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Responding to Community Needs in Central New England

UMass Memorial Medical Center · Clinton Hospital · HealthAlliance Hospital Marlborough Hospital · Wing Memorial Hospital and Medical Centers

Drawing our mission and inspiration from the World Health Organization's broad definition of health ­ "a state of complete physical, mental and social well-being and not merely the absence of disease" ­ our hospitals continue to shape our community benefit programs to better address the changing needs of people in Central New England. ­ John O'Brien, President and CEO UMass Memorial Health Care

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Cover photo: Sara Connor, RNCS/FNP, treats a patient in the Ronald McDonald Care Mobile.

Table of Contents

Message from the President and CEO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 UMass Memorial Health Care

Community Benefits Mission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Contributions to the Community . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 About the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Partnership with UMass Medical School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Tackling Hunger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Assisting the Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

UMass Memorial Medical Center

Providing Access to Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 Developing Good Habits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Responding to Community Health Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Building "the" Brighter Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Empowering Youth to Succeed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Utilizing Literacy for Better Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 Addressing Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 Becoming a Good Neighbor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26

Clinton Hospital

Feeding the Needy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 Serving a Senior Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30

HealthAlliance Hospital

Teeing Up Scholarships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 Eliminating Disparities of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

Marlborough Hospital

Increasing Awareness of Health and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 Tuning in to the Community . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38

Wing Memorial Hospital and Medical Centers

Improving the Health of Belchertown Residents . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40 Training Future Health Care Professionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42

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Message from the President and CEO

"When it comes to improving health in our region, UMass Memorial Medical Center cannot do it alone. We value the time, effort and knowledge put forth by our community partners and key stakeholders to help us advance our community benefits agenda." Walter Ettinger, MD, President UMass Memorial Medical Center

Our communities are at the heart of all that we do. As such, providing sustainable and tangible programs that support the overall health and well-being of our communities is an integral part of our work at UMass Memorial Health Care. Drawing our mission and inspiration from the World Health Organization's broad definition of health ­ "a state of complete physical, mental and social well-being and not merely the absence of disease" ­ our hospitals continue to shape our Community Benefit Programs to better address the changing needs of people in Central New England.

"We believe good physical and mental health is contingent upon one's understanding of how to lead a safe and healthy lifestyle. Through our Community Benefits Program at Clinton Hospital, we promote healthy environments and offer resources that provide affordable access to quality food and preventive health care services." Sheila Daly, President and CEO Clinton Hospital

As the second largest health care provider and the ninth largest employer in the state, UMass Memorial Health Care has an important role to play in extending the ideas of health and wellness beyond its hospital walls. In 2008, we contributed $146 million to our community, including $72.4 million for charity care, subsidized health services, education for health care professionals and community programs. We also supported the teaching of the next generation of physicians and clinicians in partnership with the state's only public medical school ­ the University of Massachusetts Medical School ­ and absorbed more than $57 million in nonreimbursed costs.

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Our five hospitals ­ UMass Memorial Medical Center, Clinton Hospital, HealthAlliance Hospital, Marlborough Hospital, and Wing Memorial Hospital and Medical Centers ­ work closely with their respective communities to identify and prioritize needs, and each has its own story to tell about building relationships and developing partnerships to meet these increasing needs. Over the past year, we reached out to neighborhoods, local organizations, health departments, coalitions and advocacy groups, and the medically underserved, creating a presence in each community that nurtures planning, collaboration and opportunities to enrich the lives of our patients and communities. We feel a deep responsibility to our communities and are proud of the many benefits and services we provide. As we navigate the rapidly changing health care environment, our hospitals will continue to work closely with residents and key stakeholders in Central New England to identify, evaluate and meet a broad range of community needs. On behalf of UMass Memorial Health Care and all of our employees, I am proud to present this brief report that highlights just a few of our Community Benefit Programs and the work of nearly 13,000 dedicated employees who, in different ways, make these programs possible.

"At Wing Memorial Hospital and Medical Centers, our mission is to improve the health care of the residents in our service area and our Community Benefit Program is an integral part of that. It is an obligation that our employees turn into action day after day, year after year." Charles Cavagnaro III, MD, President and CEO Wing Memorial Hospital and Medical Centers "HealthAlliance Hospital is dedicated to promoting health and wellness in our community. Through our partnerships and allocation of our resources, we are better able to respond to identified priorities that positively affect overall health and well-being for the individuals and families we serve." Patrick Muldoon, President and CEO HealthAlliance Hospital

"As a not-for-profit organization, Marlborough Hospital invests its resources and energies into understanding and meeting the diverse health needs of our community members. We take an active approach and strive to provide services that will help ensure a healthier tomorrow." John Polanowicz, President and CEO Marlborough Hospital

John G. O'Brien President and CEO UMass Memorial Health Care

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U M A S S M E M O R I A L H E A LT H C A R E

