAL NUMBER OF PATIENTS WITH PROSTATE CANCER MAY, IN FACT, BENEFIT FROM IMMUNOTHERAPIES. "WE WERE SURPRISED TO FIND ALL THE FEATURES OF MORE TRADITIONALLY IMMUNOGENIC CANCERS IN THESE PROSTATE CANCERS, AND THAT THIS IS NOT A RARE SUBTYPE, OBSERVED IN ABOUT A QUARTER OF HIGH-RISK TUMORS," SAID CO-CORRESPONDING AUTHOR DAVID J. EINSTEIN, MD, A MEDICAL ONCOLOGIST AT BIDMC. "WE'RE INTERESTED IN WHETHER THERE IS A SUBSET OF PATIENTS WITH LOCALIZED PROSTATE CANCER, ESPECIALLY MORE AGGRESSIVE ONES, WHOSE CANCERS MIGHT BE MORE RECOGNIZED BY THE IMMUNE SYSTEM AND THEREFORE MORE TREATABLE WITH IMMUNOTHERAPIES. THESE WOULD ALSO BE SOME OF THE PATIENTS AT GREATEST RISK FOR RELAPSE AND METASTATIC SPREAD." EINSTEIN AND COLLEAGUES, INCLUDING CO-CORRESPONDING AUTHOR STEVEN BALK, MD, PHD, A PHYSICIAN AT BIDMC, FOCUSED ON TWO CHARACTERISTICS THAT MAKE TRADITIONALLY IMMUNOGENIC CANCERS SUSCEPTIBLE TO IMMUNOTHERAPY: PD-L1 EXPRESSION AND T CELL INFILTRATION. PD-L1 IS A PROTEIN INVOLVED IN TUMOR EVASION OF THE IMMUNE SYSTEM. T CELLS ARE THE SENTINELS OF THE IMMUNE SYSTEM, PATROLLING THE BODY FOR POTENTIAL PATHOGENS OR DISEASE. THE RESEARCHERS IDENTIFIED PROSTATE CANCERS THAT HAD BEEN REMOVED FROM PATIENTS, LOOKING FOR THOSE THAT HAD AREAS OF HIGH PD-L1 EXPRESSION AND THEN LOOKED FOR THE PRESENCE OF INFILTRATING T CELLS. NEXT, THE TEAM COMPARED THE T CELL LANDSCAPE IN THE MORE IMMUNOGENIC PROSTATE CANCERS TO THAT OF MORE TYPICAL PROSTATE CANCERS, AS WELL AS TO KIDNEY CANCER, ONE OF THE MOST IMMUNOGENIC TUMOR TYPES. FINALLY, THE TEAM USED DNA SEQUENCING TO COMPARE THE GENETIC PROFILES FROM THESE IMMUNOLOGICALLY HOT AREAS TO THAT OF THE SO-CALLED COLD AREAS IN THE SAME TUMORS, AS WELL AS TO THE GENOMIC LANDSCAPE OF IMMUNOGENIC CANCERS IN GENERAL. THE SCIENTISTS WERE SURPRISED TO LEARN HOW MANY MORE T CELLS INFILTRATED THE IMMUNOGENIC PROSTATE CANCERS COMPARED WITH MORE TYPICAL PROSTATE CANCERS, AND TO OBSERVE ALL THE FEATURES OF MORE TRADITIONALLY IMMUNOGENIC CANCERS LIKE KIDNEY CANCER IN THESE MORE IMMUNOGENIC PROSTATE CANCERS. THEY ALSO NOTED SIGNIFICANTLY MORE LOSS OF SOME KEY TUMOR SUPPRESSOR GENES IN THESE IMMUNOGENIC PROSTATE CANCERS COMPARED WITH TYPICAL PROSTATE CANCER, A DIFFERENCE THAT COULD POTENTIALLY SERVE AS MARKERS TO FIND CANCERS MORE TREATABLE WITH IMMUNOTHERAPIES.
FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 60 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 785 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 52 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 60 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS: ANESTHESIOLOGY EMERGENCY MEDICINE EAR, NOSE AND THROAT (OTOLARYNGOLOGY) INTERNAL MEDICINE NEUROLOGY NEUROSURGERY OBSTETRICS AND GYNECOLOGY PATHOLOGY PLASTIC SURGERY PSYCHIATRY RADIOLOGY SURGERY TRANSITIONAL YEAR UROLOGYDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER HAD NET EXPENDITURES OF $68,456,175 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE MEDICAL CENTER'S TEACHING FUNCTION WHICH REPRESENTED 3.13% OF THE MEDICAL CENTER'S TOTAL EXPENSES.RESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. OVER HALF OF THESE PROGRAMS (59 OF 109) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS: ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS) EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, ACADEMIC EMERGENCY MEDICINE INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY PSYCHIATRY RADIOLOGY-DIAGNOSTIC: ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING MSK, NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATEDADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLESBELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:
HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMC THE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HOSPITAL, TUFTS MEDICAL CENTER, ST. VINCENT HOSPITAL, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.
JUNIOR AND SENIOR RESIDENCY RESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE. DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC. ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH TO BE EFFECTIVE PRACTITIONERS IN UNDERSERVED, RESOURCE-LIMITED SETTINGS AND TO DESIGN, MANAGE, IMPROVE AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS THAT ADDRESS THE HEALTH PROBLEMS OF THE WORLD'S NEEDIEST POPULATIONS.PROGRAM OBJECTIVES INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS CONTRIBUTE TO THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS IN BOSTON AND AROUND THE WORLD ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS WITH LIMITED RESOURCES EXPAND RESEARCH OPPORTUNITIES ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. PHYSICIAN AND NURSE TRAINING ON HIV/AIDS CARE IN VIETNAM TAKES PLACE THROUGH FUNDING FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH.
NEUROLOGY EDUCATION AT BIDMC THE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. *****PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING. RADIOLOGY EDUCATION AT BIDMCTHE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE: THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR. FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR. ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.
OUR UNIQUE EDUCATIONAL TRACKS CURRENTLY, SIX TRACKS ARE OFFERED: CLINICAL EDUCATION RESEARCH GLOBAL HEALTH QUALITY IMPROVEMENT HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.*****SURGERY EDUCATION AT BIDMCTHE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. STUDENTS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. STUDENTS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE: RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.BIDMC-ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)OPEN MEDICAL STAFF AND COMMUNITY BOARDAS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS.AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, BIDMC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.BETH ISRAEL LAHEY HEALTH (BILH) IS THE PARENT AND A SUPPORT ORGANIZATION OF THE BILH NETWORK OF AFFILIATES. THE NETWORK COMPRISES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM INCLUDES ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BILH SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. AS A SUPPORT ORGANIZATION OF THESE ENTITIES, BILH PROVIDES CENTRALIZED SERVICES AND SUPPORT TO ITS AFFILIATES IN AREAS SUCH AS MANAGEMENT, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFITS, DEVELOPMENT AND FUNDRAISING, LEGAL SERVICES, FINANCE, TREASURY, INVESTMENT, INSURANCE, COMPLIANCE AND TAXATION AS WELL AS PATIENT CARE CONTRACTING AND OTHER SERVICES.BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.BILH IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD-CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A NEW MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES;4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES.
