ARIA HEALTH 15 Community Health Needs Assessment (CHNA) Aria Health’S Commitment to Community Health

20 ARIA HEALTH 15 Community Health Needs Assessment (CHNA) Aria Health’s Commitment to Community Health

At the turn of the 20th Century, Philadelphia, like many major cities in the United States, was experiencing a severe typhoid epidemic. At that time, Dr. Joseph Ball, a family physician in Northeast Philadelphia, became frustrated that the larger hospitals in Center City, Philadelphia could not admit his patients due to overcrowding. As a result, Dr. Ball, along with fellow community physicians, founded Aria Health as Frankford Hospital in 1903. The community hospital’s founding mission was to provide convenient, high-quality medical care to the immediate neighbors, so that all would have access to care. More than 112 years later, Aria Health continues to exemplify this mission as it remains the only local hospital to serve the Frankford area community.

Through the decades that followed, Aria grew rapidly. Today, the community healthcare system has three acute care hospitals, numerous outpatient centers, and an expansive network of primary care physicians and medical specialists that provide care to a population of more than 1 million in Northeast Philadelphia and Bucks County. Aria’s broad geographic reach has helped it become the largest healthcare provider and one of the largest employers in its service area.

Dr. Ball’s vision has remained Aria’s guiding principle. Aria is committed to improving the health of its surrounding communities, extending beyond the hospital to promote healthy lifestyles, provide preventive care services, and engage people in communities where they live. Aria’s Community Health Needs Assessment (CHNA) has been the foundation upon which we have worked to meet the healthcare needs of our communities, both within and outside of the hospital. Process and Methods

In order to effectively care for a community, it is necessary to understand the health conditions, behaviors, and needs of the individuals who live there. This is achieved through the Community The purpose of the Health Needs Assessment (CHNA) process, which includes defining the community, analyzing Community Health Needs primary and secondary data related to the community’s health status and health needs, Assessment (CHNA) is identifying the greatest needs, and designing a plan to meet those needs. threefold:

Data Sources, Methods, and Prioritization 1. Identify common health conditions and concerns Aria obtained primary and secondary data from multiple sources. Primary data was collected that are affecting the through interviews with leaders of community-based organizations who represent the needs of members of the community. the community, local public health officials, and through health-related surveys of community 2. Identify barriers faced by residents. members of the community Secondary data was obtained from the Public Health Management Corporation’s (PHMC) that impact their ability to Southeastern Pennsylvania Household Health Survey; Pennsylvania Department of Health, maintain good health and Division of Health Informatics; Healthy Communities Institute (HCI); National Cancer Institute well-being. (NCI); and the American Community Survey (ACS). 3. Engage healthcare providers The data obtained was analyzed by region and compared to county, state and national level and community members in joint efforts to improve the indicators and Healthy People 2020 objectives (where available). Data was also analyzed health of the community. using the Healthy Communities Institute’s Data Scoring Tool, which ranks indicators based on systematic comparison that assigns the community a score based on comparison to other communities, health targets, and trends over time. Socioeconomic impact and disparities Through initiatives following Aria’s previous between groups (such as age, gender, or race) are also accounted for in the HCI SocioNeeds CHNA, the hospital was able to reach hundreds Index which ranks areas based on socioeconmic variables that are known to result in poor health of community members with programs targeting outcomes. Type 2 diabetes, obesity, smoking cessation, general health management, and programs Prioritization of health needs was based on the community’s health status and behaviors, specific to the health of older adults. Feedback disparities among groups, root causes of conditions, common themes stemming from key from initiative participants, as well as knowledge informant interviews, potential to improve health status, and resources and expertise to address and biometric assessments, showed positive the need. The findings of the assessment are then used to set goals for community health impacts of these programs on health and improvement and to develop strategic initiatives to achieve those goals. well-being. The Aria Community

Aria serves a diverse population, with a service area that stretches from Kensington and Port Richmond to the south, through Northeast Philadelphia, and into Lower Bucks County. Aria’s catchment can be grouped based on geographic, demographic, and other factors into roughly five regions (as indicated in the map below).

Lower Bucks County (West) Northeast Philadelphia Feasterville-Trevose (19053) Burholme/Fox Chase (19111) Newtown (18940) Bustleton (19115) Richboro (18954) Holmesburg (19136) Southampton (18966) Mayfair (19149) Warminster (18974) Rhawnhurst (19152) Somerton (19116) Lower Bucks County (East) Fairless Hills (19030) Lower Northeast Philadelphia Langhorne (19047) Bridesburg (19137) Levittown(19054-19057) Frankford (19124) Morrisville (19067) Hunting Park (19140) Kensington (19125) Lower Bucks County (South) Olney (19120) & Far Northeast Philadelphia Port Richmond (19134) Bensalem (19020) Tacony (19135) Bristol (19007) Byberry (19154) Croydon (19021) Torresdale (19114) Aria’s service area currently includes over 1.04 million residents and is expected to grow, especially in Lower Northeast Philadelphia. The population that Aria serves is very diverse in terms of age, race, education, and income. Socioeconomic status (SES) is variable across the service area as well. The HCI SocioNeeds Index was used to rank areas based on socioeconomic variables that relate to poor health outcomes. Index values within the service area range from 1 (low need) to 5 (highest need), and can be seen in the map below.