Community Benefits Mission

UMass Memorial Health Care is committed to improving the health status of all those it serves and to addressing the health problems of the poor and other medically underserved populations. In addition, nonmedical conditions that negatively impact the health and wellness of our community are addressed. Through Community Benefit Programs, our hospitals are meeting the needs of their respective geographical service areas. Priority areas include, but are not limited to:

HealthAlliance Hospital Clinton Hospital

· Access to Care/Health Disparities · Obesity and Hunger

Leominster and Fitchburg

Clinton Marlborough

· Health Literacy · Healthy Community Initiative · Oral Health

Worcester Palmer

Wing Memorial Hospital and Medical Centers

UMass Memorial Medical Center Marlborough Hospital

· Positive Youth Development · Public Health Programming

UMass Memorial Health Care is the largest not-for-profit health care system in Central New England. Through the collective efforts of UMass Memorial Medical Center and our four community hospitals ­ Clinton Hospital, HealthAlliance Hospital, Marlborough Hospital and Wing Memorial Hospital and Medical Centers ­ we are improving the health of the people of Central New England through excellence in clinical care, service, teaching and research.

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U M A S S M E M O R I A L H E A LT H C A R E

Contributions to the Community

In 2008, UMass Memorial Health Care contributed nearly $146 million to positively impact the health and well-being of the community we serve. Our contributions support charity care, subsidized health services, education of health professionals, community-based programming and partnerships, and the University of Massachusetts Medical School. More than $57 million was absorbed through bad debt write-offs and Medicare shortfalls.

2008 UMass Memorial Health Care Community Benefit Total: $72.4 million Other Significant Contributions Total: $73.4 million

Contributions Associated with Charity Care $29.1 M

Subsidized Health Services $17.0 M

UMass Medical School $16.3 M

Bad Debt* $11.1 M

Health Professions Education $15.0 M Community Health Programs, Partnerships, Donations $11.3 M

Medicare Shortfall** $46.0 M

* Bad debt: Expenses for receivables that can no longer be collected and are written off. ** Medicare shortfall: The net loss incurred for the cost of providing services to Medicare patients versus the income received from the Medicare program.

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U M A S S M E M O R I A L H E A LT H C A R E

About the System

UMass Memorial Health Care is:

· The largest not-for-profit health care system in Central New England and the largest provider to the uninsured outside of Boston. More than 20 percent of patients are low income, including 3 percent who have no insurance and 2.2 percent who are enrolled in Commonwealth Care, the state-subsidized health insurance program for the uninsured · The only safety net provider in Central New England, and the fourth largest in the Commonwealth · Financing a dedicated insurance enrollment/financial benefits program at its five hospitals that connects medically underserved, linguistic minority patients and community members to public insurance benefits and other benefits · Comprised of a community medical group of more than 850 physicians, one of the largest and most diverse groups on the US East Coast

UMass Memorial Medical Center Clinton Hospital

41 19 93 289 1,538 13,534 24,270 ­ ­

HealthAlliance Hospital

150 (21) 205 398 1,542 7,289 60,774 160,601 1,098 ­

Marlborough Hospital

79 149 186 667 3,713 26,945 74,873 ­ ­

Wing Memorial UMass Memorial Hospital and Health Care Medical Centers Total

60 89 156 771 2,943 18,502 167,723 ­ ­ 1,111 (84) 1,598 3,019 13,467 56,095 252,383 1,254,475 5,176 731

Licensed Beds (plus bassinets) Active Medical Staff Registered Nurses Employees Hospital Admissions Emergency Department Visits Ambulatory Department Visits Births Life Flight Transfers

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781 (63) 1,167 2,186 10,198 40,612 132,628 827,008 4,078 ­

U M A S S M E M O R I A L H E A LT H C A R E

Partnership with UMass Medical School

UMass Memorial Health Care and its academic partner, the University of Massachusetts Medical School, share the common goal of serving the region through excellence in clinical care, education, research and public service. Through this relationship, our staff teaches tomorrow's physicians, nurses and other health care professionals. The School of Medicine, one of three graduate schools, plays a critical role in training the next generation of physicians for the Commonwealth, and provides continuing education to both primary care physicians and specialists throughout the region. Our staff also participates in research efforts that bring our patients the very latest diagnostic and treatment protocols, and research breakthroughs. The University of Massachusetts Medical School is also comprised of the Graduate School of Nursing, which prepares registered professional and advanced practice nurses for faculty, research and other nursing leadership positions, and the Graduate School of Biomedical Sciences, which trains students in specialty areas in preparation for research with direct relevance to human disease.