BILH BEHAVIORAL HEALTH SERVICES THE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. BILHBS (WHICH INCLUDES THE ACTIVITIES OF BILH'S TAX-EXEMPT AFFILIATE NORTHEAST BEHAVIORAL HEALTH CORP) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS. BILHBS' NETWORK OF BEHAVIORAL HEALTH CARE INCLUDES SERVICES FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TREATMENT TO COMMUNITY-BASED PROGRAMS. SERVICES INCLUDE: INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; EMERGENCY PSYCHIATRIC AND MOBILE EMERGENCY SERVICES TEAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION TREATMENT; INDIVIDUAL/COUPLE/FAMILY THERAPY; MEDICATION ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS; AND SCHOOL-BASED AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES.SINCE THE CREATION OF BILH IN MARCH 2019, BILH HAS INVESTED SIGNIFICANTLY IN IMPROVING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH A SYSTEM-WIDE APPROACH TO CARE DELIVERY. FIRST, IT HAS MADE A MULTI-YEAR COMMITMENT TO PROVIDE BEHAVIORAL HEALTH SUPPORT TO ITS EMPLOYED PRIMARY CARE PRACTICES USING AN EVIDENCE-BASED APPROACH KNOWN AS THE IMPACT MODEL. BY THE END OF FY 2021, BILH HAD IMPLEMENTED THE IMPACT MODEL IN 67% OF ITS EMPLOYED PRIMARY CARE PRACTICES AS PART OF ITS COLLABORATIVE CARE PROGRAM IMPLEMENTATION. IN 2021, BILHBS EXPANDED ITS PRIMARY CARE BEHAVIORAL HEALTH INTEGRATION (PCBHI) SERVICES BY INCORPORATING A DSRIP PILOT PROJECT AIMED AT INTERPROFESSIONAL PSYCHIATRIC CONSULTS. THE PCBHI INTERPROFESSIONAL CONSULTATION INCLUDES AN ASSESSMENT AND MANAGEMENT SERVICE IN WHICH A PATIENT'S PRIMARY CARE PROVIDER (PCP) REQUESTS THE OPINION AND/OR TREATMENT ADVICE OF A PSYCHIATRIC CONSULTANT TO ASSIST IN THE DIAGNOSIS AND/OR MANAGEMENT OF THE PATIENT'S BEHAVIORAL HEALTH CONDITION WITHOUT THE NEED FOR THE PATIENT'S FACE-TO-FACE CONTACT WITH THE CONSULTANT. INTERPROFESSIONAL CONSULTATION ENABLES A COMPREHENSIVE ASSESSMENT, ENHANCES PATIENT CARE, REDUCES MISDIAGNOSIS, AND SUPPORTS THE INTEGRATION OF DISCIPLINES IN THE DELIVERY OF CARE. THE PCBHI INTERPROFESSIONAL PSYCHIATRIC CONSULTANTS PROVIDE PCPS WITH ANOTHER AVENUE FOR INTEGRATED CARE. THE IMPLEMENTATION OF PCBHI INTERPROFESSIONAL SERVICES WILL BE OFFERED IN PRACTICES WHERE COLLABORATIVE CARE IS NOT CURRENTLY AVAILABLE. ADDITIONALLY, IN 2021, BILHBS CONTINUED TO OVERSEE THE BILH-WIDE CENTRALIZED BEHAVIORAL HEALTH (BH) BED MANAGEMENT, WHICH SUPPORTS INPATIENT BEHAVIORAL HEALTH BED CAPACITY AND IMPROVING ACCESS TO THESE BEDS, WITH THE PARALLEL GOAL OF REDUCING BOARDING BY BEHAVIORAL HEALTH PATIENTS IN THE EMERGENCY DEPARTMENTS ("EDS"). AS PART OF THE CENTRALIZED BH BED MANAGEMENT, BILH STAFF ENGAGE IN A DAILY HUDDLE