Minority Poverty Poverty Age 65+ No HS diploma Unemployed

Lower Bucks County (West) 8.8% 4% 5.1% 5.6% 8.1%

Lower Bucks County (East) 13.9% 5.7% 5.4% 6.9% 8.2%

Lower Bucks County (South) 21.5% 8.3% 7.4% 11.1% 10.4% & Far Northeast Philadelphia

Northeast Philadelphia 37.5% 16.4% 15% 16.1% 14.1%

Lower Northeast Philadelphia 64.1% 34.7% 19.8% 28.7% 21.6%

Population Distribution by Region 30%

20%

10%

Lower Bucks Lower Bucks Lower Bucks Northeast Lower (West) (East) (South)/Far Philadelphia Northeast Northeast Philadelphia

>15 15-17 18-34 35-54 55-64 65+

Areas with high poverty, low employment, and low educational attainment suffer from greater health needs and disparities. Sub-populations within the service area also experience different health needs. Many racial and ethnic minorities are known to experience increased risk factors and greater health disparities. Older adults (ages 65+) also have different health needs that put them at a disadvantage for maintaining good health, including higher incidence of disease and decreased physical ability. Community Health Status There are a number of factors that contribute to overall health of an individual and of a community. These include health conditions and diseases, health behaviors, and healthcare access and utilization. Health Conditions & Disease Prevalence Among the leading causes of death in Philadelphia and Bucks Counties are heart disease, cancer, stroke, lower respiratory disease, and diabetes. These most prevalent conditions are often interrelated and share common causes and treatments.

Leading Causes of Death in Philadelphia & Bucks Counties

Philadelphia Rate* Heart Disease 219.9 Cancers 209.2 Accidents 49.4 Stroke 45.4 Chronic Lower Respiratory Disease 38.5 Diabetes 23.6 Septicemia 22.7 Bucks County Rate* Cancers 165.7 Heart Disease 140.7 Accidents 39.1 Stroke 35.8 Chronic Lower Respiratory Disease 35.3 Alzheimer’s Disease 15.9 Diabetes 15.6 * Rate per 100,000 population Obesity, Diabetes, Hypertension & Related Conditions

Obesity Obesity is one measure of overall health and lifestyle of a community. In addition to the risk of developing many chronic conditions and poor quality of life, obesity has an economic impact due to increase in healthcare costs and days of work lost due to illness. Obesity and related conditions, diabetes, hypertension, heart disease, and stroke, are very prevalent in Aria’s service area. Obesity is a risk factor for all of these conditions and can cause further complications in people who have them. The obesity rate of adults continues to grow. In Philadelphia, 30% of adults, 19% of children (grades K-6) and 20% of teens (grades 7-12) are obese. In Obese Overweight Bucks County, these rates are 25%, 14% and 14%, respectively. Children and adolescents who are overweight or obese are more likely to become obese Aria’s Service Area adults and have increased risk factors for chronic health conditions. Adults 33% 35% Numerous health and lifestyle factors contribute to obesity. Two of the Children (Grades K-6) 35% 23% largest contributors are nutrition and activity. In Aria’s service area: Teens (Grades 7-12) 19% 16% • 81% of adults eat less than the recommended servings of fruits and vegetables daily Philadelphia Adults 30% 34% • 40% of adults do not monitor their sodium intake and 28% rarely or Children (Grades K-6) 19% 11% never purchase foods labeled as low-salt or low-sodium Teens (Grades 7-12) 20% 8% • Nearly 37% of adults have eaten fast food at least one time in the past week, 6% have eaten fast food three or more times. Bucks County Adults 25% 38% • One third of adults drink sweetened beverages at least once a day. About half drink multiple sweetened beverages per day. Children (Grades K-6) 14% 16% Teens (Grades 7-12) 14% 17% • Between one quarter and one third of adults do not engage in any physical activity or are physically active less than once per week. Diabetes Diabetes is estimated to affect 25 million people in the U.S., many of who are undiagnosed. Diabetes can lead to complications in most of the organs in the body. People with diabetes are at higher risk for heart disease, neuropathy, and stroke. Diabetes is also a major cause of end-stage renal disease, amputation, and of blindness. The rate of Type 2 diabetes in children has been rising over the past two decades. In the service area, 16% of adults have been diagnosed with diabetes. These are higher than the rates in both Philadelphia and Bucks Counties (12% and 8% respectively). In Philadelphia the percentage of children with diabetes has remained fairly steady; however, the percentage of children with Type 2 diabetes in Bucks County has declined drastically in the past five years. Much like obesity, Type 2 diabetes can be prevented or controlled with nutrition and physical activity. Both nutrition and physical activity can lower blood sugars, which reduces the risk of complications like heart disease and stroke, among others. Hypertension Hypertension is a major cause of heart attack and stroke, but often does not cause any symptoms in people affected by it. Approximately 35% of adults in Aria’s service area have been diagnosed with high blood pressure or hypertension; 60% of the older adult population has been diagnosed with hypertension. Regular blood pressure measurement and control of high blood pressure are important. In Aria’s service area, approximately 90% of adults have had their blood pressure measured in the past year. The majority of people with hypertension have been prescribed medications to lower their blood pressure; however, 12.5% of people are not compliant with taking their medication as prescribed. Like obesity and diabetes, hypertension can be managed through diet and lifestyle. Diet is a large component in reducing hypertension and controlling blood pressure. A low percentage of people in Aria’s service area monitor their sodium intake or purchase low-sodium foods. When asked about their opinion of how harmful eating too much sodium/salt is, one quarter of people in Aria’s service area answered “not at all” or “a little”. However, older adults show more concern for sodium consumption and its health effects. Heart Disease and Stroke Cardiovascular diseases, including heart disease and stroke, are a major cause of death and disability locally and nationally. There are many factors that contribute to cardiovascular disease including genetics and family history; however, there are numerous controllable factors that increase risk of heart disease. These include smoking, obesity, physical activity, and diet. Controlling blood pressure and cholesterol are important strategies for preventing heart disease and stroke. In Philadelphia and Bucks Counties, 14% of adults have coronary heart disease, or have had a heart attack or stroke. In Philadelphia, 49% of the Medicare population 65 years or older has high cholesterol, 64% have hypertension. In Bucks County, 55% have high cholesterol, 61% have hypertension. The rate of hypertension in Aria’s service area population age 65 years or older is consistent with the county rates. Both of these risk factors for heart attack and stroke can be controlled through physical activity, diet, and medication, if necessary. Smoking Smoking is a major contributor to lung cancer and to chronic lower respiratory diseases (such as COPD and emphysema), as well as to hypertension and stroke. It is estimated that smoking contributes to one out of every five deaths in the U.S. and can be attributed to 9 out of every 10 lung cancer deaths, and 8 out of every 10 chronic lower respiratory disease deaths. Lung cancer deaths in Philadelphia are more than 25% higher than the U.S. rate.

