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COMMUNITYHEALTHIMPROVEMENT REPORTFor thefiscal year ending:JUNE 302016

PALOMAR HEALTHCOMMUNITY HEALTHIMPROVEMENT REPORTFY2016Community Health Improvement Report FY20162Whether an emergencyroom visit, a health class,or an outpatient surgery,Palomar Health is committedto enhancing access to care andimproving our community’s health.As a public health district, Palomar Healthreceived 15 million from property taxes infiscal year 2016 (FY16), while devoting morethan 120 million to the community throughcommunity health improvement programs andservices. Community health improvement projects include: Programs and activities that respond to identifiedcommunity needs Health education and training programs Unreimbursed medical care servicesOURMISSION:To heal, comfort andpromote health in thecommunities we serve.Palomar Health collaborates with other health systems, governmentagencies, and community groups to identify the greatest health needs inthe region. Based upon the 2016 Community Health Needs Assessment(CHNA), the top health needs in San Diego County are cardiovascular disease,diabetes (Type 2), behavioral health, and obesity. In addition, the CHNA identifiedthe region’s most prevalent social determinants of health, which included: foodinsecurity/access to healthy food, access to care, housing issues and physical activity.Although numbers never tell the whole story, Palomar Health reports community healthimprovement activities as a way to be accountable to the communities we serve. This reportoffers a snapshot of some of the community health improvement programs offered by PalomarHealth in FY16.

e sAsk-A-Nurseblood pressurescreeningsflu shots inthe communitysupport groupmeetings3Community Health Improvement Report FY20162015-16 PALOMAR HEALTH QUICK FACTS

Protecting School Kids& Parents from the FluTakingServicesto theCommunityCommunity Health Improvement Report FY20164Palomar Health’s missionextends beyond the wallsof our hospitals by takinghealth services to thecommunity. Programs suchas free blood pressurescreenings, Ask-A-Nurseforums, health educationclasses and influenzavaccination clinics are justsome of the ways PalomarHealth promotes health inthe community.Imagine 3,307 sleeves rolled upwith arms waiting for flu shots.Luanne Arangio-Law RN doesn’thave to imagine — she and herteam administered all thosevaccinations during the 20152016 flu season at clinics hostedby Palomar Health.needy families last night.It is very much appreciated by alland a great public service to ourcommunity. Your dedication tothese flu shot clinics over the pastfour years has been instrumentalin helping our students maintainbetter school attendance.”The flu shots were given to adultsand children all over San DiegoCounty’s North Inland region —during a season that saw morethan 6,000 cases of influenzathroughout the county.“We have numerous peopletell us about their positiveexperiences in our hospitalsystem, share their health needsand express heartfelt thanks forthe protection against influenza,”said Arangio-Law. “We havepeople who come back to theclinics time and again, waitingpatiently for the date when wearrive at their favorite location.”Beyond protecting our communityfrom influenza, one of the benefitsof the flu shot is keeping childrenin the classroom rather than homein bed with the flu.In a note, Olivia Leschick,Administrator of Special Projectsat the Valley Center-PaumaUnified School District, expressedher gratitude for a flu shot clinicheld at one of their schools:“I cannot overstate how gratefulwe are for your service and thatof the Palomar Health staff thatprovided the flu shots to our

Helping PatientsFocus onHealingAccess to health careremains a seriousproblem for some inour community. PalomarHealth’s goal is to ensurethat everyone receivesmedical help, regardlessof their ability to pay.The organization offersfinancial assistanceprograms for thosewho are uninsured,underinsured, ineligiblefor a governmentprogram or otherwiseunable to pay formedically necessary care.Palomar Health providesuncompensated care forpatients unable to payfor services and absorbsthe unreimbursed costsof public programs suchas Medi-Cal, Medicare,Tri-Care, San DiegoCounty Indigent MedicalServices (CMS) and theLow Income HealthProgram (LIHP).Community Health Improvement Report FY20165Peace of MindSleepless nights and stress often give way to tearsof joy when Cynthia Burns and her team in financialservices visit a patient’s room to help them addresstheir hospital bills.That’s what happened recently when “Letitia,”a 40-year old Palomar Medical Center Escondidopatient learned that she and her husband wouldlikely qualify for Palomar Health’s charity program.“I offered charity because I could see on bothof their faces that they were stressed aboutmore bills coming in,” said Patient FinancialRepresentative Ruby Martinez. “After I explainedthat they might qualify for charity, you should haveseen their faces.”“It goes back to our mission statement—the need to heal, provide comfort, andpromote health in the communities we serve,”said Burns. “It is a charitable contributionthat shows on our financials.”Director of Patient Access Cynthia Burns, overseesthe charity care program, which forgives the patient’sentire hospital bill—in Letitia’s case, a five-day stay.And taking away the stress of a hospital bill allowsthe patient to focus on both the emotional andphysical parts of healing.“It’s just the biggest relief to the patient,” saidBurns. “It takes the stress away immediately. “Families who have been beneficiaries of the charityoften come back to visit and express their heartfeltgratitude—as Elizabeth and Tony Vukovics recentlydid on behalf of Elizabeth’s mother, whose hospitalbill was forgiven under the program.Letitia and her husband felt an obligation to paytheir entire hospital bill, but doing so would havebeen a huge financial burden and would have takenmany years to pay off—so the charity applicationmade the most sense and helps Palomar Healthfulfill the hospital’s role in the community.Through tears of joy, Elizabeth thanked the PatientAccess Team for helping her family become physicallyand financially whole again.