WITH REPRESENTATIVES FROM BILH HOSPITALS' EDS AND BEHAVIORAL HEALTH UNITS TO DISCUSS PATIENTS APPROPRIATE FOR TRANSFER TO THE UNIT. THE DAILY HUDDLES HAVE BECOME A FORUM FOR WHICH PARTICIPANTS DISCUSS BEHAVIORAL HEALTH PATIENT VOLUME AND BED CAPACITY ACROSS THE SYSTEM, AS WELL AS DISCHARGE PLANNING AND PLACEMENT OPPORTUNITIES FOR DIFFICULT-TO-PLACE PATIENTS.SEPARATELY, IN MARCH 2021, BILHBS LAUNCHED ITS CENTRALIZED BED FINDING TEAM. THIS TEAM IS PART OF OUR CENTRAL CALL CENTER, WHICH CENTRALIZES CALLS TO BILHBS' THREE EMERGENCY SERVICE PROGRAM (ESP) CATCHMENT AREAS REDUCING REDUNDANCIES ACROSS THE AGENCY AND STREAMLINING ALL CALLS TO ONE CENTRAL SERVICE. THIS CENTRALIZED BED FINDING TEAM IS RESPONSIBLE FOR CONDUCTING BED SEARCHES FOR PATIENTS SEEN THROUGH THE ESP AND WHO ARE AWAITING AN INPATIENT PSYCHIATRIC PLACEMENT. THIS TEAM DIRECTLY INCREASES THE AVAILABILITY OF CLINICIANS TO CONTINUE TO SEE PATIENTS IN THE ED AND THE COMMUNITY WHO ARE EXPERIENCING A BEHAVIORAL HEALTH AND/OR CO-OCCURRING SUBSTANCE USE DISORDER CRISIS WHILE OTHER TEAM MEMBERS SEARCH FOR AVAILABLE INPATIENT PLACEMENTS. THIS INITIATIVE SUPPORTS DECREASED RESPONSE TIME TO RESPONDING TO NEW PATIENTS IN CRISIS AND REDUCES ED BOARDING TIME FOR PATIENTS WHO CAN BE SAFELY MANAGED IN THE COMMUNITY.BILHBS SERVES APPROXIMATELY 35,000 UNDUPLICATED INDIVIDUALS ANNUALLY, OFFERING A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS. SERVICES RANGE FROM INPATIENT TO HOME AND COMMUNITY-BASED SERVICES. BILHBS OPERATES OVER 250 BEDS IN 9 FACILITIES FOR CLIENTS REQUIRING ACUTE PSYCHIATRIC CARE, DETOXIFICATION AND RESIDENTIAL STEP-DOWN SERVICES. DURING THE PERIOD COVERED BY THIS FILING, COMMUNITY-BASED SERVICES INCLUDED MOBILE EMERGENCY SERVICES TEAMS IN THREE CATCHMENT AREAS AND HOME-BASED COUNSELING FOR ADULTS, YOUTH AND THEIR FAMILIES. BILHBS ALSO PROVIDED SERVICES IN 63 MIDDLE AND HIGH SCHOOLS, AS WELL AS 9 POLICE DEPARTMENTS.BILHBS ALSO CONTINUES TO IMPROVE ACCESS THROUGH THE URGENT PSYCHOPHARMACOLOGY SERVICES IN BILH'S LOWELL EMERGENCY SERVICES PROGRAM. THIS CLINIC PROVIDES URGENT ACCESS FOR PATIENTS REQUIRING A CHANGE TO THEIR MEDICATIONS. THIS SERVICE IS OFFERED 20 HOURS PER WEEK AND INCLUDES UNINSURED, MEDICAID, AND MEDICARE POPULATIONS, AS WELL AS ANY PERSON IN NEED OF THE SERVICE REGARDLESS OF THE PAYER SOURCE. BILH'S COMMUNITY CRISIS STABILIZATION ("CCS") UNITS IN LAWRENCE AND SALEM, WHICH TYPICALLY CARE FOR PATIENTS WITH MENTAL HEALTH ISSUES, INCREASED THEIR ABILITY TO TREAT PERSONS WITH CO-OCCURRING SUBSTANCE USE DISORDERS. THE CCS UNITS CONTINUE TO BE ABLE TO INDUCT PATIENTS WITH OPIOID USE DISORDER (OUD) ON BUPRENORPHINE AND ARE ALSO ABLE TO MAINTAIN PATIENTS WHO