In Aria’s service area, 47% of adults have a history of smoking, and many still do smoke. A majority of smokers have attempted to quit smoking in the past year. The most common quit method used was to go “cold turkey”; however, the American Cancer Society estimates that only 4-7% of people are able to quit smoking on any given attempt without some type of medication or other support.

Smoking causes:

• 9 out of every 10 lung cancer deaths • 8 out of every 10 chronic lower respiratory disease deaths • 2-4 times greater risk of coronary heart disease • 2-4 times greater risk of stroke • Diminished overall health • Increased healthcare cost and utilization The most common methods attempted to quit smoking were:

“Cold turkey” 44.5% Nicotine replacement products 34.4% Switching to electronic cigarettes 8.6% Cancers & Health Screenings Routine health screenings can greatly increase early cancer detection and successful treatment. Compared to the Southeastern Pennsylvania (SEPA) region adults in Aria’s service area are less likely to receive preventive screenings.

Breast Cancer is the second leading cause of all cancer-related deaths in the U.S. In Bucks County, the incidence rate of breast cancer is higher than the Philadelphia, Pennsylvania, or U.S. rates. The number of deaths due to breast cancer in Bucks and Philadelphia counties are both higher than the state or national rates. Mammography screening for breast cancer can reduce the rate of death from breast cancer by 20%. The American Cancer Society recommends that women ages 40 and over receive a mammogram annually. In Aria’s service area, more than 40% of women ages 40 or over have not had a mammogram in the past year.

Cervical Cancer will be diagnosed in one out of every 145 women in the U.S. In Philadelphia, the incidence of cervical cancer and the number of deaths from cervical cancer are 50% higher than the state rates. A major cause of cervical cancer is the human papilloma virus (HPV). The use of pap tests to detect HPV has led to a decrease in cervical cancer deaths. However, in Aria’s service area, only 77% of women have had a pap test in the last three years.

Cancer Incidence and Mortality Rates (per 100,000) Healthy People Philadelphia Bucks County Pennsylvania United States 2020 Goal All Cancers Incidence 541.6 504.3 494.8 459.8 Death Rate 218.4 169.4 182.0 173.8 161.4 Breast Cancer (female) Incidence 128.9 131.0 126.8 122.7 Death Rate 29.2 24.2 23.5 22.2 20.7 Cervical Cancer (female) Incidence 12.5 6.6 7.9 7.8 Death Rate 3.3 1.8 2.1 2.3 2.2 Colorectal Cancer Incidence 52.5 42.2 46.9 43.3 Death Rate 21.1 14.5 17.2 15.9 14.5 Lung Cancer Incidence 83.9 65.5 68.3 64.9 Death Rate 60.7 45.2 45.9 48.4 45.5 Prostate Cancer (male) Incidence 190.5 157.9 145.9 142.3 Death Rate 33.7 19.4 22.0 22.3 21.8 Colorectal Cancer is the third most common cause of cancer-related death. In Philadelphia, the death rate from colorectal cancer is 1 1/3 times the national rate. With regular screenings, the number of deaths from colorectal cancer could be reduced by 60%. Screenings are recommended for men and women over the age of 50. In Aria’s service area, 29% of adults over the age of 50 have never received a colorectal screening.