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U M A S S M E M O R I A L H E A LT H C A R E

Tackling Hunger

In March of 2008, US Congressman James McGovern, Governor Deval Patrick's administration and dozens of leaders and organizations at state, federal and local levels came together to talk about ways to eliminate hunger in the Commonwealth. More recently, Congressman McGovern asked UMass Memorial Health Care President and CEO John O'Brien to take a lead role in mobilizing hospitals across the state to identify food insecurity as a health issue. As one example, Massachusetts hospitals are now encouraged to screen lower income patients for food insecurity and assist with applications for food stamps and the Women, Infants and Children Nutrition Program (WIC). Currently, UMass Memorial Medical Center helps more than 100 families every month apply for food stamps or WIC. This service is offered both to our hospital patients and the broader community. Across our health care system, we enrolled 1,500 people in SNAP (Supplemental Nutrition Assistance Program) in 2009. UMass Memorial hospitals also encourage local residents to grow their own food. In the Bell Hill neighborhood of Worcester, two gardens are cultivated by neighborhood residents and the produce is donated to elders living in a Bell Hill public housing site. Similarly, Clinton Hospital offers the Community Gardens Programs and awards vegetable gardens to families with limited economic means, assisting them to grow their own food. In addition, the UMass Memorial Medical Center cafeteria prepares 1,000 lunches per month for the local Meals on Wheels program.

Young men from the Worcester Youth Center show the fruits of their labor, all grown in a community garden.

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U M A S S M E M O R I A L H E A LT H C A R E

Assisting the Uninsured

Since the enactment of mandatory health insurance for Massachusetts residents, thousands of patients and community members have navigated the system with the assistance of UMass Memorial Health Care. Our financial counselors work with the uninsured and underinsured at every stage of the application process. They assess policy affordability, gather information for documentation and income verification, and

Connecting with the Community

In FY 2008, UMass Memorial Health Care hospitals assisted more than 15,000 individuals in applying for health insurance and other benefits.

troubleshoot problems to avoid coverage delays. Applicants also learn about the importance of health insurance and other benefits, the role of primary care physicians and appropriate emergency department use. Keys to our success have been a call-in center and community outreach services in neighborhood centers, food pantries, churches and shelters.

UMass Memorial Medical Center . . . . . . . . . . . . .10,500 Clinton Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . .1,212 HealthAlliance Hospital . . . . . . . . . . . . . . . . . . . . .1,580 Marlborough Hospital . . . . . . . . . . . . . . . . . . . . . . . .844 Wing Memorial Hospital and Medical Centers . . . . .355

A 2008 enrollment fair, sponsored by the clinical system, drew more than 300 people in Clinton, Palmer, Marlborough, Leominster and Worcester, where counselors directly assisted 163 new health insurance applicants and completed review forms to retain insurance.

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U M A S S M E M O R I A L H E A LT H C A R E

One young mother reported paying the penalty on her 2007 taxes and came to the fair to understand her eligibility for the complex state benefits and programs. Another man said that until then, he could not afford individual insurance and had not received any medical services in more than 10 years. Our efforts are paying off. Newly insured patients have experienced improved access to care and minimized demand on emergency care resources.

UMass Memorial staff assists the uninsured and underinsured to apply for health coverage and educates them about other benefits.

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UMASS MEMORIAL MEDICAL CENTER

Providing Access to Care

Despite successful implementation of the Massachusetts Health Care Reform Law, access to care is still a problem for many. Since 2000, UMass Memorial Medical Center has addressed this concern by hitting the street with the Ronald McDonald Care Mobile. The Care Mobile brings preventive dental services to 2,600 children under the age of 12 at 14 elementary schools and 10 low-income neighborhoods in Worcester, paying special attention to tooth decay, the most common chronic childhood disease in the United States today. Staffed by a medical director, nurse practitioner, dental director, dental hygienists, phlebotomists and bilingual/bicultural support personnel, the Care Mobile is making a difference. In 2008, staff conducted 8,200 medical and dental visits and 18,299 procedures that were offered to children and families. The Care Mobile team also makes valuable community connections for patients with nonmedical needs. Maria's Story -- On Thanksgiving Eve, a woman without access to health insurance or primary care came to the Care Mobile. Maria was experiencing extreme fatigue and had a dangerous blood sugar level. With help from the staff, she got to the hospital, received medication for her diabetes and secured a follow-up appointment with a primary care doctor for ongoing care. She was also connected to housing, employment, food and English as a Second Language classes, so that within two weeks, Maria had a new job and a belated celebration with a turkey dinner in her own apartment.

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The Care Mobile staff in the local Bell Hill neighborhood.

UMASS MEMORIAL MEDICAL CENTER

Developing Good Habits

Positive youth development efforts are taking place through the HOPE Coalition (Healthy Options for Prevention and Education), a program that encompasses 18 local agencies and 20 teens, to reduce youth violence and substance abuse in Worcester. With UMass Memorial as the lead agency, teens conducted a public health research project to determine the distribution of tobacco vendors and advertising in the city. Using geographic information system mapping technology, peer leaders discovered that displays and advertising were more highly concentrated in low-income, high-minority neighborhoods that had a high percentage of youth under the age of 18. Through HOPE Coalition advocacy efforts, the City of Worcester has committed to rewrite a temporary signage ordinance and reduce community exposure to underage drinking and tobacco advertising by 2010.