ARE ALREADY ON ANY OF THE THREE FDA APPROVED MEDICATIONS FOR THE TREATMENT OF OUD. THESE UNITS ARE SEEING AN INCREASE IN THE NUMBER OF PATIENTS WITH METHAMPHETAMINE DISORDERS AND HAVE DEVELOPED A PROTOCOL TO MANAGE WITHDRAWAL SYMPTOMS IN THIS POPULATION.BILHBS CONTINUES TO MAINTAIN AND ENHANCE ITS TELEHEALTH PLATFORM AND CLINICAL DELIVERY THROUGH THE USE OF DIGITAL APPLICATIONS ACROSS ALL OF ITS AMBULATORY PROGRAMS. SPECIAL EMPHASIS WAS PLACED ON SPANISH-LANGUAGE ACCESS TO LAWRENCE-BASED PROGRAMS TO ENSURE PATIENTS IN THIS REGION ACCESS LINGUISTICALLY-APPROPRIATE CARE. IN 2021, BILHBS IDENTIFIED IMPROVEMENT OF THE PATIENT EXPERIENCE AS A KEY STRATEGIC PRIORITY. TO THAT END, ALL PROGRAM DIRECTORS ARE EVALUATED AGAINST THIS GOAL AND ARE REQUIRED TO COMPLETE TWO PLAN-DO-STUDY-ACT (PDSA) CYCLES ANNUALLY. PDSA IS A WELL-ESTABLISHED PROCESS IMPROVEMENT FRAMEWORK USED IN HEALTHCARE. PROGRAM DIRECTORS REVIEW PATIENT FEEDBACK TO DEVELOP PILOT INTERVENTIONS, ANALYZE THE RESULTS, AND THEN MAKE ADJUSTMENTS TO THE INTERVENTION. EXAMPLES OF OUTCOMES ACHIEVED THROUGH THE PDSA APPROACH INCLUDE ENHANCING THE PATIENT ENGAGEMENT MODEL FOR THE BEHAVIORAL HEALTH COMMUNITY PARTNERS (BHCP) PROGRAM; IMPROVING PATIENT EXPERIENCES AND ENGAGEMENT IN THE USE OF TELEHEALTH PLATFORMS IN BILHBS' LAWRENCE OUTPATIENT SITE, IMPROVING THE ADMISSION PROCESS IN THE BILHBS GLOUCESTER OPIOID TREATMENT CENTER, REDUCING ADMINISTRATIVE DISCHARGES BY IMPLEMENTING A HARM REDUCTION MODEL, AND IMPROVING EXTERNAL REFERRAL EXPERIENCE AT THE BILHBS HAVERHILL OUTPATIENT AND CHILDREN'S BEHAVIORAL HEALTH INITIATIVES (CBHI) PROGRAMS.
BETH ISRAEL LAHEY HEALTH'S COVID-19 PANDEMIC RESPONSE AS IN THE PRIOR YEAR, BETH ISRAEL LAHEY HEALTH'S ("BILH") HOSPITALS AND OTHER PATIENT CARE ORGANIZATIONS EXPENDED SIGNIFICANT TIME AND RESOURCES ACROSS FY 2021 IN THEIR CONTINUED EFFORTS TO RESPOND TO THE COVID-19 PANDEMIC. IN ADDITION TO PROVIDING COVID-19 TESTING AND TREATMENT, THE HEALTH SYSTEM INITIATED PATIENT AND STAFF VACCINATION EFFORTS IN FY 2021, REACHING OUT TO 1.3 MILLION PATIENTS USING A MULTICHANNEL, MULTILINGUAL APPROACH AND ULTIMATELY DELIVERING OVER 400,000 VACCINE DOSES. THE SYSTEM SUCCESSFULLY UNDERTOOK THESE EFFORTS WHILE ALSO NAVIGATING UNPRECEDENTED FINANCIAL AND OPERATIONAL CHALLENGES STEMMING FROM THE PANDEMIC, INCLUDING ONGOING WORKFORCE DISRUPTION AND A DECLINE IN PATIENT VOLUME DUE TO THE CURTAILMENT OF ELECTIVE SERVICES AND STAFFING CHALLENGES.HIGHLIGHTS OF THE SYSTEM'S PANDEMIC RESPONSE IN FY 2021 INCLUDE:STAFF TESTING, VACCINATION, AND SUPPORT IN NOVEMBER 2020, BILH IMPLEMENTED A PROGRAM TO PROVIDE ITS 36,000 EMPLOYEES WITH ACCESS TO ONSITE, VOLUNTARY, AND FREE-OF-CHARGE