Prostate Cancer is the most commonly diagnosed cancer in men, and the second most common cause of cancer-related death. In both Philadelphia and Bucks Counties the incidence of prostate cancer is significantly higher than in the state or nationally. The death rate from prostate cancer in Philadelphia is 50% higher than the national rate.

A survey of adults in Aria’s service area shows that approximately 20% were not aware that under healthcare reform their insurance company is required to offer certain health screenings at no cost to their members. People who were unaware were half as likely as those who were aware to have had any of those screenings within the past year.

Access to Care With the recent expansion of Medicaid/Medical Assistance in Pennsylvania, more low-income people have insurance coverage than previously. However, access to care is still a significant challenge for many people, as noted in many key informant interviews. The major access to care issues involve insurance – obtaining insurance, navigating the system, and finding Service providers. In Aria’s service area, 15% of adults have Medicaid/Medical Assistance. Range Area However, individuals are having difficulty finding healthcare providers who Insured with accept Medicaid and have to travel long distances to get care. The service area Medicaid/Medical Assistance 15% 7%-29% with the largest Medicaid/Medical Assistance population also has the highest Medicare Part A 31% 26%-34% percentage of adults who had to skip or cancel Medicare Part A & B 31% 25%-36% appointments because of transportation Looked for insurance in the Marketplace issues. and found it very difficult to find insurance Many people are not aware Understanding health insurance coverage plans with... that their insurance is 45% 38%-58% is also a barrier to seeking care. The … Affordable deductibles and copays 37% 29%-50% required to provide them with availability of health insurance plans … Affordable monthly premiums certain preventive health through the Federally-funded Health Did not seek needed care because of cost 11% 7%-15% screenings at no cost to them, Insurance Marketplace has also increased including annual physical access to health insurance access for many people. However, many people found it difficult to find plans that exams, mammograms, and had an affordable monthly premium, or that they could afford to use because of high deductibles or copays. colonoscopies. Within the past year, more than 11% of people in Aria’s service area did not seek care when they were sick or injured because they could not afford it. The frequency of these issues correlate with overall socioeconomic status and higher socioeconomic need scores, where areas with lower SES and higher need experience more barriers. Older Adults

Older adults have a number of health concerns that differ from the younger adult population. Many of the difficulties that older adults experience are related to cost and access to care. It was noted in a number of key informant interviews that access to programs to assist the elderly is often limited due to financial affordability, capacity of current programs, and availability of support. Older adults have unique health concerns, such as high risk of falls, and are also disproportionately affected by chronic health conditions, such as diabetes, heart disease, and stroke.

Community Input

Members of the community were asked to provide their insight into the health issues affecting the people living in Aria’s service area. These included members of the health departments, physicians, insurers, and community service organizations (Appendix A). Major themes that arose during these discussions parallel the data findings, including:

• Obesity, diabetes, and hypertension • Financial cost • Smoking cessation • Knowledge and understanding of health insurance • Health services for older adults • Ability to find and/or travel to provider locations

Prioritization Needs were prioritized across the service area and accounted for level of need, barriers to care including known disparities and SES, resources available in the community (Appendix B), and the expertise and resources that Aria can provide. The following are the highest priority needs in Aria’s service area:

• Nutrition education and counseling • Diabetes management • Smoking cessation (including general nutrition, obesity, • Preventive screenings • Older adult needs hypertension, and eating behaviors) Healthy People Priority Area Service Area Philadelphia Bucks Rank* 2020 Obesity & Related Conditions Adult obesity 33.3% 30% 25% 30.5% Adolescent obesity 34.9% 20.1% 14.4% 16.1% 1 Child obesity 19.2% 18.7% 14.0% 15.7% Adults with diabetes 15.6% 12% 8% - Adults with hypertension 35.1% - - 26.9% 2 Compliance with medication for hypertension 87.5% - - 69.5% 3 Nutrition & Physical Activity Currently watching or reducing sodium intake 59.6% - - - Always or often purchase low-sodium foods 39.6% - - - Agree that too much sodium is harmful 75.2% - - - 1 Adults eating 4+ servings of fruits/vegetables 18.8% - - - Children eating 4+ servings of fruits/vegetables 26.1% - - - Sweetened beverage consumption (1+ per day) 33.3% - - -

Adults - no physical activity 32.4% 27% 22% 32.6% 2 Older adults - no physical activity 17.8% 3 Smoking Adults who currently smoke 20.2% 23% 16% 12% 1 Adults who have attempted to quit smoking 64.1% - - 80%

Preventive Screening

Mammography 71.6% - - 81.1% Pap test 76.7% 81.1% 72.6% 93% 2 Colorectal cancer screening 67.7% - - 70.5% Access to Care

Did not seek care because of the cost 11.1% 16% 8% 2 Next Steps Through the CHNA process, Aria has identified a number of health needs in the community. High rates of obesity, diabetes and hypertension, poor nutrition, and low exercise are prevalent, along with access to care issues, and high-risk behaviors such as smoking. Aria also serves a number of disadvantaged communities that are disproportionately affected by these issues.

