2019 Community Health Needs Assessment Implementation Plan 2020-2023 Community Health Needs Assessment Implementation Plan Dana-Farber Cancer Institute 2020 - 2023 TABLE OF CONTENTS PAGE Introduction .................................................................................................................. 3 Background & Context Overview of Dana-Farber Cancer Institute Dana-Farber Community Benefits .................................................................................. 3 Community Benefits Mission & Oversight Summary of Accomplishments: 2016-2019 CHNA Implementation Plan .......................... 7 2020-2023 Community Health Needs Assessment (CHNA) ............................................. 10 Prioritization Process Key Findings 2020-2023 Implementation Plan Strategies & Responses .............................................. 13 Conclusion ............................................................................................................................ 17 This implementation plan is intended to satisfy the Community Health Needs Assessment Implementation Plan requirement under Internal Revenue Code Section 501(r)(3)(A)(iii) and the Patient Protection and Affordable Care Act. Dana-Farber Cancer Institute |Community Health Implementation Plan 2 Overview of Dana-Farber Cancer Institute Founded originally in 1947, Dana-Farber Cancer Institute aims to provide expert, compassionate care to children and adults with cancer while advancing the understanding, diagnosis, treatment, cure, and prevention of cancer and related diseases. As an affiliate of Harvard Medical School and a Comprehensive Cancer Center designated by the National Cancer Institute, Dana-Farber also provides training for new generations of physicians and scientists, designs evidence-based programs that promote public health particularly among high-risk and underserved populations, and disseminates innovative patient therapies and scientific discoveries across the United States and throughout the world. The Institute has been the top ranked cancer hospital in New England by U.S. News and World Report for 16 consecutive years and is the only cancer center in the country ranked in the top 4 for both adult and pediatric cancer programs. Dana-Farber’s Community Benefits Office In 1995, the Dana-Farber Cancer Institute Board of Trustees formally adopted a Community Benefits (CB) Mission Statement which affirms Dana-Farber’s commitment to supporting community-based programs, participating in outreach activities to reduce cancer incidence, morbidity, and mortality, and conducting community-based research. Community Benefits Mission: Dana-Farber Cancer Institute’s community outreach mission contributes to the Institute's goal of advancing the understanding, diagnosis, care, treatment, cure, and prevention of cancer and related diseases by: • Ensuring that patients from diverse backgrounds receive equitable cancer care and treatment, including but not limited to, education about the importance of clinical trials participation • Establishing quantifiable, evidence-based, and sustainable programs in cancer prevention focusing on at-risk, underserved and diverse populations • Providing expertise in cancer care to city and state health departments, community- based agencies and health care providers Last updated, July 2009 The Dana-Farber Board of Trustees Community Programs Committee oversees the development and implementation of Dana-Farber’s Community Health Needs Assessment (CHNA) Report and Community Health Implementation Plan (CHIP). In their oversight capacity, Committee members provide the Community Benefits staff with guidance and leadership around program initiatives. Additionally, the Dana-Farber Community Benefits External Advisory Committee (EAC), consisting of representatives from community organizations, neighborhood health centers, cancer survivors, city and state health departments who share Dana-Farber’s commitment to reducing disparities in cancer care, education, and treatment, provides input and guidance on Dana-Farber’s Community Benefits programs. The EAC is also responsible for the development and implementation of specific Community Benefits initiatives, including Community Health Initiatives (CHI) associated with Dana-Farber’s recently approved Determination of Need (DoN) application for satellite expansion. Further, the EAC ensures that Dana-Farber Cancer Institute |Community Health Implementation Plan 3 community health priorities align with priorities and general principles set by the Massachusetts Department of Public Health (MDPH) and the Massachusetts Attorney General’s Office (AGO). Through collaborative and inter-disciplinary work across various departments within the Institute and our satellite locations, the Dana-Farber Community Benefits Office serves as a bridge to community organizations and supports evidence-based and sustainable outreach programs. Background: Community Health Needs Assessment and Implementation Plan Dana-Farber’s Community Benefits activities are informed by the Institute's CHNA/CHIP process, conducted every three years to gain a greater understanding of the health issues facing Boston residents. The purpose of the CHNA is to advance community efforts and priority areas by: assessing cancer burden in the community as well as access to and availability of cancer-related services; identifying key areas of significant community need and vulnerable populations; examining the impact and role of social determinants of health; and facilitating the development of multi-year implementation strategies to guide the hospital’s community health initiatives and community investments. This document serves as the Institute’s 2020-2023 CHIP, as informed by the CHNA Report completed in2019. The CHNA Executive Summary and Report accompanying this document have validated Dana-Farber’s past and current Community Benefits activities and community engagement, while identifying opportunities for future initiatives. Summary of 2019 Community Health Needs Assessment Process In 2019, Dana-Farber and a wide variety of Boston stakeholders— community organizations, community development corporations, health centers, hospitals, and the Boston Public Health Commission— formed the Boston CHNA-CHIP Collaborative to develop Boston’s first large-scale collaborative city-wide Community Health Needs Assessment (CHNA) and Community Health Improvement Plan (CHIP). Simultaneously, Dana-Farber worked with Boston Medical Center (BMC) to develop a cancer-specific CHNA report that provides a deeper analysis of issues across the cancer continuum. The cancer CHNA report presents findings from the cancer-focused assessment as well as integrates the key results of the larger citywide CHNA to provide a deeper dive into residents’, cancer patients’, and survivors’ experiences, concerns, supports, and challenges related to cancer prevention, screening, treatment, and survivorship within the larger framework of health equity and the social determinants of health. Dana-Farber, BMC and the Boston CHNA-CHIP Collaborative contracted with Health Resources in Action (HRiA), a Boston-based public health research firm, to facilitate the CHNA processes and develop both CHNA reports. The Boston CHNA report and Dana-Farber’s cancer specific CHNA are available on Dana- Farber’s website (see page 17 for link). This effort not only complies with the IRS CHNA requirement under the Internal Revenue Code Section 501(r)(3)(A)(iii) and the Massachusetts Attorney General’s mandate for conducting a community health needs assessment, but also aligns with Massachusetts Department of Public Health priorities and Dana-Farber’s approach of utilizing data to inform the development of its initiatives. The strategies and goals outlined in our 2020-2023 CHNA Implementation Plan are a natural continuation of the efforts identified in our 2016-2019 Plan and are designed to advance and strengthen our existing community-based initiatives while also seeking to address the social determinants of health through collaborative partnerships. Dana-Farber Cancer Institute |Community Health Implementation Plan 4 Summary of Findings Cancer is the leading cause of death in Boston and Massachusetts for residents of all racial/ethnic groups and has remained so for the past six years. The CHNA findings suggest that collective efforts to advance cancer prevention and early detection are making a difference, however, significant disparities in cancer screening, incidence, and mortality persist among vulnerable and medically underserved residents of Boston, particularly communities of color. More work is needed to address the disproportionate cancer burden across the City of Boston. The findings highlight the diversity and richness of Dana-Farber’s priority neighborhoods of Roxbury, Mission Hill, Dorchester, Mattapan, and Jamaica Plain, as well as many of the broader socioeconomic challenges and healthcare access barriers facing community residents in these neighborhoods. When Boston residents were asked to identify the top most important concerns in their neighborhood that shape their community’s health, housing quality or affordability and alcohol/drug abuse emerged as top priorities, followed by mental health and community violence, as shown below. One in five people completing the Boston CHNA community survey identified cancer as one of their top five health concerns. Additionally, a high proportion of survey respondents identified factors that are linked to cancer—smoking, obesity,