"I am impressed by the dedication and commitment of the young people of the HOPE Coalition. They have addressed the tough issues of teen smoking and substance abuse and have taken action with passion. Each week they come together to bring their voice to important concerns we all need to care about for our youth in Worcester." Linda Cavaioli, Executive Director YWCA of Central Massachusetts

HOPE Coalition members rally to increase awareness to change Worcester's signage ordinance regarding the sale of alcohol and tobacco products.

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UMASS MEMORIAL MEDICAL CENTER

Responding to Community Health Concerns

The numbers are alarming. Over the past 20 years, the national obesity rate has doubled among children ages 6 to 11, and tripled among adolescents ages 12 to 19. Yet, one of every three children lives in a family that struggles to put food on the table. Studies show a correlation between obesity and low-income levels as families and individuals select larger quantities of more affordable, high-fat, high-carbohydrate foods in place of more costly, smaller portions of healthy food. Locally, UMass Memorial, in partnership with Common Pathways, a Healthy Communities initiative, identified obesity as a priority issue through a community engagement process. UMass Memorial is responding to this health concern by funding five collaborative partnerships that pair large and small organizations to bring healthy weight and wellness programs to more than 500 vulnerable children and youth ages 3 to 24. The goals include enhanced knowledge of nutrition, development of healthy eating habits and increased physical activity. The outcomes are noteworthy. A collaboration between the YMCA and Emmanuel Baptist Church, for example, motivated 65 young people of color to become physically active through increased participation in YMCA programs. A healthy cooking program in a public housing facility was the result of a partnership between Plumley Village Health Services and Community Builders. And, an eight-week YWCA nutrition program helped Grafton Street School students in grades 3 to 6 add more fresh food and local produce to the school lunch menu and increased access to fitness programs. Other efforts include Great Brook Valley Health Center partnering with the YMCA and a research project that the University of Massachusetts Medical School is developing with the Women, Infants and Children Program.

A youth exercises as part of a YMCA program that addresses healthy weight.

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UMASS MEMORIAL MEDICAL CENTER

Connecting with the Community

UMass Memorial Medical Center provides and funds these Community Benefit Programs for positive youth development: · Hope Coalition, to reduce violence and substance abuse, and to provide access to mental health services · Building Brighter Futures, a job development program · Worcester Youth Summit, an anti-violence prevention program in partnership with the Worcester Police Department · Worcester Youth Center · United Way Youth Leadership Institute · Health Care Career Expo · City of Worcester Youth Opportunities Office · YouthNet · Southeast Asian Center Leadership Program · Safe Products in the Neighborhood · Financial Literacy Program

Building "the" Brighter Future

Keeping a community healthy often means going beyond hospital walls. In 2004, UMass Memorial Medical Center took a leadership role with the United Way of Central Massachusetts and other community stakeholders to build a brighter future for Worcester teens by making job development a priority. The Worcester Youth Employment Initiative, a citywide coalition, successfully leveraged $1.7 million in funding and created nearly 3,000 jobs over three years, and more than 1,800 in 2008 alone. Building Brighter Futures, a job development program at UMass Memorial, provided summer and year-round employment opportunities for 75 inner-city youth. The curriculum included pre-employment training, financial literacy and an orientation to health career opportunities.

Building Brighter Futures participant, Akosua Sakyi, is a student at UMass Amherst.

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UMASS MEMORIAL MEDICAL CENTER

Akosua Sakyi, a sophomore at the University of Massachusetts Amherst, is in her third year with Building Brighter Futures. Her diverse experience at UMass Memorial confirmed her desire to pursue a career in the medical field, while exploring new and exciting opportunities. When asked to describe the experience, she smiled and said, "Life changing. That's the first thing that comes to my mind." In a time when the industry is anticipating a shortage of health care workers, young people like Akosua are bringing new talent, knowledge and spirit to health care in Central New England and beyond.

In 2008, 75 students participated in the UMass Memorial job development program, Building Brighter Futures.

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UMASS MEMORIAL MEDICAL CENTER

Empowering Youth to Succeed

In every community, teens and young adults need a place to go where they can build healthy lifestyles, experience solid relationships with their peers, overcome personal problems and have the support of caring adult mentors. In urban settings, the need for a safe haven and a sense of belonging is even greater. The Worcester Youth Center on Chandler Street is such a place, offering educational, recreational and social opportunities to youth ages 14 to 24. And the center is restoring hope due to significant funding from UMass Memorial Medical Center, which supports two positions and provides on-site medical and dental care. Nearly 98 percent of the center's youth participants live in poverty. Their neighborhoods suffer from crime, a high drop-out rate and inadequate housing. Many come from homes where family members are struggling with drug and alcohol abuse or are serving time in jail. Ten percent do not have a home. With a motto of "Not just a place to go; a place to go farther," Worcester Youth Center is seeing positive and encouraging results. Its services include GED classes and academic enrichment, leadership development, work readiness, performing arts, health and wellness, literacy and recreation programs ­ all directed toward building the confidence and skills needed to be a successful adult. For many, the program also has expanded possibilities beyond what participants ever imagined for themselves, including the chance of attaining a college education. More than 400 inner city youth use the center on a regular basis.