COVID-19 PCR TESTING, EVEN IF THEY HAD NO KNOWN EXPOSURE OR SYMPTOMS. IN ADDITION TO SERVING AS AN IMPORTANT ELEMENT TO CONTAIN COMMUNITY SPREAD OF COVID-19, THIS EFFORT BOOSTED BILH STAFF MORALE AND CONFIDENCE DURING THIS CHALLENGING PERIOD. IN DECEMBER 2020, BILH STOOD UP STAFF VACCINATION SITES AT ITS LOCAL HOSPITALS, ULTIMATELY DELIVERING 70,000 VACCINE DOSES TO ITS WORKFORCE IN FY 2021. THE SYSTEM TOOK PROGRESSIVE MEASURES AROUND EMPLOYEE PAID TIME OFF TO SUPPORT VACCINATION EFFORTS AS WELL AS FAMILY CARE NEEDS AND TIME MISSED DUE TO COVID-19 ILLNESS OR TESTING. IN THE SUMMER OF 2021, BILH COMMUNICATED THAT COVID-19 AND FLU VACCINE WOULD BE REQUIRED AS A CONDITION OF EMPLOYMENT; THE COVID-19 VACCINATION DEADLINE WAS SUCCESSFULLY COMPLETED ON OCTOBER 31, 2021. BILH OPERATIONALIZED A CENTRALIZED CALL CENTER TO SUPPORT STAFF WITH SYMPTOM REPORTING, COVID-19 TESTING, AND RETURN-TO-WORK PROCESSES. THE CALL CENTER ENSURED CONVENIENT AND ACCESSIBLE INFORMATION FOR A WORKFORCE SPREAD THROUGHOUT EASTERN MASSACHUSETTS. AT ITS PEAK, THE CENTRALIZED CALL CENTER HANDLED OVER 1,000 PHONE CALLS PER DAY.PATIENT VACCINATION NEARLY IMMEDIATELY UPON RECEIVING VACCINE SUPPLY THAT COULD BE USED FOR PATIENTS, BILH OPENED AND OPERATED 10 VACCINE ADMINISTRATION SITES ACROSS EASTERN MASSACHUSETTS. THE LOCATIONS WERE SELECTED BASED ON SEVERAL CRITERIA, INCLUDING PROXIMITY TO HARD-HIT COMMUNITIES AND EASE OF ACCESS IN TERMS OF TRANSPORTATION. THIS WAS A SIGNIFICANT LOGISTICAL FEAT IN LIGHT OF THE SHIFTING FORECASTS IN VACCINE SUPPLY AND SPECIAL HANDLING REQUIRED FOR THE PFIZER VACCINE. BILH DEVELOPED ITS OWN VACCINATION SCHEDULING TOOL, COVAX, TO SUPPORT STAFF AND PATIENT VACCINATION EFFORTS. THIS TOOL ENABLED BILH TO IDENTIFY PATIENTS ELIGIBLE FOR VACCINATION BASED ON STATE GUIDELINES, SCHEDULE APPOINTMENTS, AND TRACK VACCINATION ACTIVITY. BILH LED A TARGETED CAMPAIGN TO SUPPORT HEALTH EQUITY BY PRIORITIZING FOR VACCINATION BILH PATIENTS WHO RESIDED IN A COMMUNITY OR TOWN IDENTIFIED AS HAVING AMONG THE HIGHEST CUMULATIVE INCIDENCE OF COVID-19 WITHIN THE STATE OF MASSACHUSETTS. BILH ALSO COORDINATED WITH MULTIPLE COMMUNITY HEALTH CENTERS TO PROVIDE THEIR PATIENTS WITH PRIORITY ACCESS TO VACCINATION APPOINTMENTS. DUE TO THESE EFFORTS, BETH ISRAEL DEACONESS CARE ORGANIZATION ("BIDCO"), AN ACCOUNTABLE CARE ORGANIZATION ("ACO") WITHIN BILH, HAD THE HIGHEST COVID-19 VACCINATION RATE FOR MEDICAID MEMBERS AMONG ALL MEDICAID ACOS IN THE STATE. BILH ESTABLISHED THE COVID-19 HEALTH EQUITY ADVISORY COUNCIL ("THE COUNCIL") WITH A GOAL TO ADDRESS HEALTH DISPARITIES BROUGHT ON BY THE PANDEMIC, LANGUAGE BARRIERS, AND OTHER SOCIAL DETERMINANTS OF HEALTH. ITS MEMBERSHIP