The highest priority needs include nutrition education, chronic disease management, smoking cessation, and the health needs of older adults. Based on these findings, Aria will develop a plan to address these priorities over the next three years, including programs to specially target high-risk populations. Addressing these concerns can greatly improve the health of the whole community.

Aria Health welcomes your input on this assessment and the healh of our community. To share your comments, please email [email protected]. Appendix A – Key Informant Interviews & Secondary Data Sources Key Informant Interviews

Organization Area of Expertise Identified Health Needs • Obesity and behavior-based inhibitors Public Health Department; Expertise in health needs of • Knowledge of Medicaid resources Bucks County Health Department Bucks County residents and health resources in Bucks • Patient follow up County • STDs and sex behaviors • Access to care Public Health Department: Expertise in the health • Smoking Philadelphia Department of Public Health needs of Philadelphia County residents; and available • Obesity health resources in Philadelphia County • Racial/ethnic disparities

Representative of an underserved community; • Older adult issues – capacity, mental health, falls Bucks County Area Agency on Aging Expertise in health needs specific to older adults • Lack of financial resources

• Poor screening rates for mammograms Representative of an underserved community; Health Bucks County Health Improvement Partnership • Chronic conditions - diabetes, obesity, and needs of the uninsured in Bucks County and barriers to (BCHIP) heart disease receiving appropriate care • Knowledge of resources to access care

Representative of an underserved community; • Lack of financial support and care compensation Expertise in the health needs specific to older adults; Community Care Center of the Northeast • Lack of support services/lack of funding for support services and resources available to provide assistance to low- • Language barriers income older adults in Northeast Philadelphia

Representation of an underserved community; • Patient compliance and lack of a health and wellness-focused culture; no- Expertise in the needs of patients in the Northeast show rate for appointments Community Physician A Philadelphia area, especially low-income and • Difficulty with insurance disadvantaged populations • Disparities in the minority populations and language barriers

Representation of an underserved community; • Chronic conditions – obesity, diabetes, hypertension Community Physician B Expertise in the needs of lower-SES patients in Lower • Smoking Bucks County • Lack of specialists who will take Medicaid

• Barriers to care – financial, trust and support, language Health needs of Philadelphia County Residents; health Keystone First • Chronic conditions – diabetes, hypertension, asthma resources in Philadelphia County • Maternal and infant health

Aria Health Community Health and Wellness Study; • Low awareness of no-cost benefits provided by insurance companies Aria Health Service Area Residents survey sent to more than 5,900 residents of Aria’s • Express interest in attending nutrition programs service area • Express interest in increasing fruit/vegetable consumption Secondary Data Sources

Source Variables American Community Survey • Poverty • Obesity • Heart disease and stroke Healthy Communities Institute (county-level data) • Diabetes • Medicare population: cholesterol, hypertension PA Department of Health, Division of Health Informatics • Mortality rates • Cancer incidence rates National Cancer Institute • Cancer mortality rates • Obesity • Blood pressure control, compliance with prescribed blood pressure medications • Nutrition & exercise • Preventive screening rates PHMC Household Health Survey (service area data) behaviors • Insurance coverage and affordability • Diabetes • Care seeking behaviors • Hypertension • Population Age Distribution • Unemployment Neilsen Claritas (via Truven Health) • Educational Attainment • Race Distribution Appendix B – Community Resources Health Centers & Services

Bucks County BCHIP Lower Bucks Clinic 2546 Knights Road, Bensalem, PA 19020 Health Center/Clinic Bucks County Health Department 7321 New Falls Road, Levittown, PA 19055 Health Department Healthlink Medical Center 1775 Street Road, Southampton, PA 18966 Health Center/Clinic Mother Bachmann Maternity Center 2560 Knights Road, Bensalem, PA 19020 Women’s Heath Center Planned Parenthood – Bensalem Health Center 2185 Galloway Road, Bensalem, 19020 Health Center/Clinic Planned Parenthood – Castor Avenue Health Center 8210 Castor Avenue, Philadelphia, PA 19152 Health Center/Clinic Planned Parenthood – Bristol Health Center 721 Veterans Highway, Bristol, 19007 Health Center/Clinic St. Mary Children’s Health Center 2546 Knights Road, Bensalem, PA 19020 Health Center/Clinic