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Worcester Youth Center participants advocating for funding to support Worcester Public Schools.

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UMASS MEMORIAL MEDICAL CENTER

Utilizing Literacy for Better Health

According to a study by the American Medical Association, "Nearly half of the US population has difficulty understanding and using health information due to limited literacy skills." Consequently, a low-literacy level is a known risk factor for poverty and poor health outcomes. In fact, the 2010 Healthy People Report indicates a direct correlation between education, income and health status. Armed with the knowledge that 17.9 percent of the Worcester population lives below the poverty line and 16 percent of students drop out of high school,

Connecting with the Community

UMass Memorial Medical Center provides these Community Benefit Programs for literacy: · Be in Charge of Your Health Program · Family Literacy for Parents · Adolescent Literacy Cooking and Nutrition Program at the Worcester Youth Center · Partner with Worcester ­ A City That Reads · The Big Read · Financial Literacy Program

UMass Memorial conducted three important programs in 2008 that promoted reading and health literacy. Reach Out and Read is a national program in which medical providers counsel parents on the importance of reading aloud with their children. The UMass Memorial Literacy Program engaged more than 100 physicians and served approximately 22,000 children. The Health Literacy Program educates medically underserved individuals to improve their understanding of medical information and how to navigate the US health care system. The program reached 435 medically underserved participants and referred those who were uninsured to the Care Mobile for medical and dental care. In 2008, UMass Memorial was the only hospital to receive a grant from the National Endowment for the Arts to coordinate The Big Read, a national effort to create a nation that reads. Locally, UMass Memorial engaged more than 400 participants from different schools and organizations to read and discuss a community-selected book. A literacy event was held at Betty Price Park in Worcester's Bell Hill neighborhood. Photo provided courtesy of the Telegram & Gazette.

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UMASS MEMORIAL MEDICAL CENTER

Addressing Public Health

For the past five years, UMass Memorial Medical Center has played a critical and necessary role in public health by funding three key positions in the City of Worcester Health Department: two public health nurses and the commissioner of public health. At the Worcester Senior Center, a full-time nurse staffs the clinic and organizes an array of fitness, health education and screening programs, including nutrition, prevention and treatment of disease, stress reduction,

Connecting with the Community

UMass Memorial Medical Center provides Community Benefit Programs for improved access to care, including: · Ronald McDonald Care Mobile · Physical activity and nutrition partnerships to reduce obesity · Oral health services at community health centers · Worcester infant mortality reduction efforts · Medical care for elders at public housing sites · Clinical services at community sites · Lab services at Akwaaba Free Medical Clinic · Plumley Village Health Services · Pharmacy indigent care

podiatry services and aerobics. The nurse also acts as a liaison between elders and their physicians, advocating for services that promote independence. In 2008, 98 programs were offered to more than 2,000 seniors. For elders residing at 14 Worcester Housing Authority sites, accessing health care often involves overcoming barriers such as reliable transportation, isolation, physical limitations, language and safety concerns. A public health nurse visits these sites and provides general wellness checks, consults with doctors and makes referrals as appropriate. In 2008, the nurse made 154 site visits to care for 951 patients, conducted 951 blood pressure screenings and administered 211 flu shots.

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UMASS MEMORIAL MEDICAL CENTER

The commissioner of public health directs the activities of the Worcester Health Department. Responsibilities include preventing and tracking more than 90 reportable infectious and communicable diseases, organizing community-based immunization programs, and working with community stakeholders to address the needs of the city's most vulnerable populations. In addition, the commissioner ensures preparedness for disasters and emergencies. A training program with the Worcester Public Schools, which began in 2008, will yield 700 high school students certified in CPR and automated external defibrillation in 2009.

James Broadhurst, MD, participated in a public immunization event coordinated through the Worcester Public Health Department.

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UMASS MEMORIAL MEDICAL CENTER

Becoming a Good Neighbor

Bell Hill, a low-income neighborhood adjacent to UMass Memorial in Worcester, is becoming a safer and more vibrant place for its 5,000 residents through increased access to medical and dental care, home ownership, improved physical conditions and resident engagement. The neighborhood surrounds Plumley Village, a federally subsidized apartment complex where 83 percent of its 400 residents are Latino and 50 percent are under the age of 18. Bell Hill's two elementary schools encompass more than 900 children.