INCLUDED KEY BILH STAKEHOLDERS AND COMMUNITY HEALTH CENTER CHIEF MEDICAL OFFICERS. AS PART OF ITS RESPONSIBILITY, THE COUNCIL REVIEWED THE SYSTEM'S VACCINE ROLLOUT STRATEGY, INCLUDING THE PATIENT PRIORITIZATION AND SCHEDULING STRATEGY, CALL CENTER MODEL, VACCINE SITE LOCATION AND OPERATING MODEL, AND STAFF RESOURCES TO HELP COMMUNICATE AND ENGAGE WITH PATIENTS ABOUT VACCINE INFORMATION, CONCERNS, AND HESITANCY.TESTING IN FY 2021, BILH PERFORMED OVER 600,000 COVID-19 TESTS ACROSS ITS 10 HOSPITAL LABORATORIES FOR PATIENTS, HEALTHCARE PERSONNEL, AND OTHER PARTNERS, SUCH AS COMMUNITY HEALTH CENTERS AND CORRECTIONAL FACILITIES. IN JANUARY 2021, LAHEY HOSPITAL & MEDICAL CENTER BEGAN TESTING ON HIGH-THROUGHPUT THERMO FISHER INSTRUMENTS, GREATLY INCREASING THE SYSTEM'S CAPACITY FOR SAME-DAY TEST RESULTS. THESE INSTRUMENTS ALSO PROVIDED BACK-UP CAPACITY FOR OTHER LABS IN THE COMMUNITY, WHICH WERE EXPERIENCING HIGH VOLUME. THE THERMO FISHER INSTRUMENTS ADDED THE ABILITY TO RAPIDLY DETECT POTENTIAL COVID-19 VARIANTS (S-GENE DROPOUTS), A PROCESS PREVIOUSLY ONLY AVAILABLE THROUGH THE MASSACHUSETTS STATE LABORATORY. EVENTUALLY, BILH IMPLEMENTED SPECIFIC VARIANT PCR (POLYMERASE CHAIN REACTION) TESTING OF PATIENT SPECIMENS TO IDENTIFY SPECIFIC VARIANTS AND BETTER GUIDE DEVELOPMENT OF INFECTION PREVENTION RECOMMENDATIONS AND APPROPRIATE MONOCLONAL ANTIBODY TREATMENT SELECTION. THE SYSTEM MAINTAINED EIGHT DRIVE-THROUGH COVID-19 TESTING SITES ACROSS EASTERN MASSACHUSETTS TO ENABLE EASY ACCESS FOR PATIENTS AND STAFF, INCLUDING A STATE-SPONSORED "STOP THE SPREAD" SITE IN CHELSEA, MA. BILH PRIMARY CARE MADE POINT-OF-CARE COVID-19 TESTING AVAILABLE TO ITS PATIENTS IN APPROXIMATELY 20 PRACTICE SITES (25% OF TOTAL SITES) SPREAD THROUGHOUT BILH'S SERVICE AREA.INFECTION PREVENTION AND PERSONAL PROTECTIVE EQUIPMENT EFFORTS THROUGHOUT FY 2021, BILH INFECTION PREVENTION AND SUPPLY CHAIN STAFF CONTINUED TO PARTNER ON PROCURING PERSONAL PROTECTIVE EQUIPMENT ("PPE") AND OTHER RELATED SUPPLIES AND REPLENISHING BILH'S PANDEMIC SUPPLY WAREHOUSE. THIS ENSURED THE SYSTEM HAD AT LEAST 90 DAYS OF INVENTORY ON HAND FOR THE HIGHEST-UTILIZED PRODUCTS, SUCH AS GLOVES, GOWNS, FACEMASKS, AND EYE AND FACE SHIELDS. IN FY 2021, BILH SUPPLY CHAIN AND INFECTION PREVENTION COORDINATED A RESPIRATOR (N95 OR EQUIVALENT) FIT TESTING PROGRAM WITH A VENDOR TO FIT TEST MORE THAN 20,000 BILH EMPLOYEES TO BOTH DISPOSABLE AND REUSABLE RESPIRATORS. THIS UNIQUE PROGRAM INCORPORATING REUSABLE RESPIRATORS ENSURED THAT BILH STAFF WOULD NOT BE SUBJECT TO FLUCTUATIONS IN SUPPLY CHAIN DURING FUTURE WAVES OF COVID-19 OR OTHER RESPIRATORY VIRAL ILLNESSES AND MITIGATED WASTE RELATED TO DISPOSABLE