Philadelphia Aria Health Clinic 5000 Frankford Avenue, Philadelphia, PA 19124 Health Center/Clinic DVCH Maria de los Santos Health Center 455 W. Allegheny Ave, Philadelphia, PA 19140 Health Center/Clinic DVCH Parkview Health Center 841 E. Hunting Park Avenue, Philadelphia, 19124 Women’s Health Center Esperanza Health Center 3156 Kensington Avenue, Philadelphia, PA 19134 Health Center/Clinic Esperanza Health Center 4417 N. 6th Street, Philadelphia, PA 19140 Health Center/Clinic GPHA Hunting Park Health Center 1999 W Hunting Park Ave, Philadelphia, PA 19140 Health Center/Clinic GPHA Frankford Health Center 4510 Frankford Avenue, Philadelphia, PA 19124 Health Center/Clinic Public Health Center 10 2230 Cottman Avenue, Philadelphia, PA 19149 Health Center/Clinic Rising Sun Health Center 5675 N. Front Street, Philadelphia, 19120 Health Center/Clinic Human & Social Service Resources

APPRISE Helpline: 1-800-783-7067 Human/Social Services Benefits Data Trust Helpline: 1-866-712-2060 Human/Social Services Pennsylvania Health Law Project Helpline: 1-800-274-3258 Human/Social Services Pennsylvania Department of Public Welfare Helpline: 1- 800-692-7462 or www.dpw.state.pa.us Human/Social Services Planned Parenthood – Bensalem Health Center 2185 Galloway Road, Bensalem, 19020 Health Center/Clinic Planned Parenthood – Castor Avenue Health Center 8210 Castor Avenue, Philadelphia, PA 19152 Health Center/Clinic Planned Parenthood – Bristol Health Center 721 Veterans Highway, Bristol, 19007 Health Center/Clinic St. Mary Children’s Health Center 2546 Knights Road, Bensalem, PA 19020 Health Center/Clinic Bucks County Bucks County Assistance Office 1214 New Rodgers Road, Bristol, PA 19007 (215-781-3300) Human/Social Services Family Resource Center 2546 Knights Road, Bensalem, PA 19020 (215-245-8563) Human/Social Services Bensalem WIC Clinic 2546 Knights Road, Bensalem, PA 19020 (215-244-2674) Human/Social Services Bucks County Mental Health & Developmental Programs Dept 600 Louis Drive, Warminster, PA 18974 (215-444-2800) Human/Social Services Center for Independent Living Bucks County 1226 Veteran's Highway Bristol, PA 19007 (215-781-5070) Human/Social Services CSS Bucks County Family Service Center 100 Levittown Parkway, Levittown, 19054 (215-945-2550) Human/Social Services Levittown WIC Clinic 7321 New Falls Road, Levittown, PA 19055 (267-580-3570) Human/Social Services Northwestern Human Services of Bucks County 600 Louis Drive, Warminster, PA 18974 (610-260-4600) Human/Social Services Warminster WIC Clinic 605 Louis Drive, Warminster, PA 18974 (215-442-1099) Human/Social Services YWCA Bucks Landing Family Center 120 E. Street Road, Warminster, PA 18974 (215-672-2974) Human/Social Services YWCA Bucks Meadow Family Center 3131 Knights Road, Bensalem, PA 19020 (215-633-1768) Human/Social Services YWCA Country Commons Family Center 3338 Richlieu Road, Bensalem, PA 19020 (215-639-5853) Human/Social Services YWCA Creekside Family Center 2500 Knights Road, Bensalem, PA 19020 (215-639-9550) Human/Social Services YWCA Program Outreach Center 2425 Trevose Road, Trevose, PA 19053 (215-953-7793) Human/Social Services Family Services Association of Bucks County 2 Canal’s End Road, Bristol, PA 19007 (215-781-6602) Human/Social Services Family Services Association of Bucks County 4 Cornerstone Drive, Langhorne, PA, 19047 (215-757-2115) Human/Social Services Human Services of Bucks County 215-348-6201 www.buckscounty.org/government/humanservices Human/Social Services Bucks County Transport Information Line: 215-794-5554 Human/Social Services Human & Social Service Resources (cont.)