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UMASS MEMORIAL MEDICAL CENTER

Approximately 65 percent are Latino, African-American and Asian, and more than 80 percent of students qualify for the reduced lunch program. A UMass Memorial outreach liaison works closely with the schools to identify families who need medical and dental services and refers them to the Ronald McDonald Care Mobile. Children receive dental screenings, sealants, cleanings, oral health education and fluoride varnish treatments. In addition, families are connected to health care and other support services. The outreach liaison also organizes crime watch meetings, community gardens and cleanups with neighborhood residents. Abandoned buildings are being transformed into affordable ownership and rental properties through the UMass Memorial Neighborhood Revitalization Initiative, a unique, nontraditional public/private partnership with the East Side Community Development Corporation, NeighborWorks Homeownership Center, Massachusetts Housing Partnership, State Department of Housing and Community Development, and the City of Worcester. First-time homeowners receive financial training and loan assistance. The initiative, which was recognized by Governor Deval Patrick's

Connecting with the Community

UMass Memorial Medical Center provides these Community Benefit Programs for the Bell Hill neighborhood: · Neighborhood revitalization - Bell Hill Healthy Community Initiative - Neighborhood stabilization and housing initiative · English as a Second Language Program at Belmont Street Baptist Church · Four community neighborhood events coordinated with the Worcester Parks and Recreation Department · Three neighborhood beautification cleanup efforts · Health surveys conducted at two schools; 52 families connected to needed services

administration, leveraged $3 million for down payments for 18 first-time homeowners.

This revitalized home was purchased through a first-time home ownership program in the Bell Hill-East Side neighborhood.

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C L I N T O N H O S P I TA L

Feeding the Needy

Clinton Hospital, in collaboration with the Growing Places Garden Project and the town's Parent-Child Home Program, is ensuring that needy families are able to put a healthy meal on their table. Using hospital land, the Community Gardens Program awards vegetable gardens to families with limited economic means and provides assistance so families can grow their own food. They learn how to maintain the garden and gain information on how to grow, harvest, use and store their fresh produce throughout the growing season. At the end of two years, gardeners may continue working on-site or can choose to garden on their own. The program continues to provide newsletters, answer questions and offer extra seeds to help ensure their long-term success. A Clinton Hospital nutritionist also teaches families about the nutritional value of planting and harvesting certain foods as well as preparation and storage. In addition to feeding needy families, the Community Gardens Project offers an opportunity for positive social interaction. Eleven families speaking five different languages participate in the project, resulting in beneficial cross-cultural friendships. In total, 33 gardens fed 40 children and their families in 2008.

The Community Gardens Project, a program supported by Clinton Hospital, has helped dozens of families put healthy meals on their tables.

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C L I N T O N H O S P I TA L

Serving a Senior Population

With an estimated 2,519 elderly residents in the town of Clinton ­ 18.7 percent of its total population -- Clinton Hospital has made considerable progress toward expanding specialized services to this increasingly fragile group.

Clinton Hospital provides these Community Benefit Programs: · Community gardens · Educational programs for seniors on medication and home safety · Health screenings and depression education · Donated space for local support groups · Scholarships for local high school graduates · Asthma Control Program for adults and children · Crisis Intervention Program · Backpack Education Program to prevent physical injuries in school children · Youth Fitness Camp

Connecting with the Community

One such service is a medication safety program provided by the Pharmacy Department at local senior centers. Participants speak with hospital pharmacists and discuss uses, potential interactions and the best time of day to take medications, and learn about the importance of keeping a complete list of current medications and over-the-counter supplements. Seniors receive a pill organizer and wallet-size medication card to maintain their medication history in a convenient and consistent place. Older adults are also concerned about their susceptibility to falls. Each year, thousands fall while at home, causing serious injury or even disability.

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C L I N T O N H O S P I TA L

To address this growing problem, the Rehabilitation Services Department presents a safety program offering tips for preventing falls and making a home safer. Seniors learn about the safe use of walkers and canes and complete a checklist to evaluate their own home safety. In addition, they can participate in exercise demonstrations to increase strength and balance, and take home a list of resources for safety equipment and home improvement. Outreach efforts to seniors in 2008 included community education programs presented by Clinton Hospital staff, including sessions on colon cancer, nutrition, healthy feet, and chronic obstructive pulmonary disease.

Local seniors participated in a memory screening conducted by Clinton Hospital's Geriatric Medical Psychiatry Program.

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H E A LT H A L L I A N C E H O S P I TA L

Teeing Up Scholarships

HealthAlliance Hospital awarded $81,000 to 27 students at its annual Health Care Career Opportunity Fund scholarship reception. Scholarships go to students residing in the HealthAlliance Hospital service area who are accepted to or enrolled in a human studies, health care career certificate or college program. The program is open to recent high school graduates and adults who are continuing their education. A selection committee, made up of members of the HealthAlliance Hospital senior management team, review applications and anonymously evaluate students based on a variety of criteria, including financial need, interest in the medical field, extracurricular and volunteer activities, and an essay about their choice of a health career. One scholarship recipient, a trained EMT and nursing student, wrote: "The close working relationships I forged with the many doctors and nurses I came in contact with as an EMT furthered my passion for the field of medicine. My current roles, past career and education allowed me to be highly involved in my grandfather's hospice care. With the loss of my grandfather came the realization that I had found my niche; my passion for nursing was not just a career choice, but a calling." The $3,000 awards were made possible through proceeds from the HealthAlliance Hospital Golf Classic. Over the past 17 years, the tournament has raised more than $1.2 million for the scholarship program.