RESPIRATORY PROTECTION. THROUGHOUT FY 2021, BILH INFECTION PREVENTION DEVELOPED AND UPDATED CLINICAL AND OPERATIONAL GUIDANCE INCLUDING POLICIES, TOOLS, AND EDUCATIONAL MATERIALS TO SUPPORT THE PREVENTION OF TRANSMISSION OF COVID-19. FOR EXAMPLE, BILH INFECTION PREVENTION DEVELOPED STAFF EDUCATION ON COVID-19 PREVENTION TO MEET THE OSHA COVID-19 EMERGENCY TEMPORARY STANDARD FOR USE BY ALL HOSPITAL/BUSINESS UNITS; CREATED SCREENING TOOLS FOR USE AT ALL POINTS OF ENTRY FOR PATIENTS AND VISITORS AND UPDATED CRITERIA AS NEEDED BASED ON LOCAL AND NATIONAL GUIDANCE; AND, UPDATED POLICIES FOR PREOPERATIVE AND PRE-PROCEDURAL TESTING AND PPE.TREATMENT BILH HOSPITALS CONTINUED TO PROVIDE TREATMENT TO ADMITTED PATIENTS WITH COVID-19, USING TREATMENTS AUTHORIZED FOR USE AT THE TIME. LEADERS ACROSS BILH HOSPITALS CONTINUED TO MEET AND SHARE INFORMATION TO ALLOW FOR APPROPRIATE RESOURCE ALLOCATION AND LOAD BALANCING TO ENSURE BILH WAS ABLE TO MEET PATIENT DEMAND. IN FY 2021, BILH BEGAN TO MAKE AVAILABLE TO AMBULATORY PATIENTS COVID-19 THERAPEUTICS (INTRAVENOUS MONOCLONAL ANTIBODIES AND REMDESEVIR) AND PROPHYLAXIS (EVUSHELD), WITH THESE EFFORTS EXPANDING ACROSS 2022.SAFETY NET AFFILIATE SUPPORT IN ORDER TO ENHANCE SITUATIONAL AWARENESS AND THE HEALTH SYSTEM'S UNDERSTANDING OF THE PANDEMIC'S IMPACT ON ITS SAFETY NET AFFILIATES ("SNAS"), BILH INCLUDED ITS SNAS IN DAILY HUDDLES AND INCIDENT COMMAND MEETINGS. THESE COLLABORATIVE FORUMS ENABLED BILH TO PROVIDE TARGETED, CONSISTENT SUPPORT, INCLUDING DISCUSSIONS ON PATIENT TRANSFER AVAILABILITY AND BED CAPACITY ACROSS BILH. THROUGH ITS COMMITMENT TO SUPPORTING LOCAL COMMUNITIES DEVASTATED BY THE PANDEMIC, BILH DONATED $410,000 TO COMMUNITY GROUPS LOCATED IN BROCKTON AND $600,000 TO THE CITY OF CHELSEA TO AID IN ADDRESSING PROBLEMS CREATED OR EXACERBATED BY THE PANDEMIC, INCLUDING TEMPORARY HOUSING FOR EVICTED PATRONS AND FOOD INSECURITY DUE TO LOSS OF INCOME.
BETH ISRAEL LAHEY HEALTH'S COVID-19 PANDEMIC RESPONSE UNDERPINNING THESE MANY INITIATIVES WERE VARIOUS MULTI-ENTITY, INTERDISCIPLINARY COMMITTEES AND DATA COLLECTION EFFORTS TO ENSURE THAT BILH WAS PROACTIVELY MONITORING THE TRAJECTORY OF THE PANDEMIC AND NIMBLY PLANNING THE SYSTEM'S RESPONSE. THE HEALTH SYSTEM'S EFFORTS SPANNED THE CLINICAL CARE CONTINUUM, FROM PRIMARY CARE TO POST-ACUTE CARE, AS WELL AS BOTH CLINICAL AND ADMINISTRATIVE DEPARTMENTS, FROM INFECTIOUS DISEASE AND NURSING TO HUMAN RESOURCES AND INFORMATION SERVICES. BILH SUCCESSFULLY MARSHALLED ITS RESOURCES THROUGHOUT THE SYSTEM TO SERVE AS ONE OF THE PRIMARY HUBS FOR COVID-19 RELATED CARE IN MASSACHUSETTS.
Schedule H (Form 990) 2020
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