Palomar HealthPathmakers in FY16 More than 850Pathmakers More than 140,000internship hours Students from 34high schools & 23collegesJeff Bethune, RNFormer PathmakerCommunity Health Improvement Report FY20166EmpoweringTomorrow’sWorkforceThe demand for healthcareworkers continues to rise.To support the workforce oftomorrow, Palomar Healthprovides educational programsand opportunities today.Palomar Health collaborateswith local high schools,colleges and universitiesto help students explorehealthcare careers throughthe Pathmaker internshipprogram. In hospital settings,students have the opportunityto gain hands-on experience inhealthcare under the guidanceof Palomar Health staff.When Jeff Bethune worked asa salesman at Guitar Center inSan Marcos in 2010, he wouldlook across the freeway andwatch them build the brandnew Palomar Medical CenterEscondido – and dream thatsomeday he would work thereas a nurse.His dream came true in 2017when he was hired as anemergency department (ED)nurse at the hospital.— “you never know who is goingto come through the door at thestore or the hospital but you havethe opportunity to build rapportwith every one of them.”The Pathmaker Internship Programat Palomar Health has helpedlaunch the healthcare careers ofmany participants—from ages 16to as old as 57.“Jeff took this opportunity veryseriously and wasted no timelearning new skills, experiencingPalomar Health’s Pathmakernew departments, and meetingInternship Program helped create new healthcare professionalsJeff’s path to the ED, allowingevery chance he got,” saidhim to attend nursing schoolChristi Perdomo, manager of theand intern at Palomar MedicalPathmaker Internship Program.Center Escondido and the“As a result, he found his niche,Downtown Campus.which is my goal for each intern:figure out what you love to do,“Pathmakers was an invaluableand then go do it. If I was a patientexperience,” Jeff said. ”Andat Palomar Health and Jeff walkedafter I got in the ED, I felt likeinto my room as my nurse, I wouldI belonged.” He adds thatknow I was in the best handshis new colleagues in the EDpossible, because he loves whatare great teachers as well ashe does.”supportive colleagues.Jeff may have taken a longerJeff says his experiences as apathway than some, but his prideguitar salesman were easilytransferable to patients in the ED is evident when he looks at hisbadge that says: Jeff Bethune, RN.

Forensic Health Services’Investigative RolePalomar Health plays a vital rolein the community as one of twoSexual Assault Response Teams(SART) in San Diego County.The Forensic Health Services(FHS) team conducts examinationsin sexual assault cases that arepart of law enforcement’s caseagainst perpetrators.San Diego County receivedfunding from the Governor’s Officeof Emergency Services to create acoordinated community responseon handling non-fatal strangulationcases—which show a much greaterlikelihood of leading to homicide.“Palomar Health was invited to joinour San Diego community partnersto identify gaps in the capacityand accessibility for adult andteen strangulation, and domesticviolence victims to receive forensic7medical examinations,”said Michelle Shores,program manager of FHS.“We discovered that theseexams do not exist.”FHS has capacity to perform130 forensic exams for domesticviolence and strangulation,according to Shores. “There will beno cost to the victims and we havethe equipment,” she said.“We’re excited to have ForensicHealth Services as a part of thispilot program,” said EscondidoChief of Police, Craig Carter. Theiroverall level of cooperation hasbeen outstanding. This program isneeded because a victim of a nearstrangulation is hundreds of timesmore likely to become the victimof a homicide in the future.”Community Health Improvement Report FY2016And now, FHS has a newcountywide role in theinvestigation of non-fatalstrangulation cases and otherforms of domestic violence.Trained forensic nurse examinersare now performing medical examsto document injuries sustainedduring domestic violence assaults,including strangulation.In honor of Sexual AssaultResponse and Child AbuseAwareness Month, PalomarHealth displays pinwheels,each representing apatient cared for by theFHS team last year.