Health Care Career Opportunity Fund scholarship recipients attend a reception.

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H E A LT H A L L I A N C E H O S P I TA L

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H E A LT H A L L I A N C E H O S P I TA L

Eliminating Disparities of Care

Expectant mother Lesley Guerra (left), was referred to Montachusett Women's Health on the HealthAlliance Hospital ­ Leominster Campus by Dot Odgren, RN, MSN (center), and Lisa Aubin, CNM.

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H E A LT H A L L I A N C E H O S P I TA L

Connecting with the Community

Linguistically and culturally diverse groups have special needs and concerns that can get lost in translation. Through efforts such as the Maternal Child Health (MCH) Program, HealthAlliance Hospital is transforming into a culturally competent organization that can equally serve all populations with outstanding care. The MCH program was developed for patients who may otherwise experience disparities caused by cultural and linguistic barriers, or who have limited access to resources in their pre- and postnatal periods. During the planning year, the MCH program staff conducted patientcentered focus groups to identify specific needs and expectations, and completed a self-assessment of cultural competencies as a benchmark. To bridge gaps, they created partnerships with physician practices. In 2008, the program developed core training materials for patients and staff, and began recruitment efforts to hire bilingual personnel to support Latino community-based outreach programs. New staff included a social worker to provide pre- and postnatal care, a nurse educator to instruct group pregnancy and specialized teen pregnancy classes, and a nutritionist to counsel high-risk patients and teach group classes. Through the MCH program, HealthAlliance Hospital hopes to facilitate effective communication, promote equal access to care for the most vulnerable populations, facilitate cross-cultural understanding, improve patient outcomes, and enhance patient satisfaction for Latino mothers and their babies.

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HealthAlliance Hospital provides these Community Benefit Programs: · Gateway Health Access Program for care for the uninsured · Maternal Child Health Program to reduce cultural and linguistic barriers · Community wellness programs and health screenings - Flu immunizations - Kid Expo - Senior Wellness Days - Joint Replacement School · Improved emergency behavioral health evaluation and treatment · Social interventions and education services to maintain healthy families · Comprehensive home health services for HIV/AIDS patients · Early intervention partnership for pregnant women · Health Care Career Opportunity Fund scholarships · Rental subsidies on the Burbank Campus

M A R L B O R O U G H H O S P I TA L

Increasing Awareness of Health and Safety

When a review of emergency visits to Marlborough Hospital indicated an increase in preventable injuries in children, physicians and hospital leadership saw an opportunity to educate the public about health and safety. Safe Summer Fun Day, which began as a small program with educational materials and bike helmet fittings, is now entering its 12th year, and has emerged as a signature outdoor event for thousands of local children and families. The day is filled with child-centered activities in an engaging, hands-on environment. The cornerstone of the event is a bike helmet giveaway, coordinated by trained hospital staff. To date, an estimated 3,000 helmets have been fitted and distributed. Hospital departments and community groups join together to teach families important messages about health and safety. Topics include what to expect when visiting the emergency room, the importance of sunscreen and seat belts, healthy eating, stranger danger, self defense, spinal checks, exercise and more.

Bike helmet fittings are an annual attraction at Safe Summer Fun Day.

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M A R L B O R O U G H H O S P I TA L

This year's event also included an obstacle course, face painting, balloons and doctor dress-up. UMass Memorial Health Care participated through the Ronald McDonald Care Mobile, Mobile Safety Street and the Life Flight air ambulance. The success of the event is made possible through the support of community partners: the Marlborough Police and Fire Departments, Marlborough Recycling Committee, MetroWest Animal Awareness and Marlborough Public Schools.

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M A R L B O R O U G H H O S P I TA L

Tuning in to the Community

Marlborough area residents can learn how to stay healthy from the comfort of their own homes thanks to Marlborough Hospital's cable television show, "To Your Health," hosted by Chief Operating Officer Candra Szymanski, RN.

Craig Lilly, MD, director of the eICU program at UMass Memorial Medical Center, appeared on "To Your Health" with Marlborough Hospital's Chief Operating Officer Candra Szymanski, RN.