Philadelphia County Assistance Office – Boulevard District 4109 Frankford Avenue, Philadelphia, PA 19124 (215-560-6500) Human/Social Services County Assistance Office - Liberty District 219 East Lehigh Avenue, Philadelphia, PA 19125 (215-560-4000) Human/Social Services County Assistance Office - Unity District 4111 Frankford Avenue, Philadelphia, PA 19124 (215-560-6400) Human/Social Services BenePhilly Helpline:: 1-800-236-2194 (Philadelphia only) Human/Social Services Aramingo Avenue WIC Office 2401 E. Tioga Avenue, Philadelphia, PA 19124 (1-800-743-3300) Human/Social Services Kensington WIC Office 1825-31 E. Hilton Street, Philadelphia, PA 19134 (215-426-6801) Human/Social Services Northeast WIC Office 8570 Bustleton Avenue, Philadelphia, PA 19152 (1-800-743-3300) Human/Social Services Parkwood WIC Office 12041 Academy Road, Philadelphia, PA 19154 (1-800-743-3300) Human/Social Services Casa del Carmen 4400 N. Reese Street, Philadelphia, 19140 (267-331-2500) Human/Social Services CSS Northeast Philadelphia Family Service Center 7340 Jackson Street, Philadelphia, 19136 (215-624-5920) Human/Social Services Jewish Family and Children’s Services 10125 Verree Rd, Philadelphia, PA (215-934-5551) Human/Social Services Lutheran Children & Family Service 5401 Rising Sun Avenue, Philadelphia, PA 19120 (215-456-5700 Human/Social Services Lutheran Settlement House 1340 Frankford Avenue, Philadelphia, PA 19125 (215-426-8610) Human/Social Services Maternity Care Coalition – Northeast MOMobile 900 East Howell St., Philadelphia, PA 19111 (215-725-8030) Human/Social Services People Acting to Help, Inc. (PATH) 8220 Castor Avenue, Philadelphia, PA 19152 (215-728-4600) Human/Social Services Philadelphia Corporation for Aging 642 N Broad St, Philadelphia, PA 19130 (215-765-9040) Human/Social Services

Senior & Disability Service Resources Pennsylvania Department for Aging Information: 1-717-783-1550 or www.aging.pa.gov Senior/Disability Services Bucks County Bucks County Area Agency on Aging 30 E Oakland Ave, Doylestown, PA 18901 (267-880-5700) Senior/Disability Services Bucks County Mental Health & Developmental Programs Dept 600 Louis Drive, Warminster, PA 18974 (2145-444-2800) Senior/Disability Services Bucks County Transport Information Line: 215-794-5554 Senior/Disability Services Bucks County Crimes Against Older Adults Task Force Hotline:1-800-490-8505 or www.crimesagainstolderadultsbucks.org Senior/Disability Services Philadelphia DBHIDS Intellectual disAbility Services 701 Market Street, Philadelphia, PA 19106 (215-685-5900) Senior/Disability Services Philadelphia Corporation for Aging 642 N Broad St, Philadelphia, PA 19130 (215-765-9040) Senior/Disability Services COMHAR Older Adults Treatment Services (OATS) 100 West Lehigh Avenue, Philadelphia, PA 19133 (215-203-3027) Senior/Disability Services Community Care Center of the Northeast 2417 Welsh Rd, Philadelphia, PA 19114 (215-335-4416) Senior/Disability Services Special People in the Northeast (SPIN) 10501 Drummond Road, Philadelphia, PA 19124 (215-613-1000) Senior/Disability Services Jewish Family and Children’s Services 10125 Verree Rd, Philadelphia, PA (215-934-5551) Senior/Disability Services Senior Centers & Community Centers

Bucks County Benjamin Wilson Senior Center 480 Delmont Avenue, Warminster, 18974 Senior Centers Bensalem Senior Center 1850 Byberry Road, Bensalem, 19020 Senior Centers Bristol Borough Area Active Adult Center 301 Wood St, Bristol, 19007 Senior Centers Bristol Township Senior Center 2501 Bath Rd, Bristol, 19007 Senior Centers Falls Township Senior Center 282 Trenton Rd, Fairless Hills,19030 Senior Centers Middletown Senior Center 2142 Trenton Road, Levittown, 19056 Senior Centers Morrisville Senior Service Center 31 E. Cleveland Avenue, Morrisville, 19067 Senior Centers Neshaminy Senior Citizens Center 1842 Brownsville Road, Trevose, 19053 Senior Centers Northampton Township Senior Center 165 Township Road, Richboro, 18954 Senior Centers Lower Bucks Family YMCA – Fairless Hills Branch 601 S. Oxford Valley Rd, Fairless Hills, PA 19030 Community Center Lower Bucks Family YMCA – Newtown Branch 190 S Sycamore St, Newtown, PA Community Center Lower Bucks Family YMCA - Morrisville Branch 200 N Pennsylvania Ave, Morrisville, PA 19067 Community Center Philadelphia JCC Klein Senior Center 10100 Jamison Avenue, Philadelphia, 19116 Senior Centers JCC Tabas Senior Center 2101 Strahle Street, Philadelphia, 19152 Senior Centers Juniata Park Older Adult Center 1251 East Sedgley Avenue, Philadelphia, 19134 Senior Centers Lutheran Settlement House Senior Center 1340 Frankford Avenue, Philadelphia, 19125 Senior Centers Mann Older Adult Center 3201 North Fifth Street, Philadelphia, 19140 Senior Centers Northeast Older Adult Center 8101 Bustleton Avenue, Philadelphia, 19152 Senior Centers Peter Bressi N.E. Senior Center 4744-46 Frankford Avenue, Philadelphia, 19124 Senior Centers Philadelphia Senior Center – Tioga Branch 1531 W Tioga Street, Philadelphia, PA 19140 Senior Centers St. Anne’s Senior Center 2607 E. Cumberland Street, Philadelphia, 19125 Senior Centers Frankford Community Development Corporation 4900 Griscom Street, Philadelphia, PA 19124 (215-743-6580) Community Development New Kensington Community Development Corporation 2513-15 Frankford Ave, Philadelphia, PA 19125 (215-427-0350) Community Development Tacony Community Development Corporation 4817 Longshore Ave, Philadelphia, PA 19135 (215-856-3029 Community Development Mayfair Community Development Corporation 2990 St. Vincent Street, Philadelphia, PA 19149 (267-538-4668) Community Development Norcom Community Center 10980 Norcom Rd, Philadelphia, PA 19154 (215-613-1070 Community Center JCC Klein Northeast Philadelphia 10100 Jamison Avenue, Philadelphia, 19116 (267-912-1407) Community Center Max Myers Community Center 1601 Hellerman St, Philadelphia, PA 19149 (215-685-1242) Community Center Northeast Family YMCA 11088 Knights Rd, Philadelphia, PA 19154 (215-632-0100) Community Center Smoking Cessation Resources PA Free Quitline 1-800-QUIT-NOW (784-8669) or 1-855-DEJELO-YA(335-3569) Smoking Cessation BCHIP Tobacco Control Program Information: 1-215-710-2264 Smoking Cessation Aria Health Smoking Cessation Program Frankford and Torresdale Campuses: 1-877-808-ARIA (2742) Smoking Cessation Aria Health Smoking Cessation Program Bucks County Campus: 1-215-710-2264 Smoking Cessation Smoke Free Philly www.smokefreephilly.org Smoking Cessation

Nutrition & Food Access Resources Coalition Against Hunger 1-215-430-0555 or www.hungercoalition.org Food access Philabundance Food Helpline: 1-800-319-FOOD(3663)or www.philabundance.org Food access Philly Food Trust 1-215-575-0444 or www.thefoodtrust.org Food access SHARE Food Program 2901 W Hunting Park Ave, Philadelphia, PA 19129 (215-223-2220) Food access Meals on Wheels http://www.mealsonwheelsamerica.org Food access Mental Health Resources

Bucks County Bucks County Mental Health & Developmental Programs Dept 600 Louis Drive, Warminster, PA 18974 (215-444-2800) Mental Health Bucks County Mental Health Clinic 1270 New Rodgers Road, Bristol, PA 19007 (215-788-5730) Mental Health Delaware Valley Children's Center 2288 Second Street Pike, Wrightown, PA, 18940 (215-598-0223) Mental Health Maternal Child Consortium/Warwick Family Services 800 Clarmont Avenue, Bensalem, PA, 19020 (267-252-7000) Mental Health NHS Human Services 2260 Cabot Blvd W, Langhorne, PA, 19047 (215-752-5760) Mental Health NHS Human Services 600 Louis Drive, Warminster, PA, 18974 (215-970-5462) Mental Health Penndel Mental Health Center, Inc 1517 Durham Road, Penndel, PA 19047 (215-752-1541) Mental Health The Council of Southeast Pennsylvania 1701 W Lehigh Ave, Philadelphia, PA 19132-2123 (215-223-7700) Mental Health The Council of Southeast Pennsylvania 1286 Veterans Hwy, Bristol, PA 19007 (215-788-3738) Mental Health Bucks Network of Care www.bucks.pa.networkofcare.org Mental Health Philadelphia Children’s Crisis Treatment Center 1080 N. Delaware Avenue, Philadelphia, 19125 (215-496-0707) Mental Health Community Organization for Mental Health & Retardation (COMHAR) 3201 Frankford Avenue, Philadelphia, PA 19134 (215-427-5800) Mental Health Community Organization for Mental Health & Retardation (COMHAR) 100 West Lehigh Avenue, Philadelphia, PA 19133 (215-203-3027) Mental Health COMHAR Older Adults Treatment Services 100 West Lehigh Avenue, Philadelphia, PA 19133 (215-203-3027) Mental Health Phila Dept of Behavioral Health & Intellectual disAbility Svcs (DBHIDS) 1101 Market Street, Philadelphia, PA 19107 (215-685-5400) Mental Health Friends Hospital Crisis Response Center 4641 Roosevelt Blvd, Philadelphia, PA 19124 (215-831-2600) Mental Health Northwestern Human Services of Philadelphia 11082 Knights Road, Philadelphia, PA 19154 (215-632-9040) Mental Health Northwestern Human Services of Philadelphia 2900 Southampton Road, Philadelphia, PA 19154 (215-671-5005) Mental Health People Acting to Help, Inc. (PATH) 8220 Castor Avenue, Philadelphia, PA 19152 (215-728-4600) Mental Health Temple/Episcopal Hospital Crisis Response Center 100 East Lehigh Avenue, Philadelphia, PA 19125 (215-707-2577) Mental Health Philadelphia Network of Care www.philly.networkofcare.org Mental Health