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M A R L B O R O U G H H O S P I TA L

Connecting with the Community

Marlborough Hospital provides these Community Benefit Programs:

The 30-minute health information program covers a wide range of topics including sports injuries, diabetes, skin cancer, congestive heart failure, prostate disease and more. A new subject is explored each month, and timely topics are often introduced into the production schedule to keep community members informed. The show airs in several time slots each week and enjoys a loyal following. Guests have included UMass Memorial Health Care administrators, clinicians and regional medical experts. Over the course of an eight-year run, special editions explored new legislation, such as Commonwealth insurance programs and laws surrounding ambulance diversions, and provided information about an antibioticresistant staph infection following an increased regional reporting of the disease. "To Your Health" is produced by WMCT-TV Marlborough local access and serves the towns of Marlborough, Hudson,

· Safe Summer Fun Day to promote bike safety and wellness · "To Your Health," a Marlborough public access television program · Community wellness programs and health screenings - Senior health fairs - Stroke education - Flu immunizations · Support of the Young Adult Initiative Board for success in the labor market · Assistance at walk-in medical programs at area churches · Healthy lifestyle information for the teen population · Community newsletter Be Well

Northborough, Southborough and Shrewsbury, a region encompassing 115,000 residents.

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W I N G M E M O R I A L H O S P I TA L A N D M E D I C A L C E N T E R S

Improving the Health of Belchertown Residents

Wing Memorial Hospital and Medical Centers has a rich history of caring for residents of the Quaboag Hills and Pioneer Valley. When funding for a part-time public health nurse in Belchertown ended in 2005, the local director of public health reached out to area agencies

"By funding Belchertown's public health nurse, Wing Memorial is providing a much-needed service to the town's 13,000 residents. This is a responsibility we take very seriously." Charles Cavagnaro III, MD, President and CEO Wing Memorial Hospital and Medical Centers

for support. Wing Memorial stepped in to retain this valuable resource for the town's residents, and has continued to fund the position for the past four years. Margarita Canuel, RN, who took on the role of public health nurse at that time, continues to serve the health care needs of the town to this day. Her primary responsibilities focus on the case management and education of individuals with communicable diseases, community education about disease prevention and health promotion, and immunization programs.

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W I N G M E M O R I A L H O S P I TA L A N D M E D I C A L C E N T E R S

In FY 2008, Ms. Canuel conducted follow ups with patients treated for Lyme disease, hepatitis C, HIV and pertussis. In addition, she coordinated community education events for children in the town school system and for seniors at the Belchertown Senior Center.

Margarita Canuel, RN, (left) understands the importance of vaccination for health care clinicians and received a flu shot from Trish Young, RN, nurse manager of Wing Medical Center.

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W I N G M E M O R I A L H O S P I TA L A N D M E D I C A L C E N T E R S

Training Future Health Care Professionals

As the health care industry continues to grow, Wing Memorial Hospital and Medical Centers maintains a commitment to developing tomorrow's health care professionals through collaborations with local school districts and area colleges. The goal is to encourage interest in health careers at the high school level and mentor college students as they progress through clinical rotations in their chosen fields. The hospital's education and outreach efforts extended to high school students in Belchertown, Ludlow, Monson, Palmer and Wilbraham. Wing

Rock Jean-Guillaume, MD, (second from left) medical director of Wing Memorial's Emergency Department, instructs high school students on emergency room procedures during a health care career fair.

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W I N G M E M O R I A L H O S P I TA L A N D M E D I C A L C E N T E R S

Connecting with the Community

Wing Memorial Hospital and Medical Centers provides these Community Benefit Programs: · Funding for the Belchertown public health nurse

Memorial offered school-to-career initiatives including Career Day presentations and demonstrations, and job shadowing in several hospital departments. In addition, students of Pathfinder Vocational Regional High School in Palmer completed clinical rotations in 13 departments at Wing Memorial. In 2008, college students received hands-on experience in nutrition, counseling, phlebotomy, nursing, medical and physician assistance, and physical therapy. Our collaborators covered a broad regional area extending west to Springfield College, Springfield Technical Community College and Elms College; north to the University of Massachusetts, Holyoke Community

· Educational collaborations to encourage health care careers and train workers · Funding for the Palmer Senior Center nurse · Monthly clinician visits to area senior centers - Health screenings and falls assessments - Flu immunizations - Community wellness programs · Behavioral health and substance abuse programs · Health fairs and community outreach

College and American International College; east to the Quaboag Valley Visiting Nurses Association and Massachusetts College of Pharmacy; and the far northeast to Antioch College and the University of New Hampshire.

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UMass Memorial Health Care is the largest not-for-profit health care system in Central Massachusetts with 1,500 physicians and more than 12,000 employees. Our comprehensive network of care includes teaching hospitals, affiliated community hospitals, outpatient clinics, community-based physician practices, and home health, hospice, rehabilitation and mental health services. UMass Memorial is dedicated to promoting health and wellness in the community, and is proud to be the clinical partner of the University of Massachusetts Medical School.

Biotech One 365 Plantation Street Worcester, MA 01605 Tel: 508-334-1000 www.umassmemorial.org

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