2013 Community Health Needs Assessment and Implementation Strategy ELMHURST HOSPITAL CENTER 79-01 Broadway Elmhurst, NY 11373 (718) 334-4000 Please contact Vincent Henry at (718) 334-5827 for additional information. Table of Contents I. Description of Community Served by Elmhurst Hospital Center 3 II. Process and Methodology 5 III. Health Needs Identified 6 IV. Community Assets Identified 7 V. Summaries: Assessments and Priorities 8 VI. Implementation Strategy 8 a. Target Areas and Populations b. How the Implementation Strategy Was Developed c. Major Needs and How Priorities Were Established d. Description of What Elmhurst Will Do to Address Community Needs VII. Approval 10 I. Description of Community Served by Elmhurst Hospital Center Elmhurst Hospital Center (EHC), a member of the New HHC is a crucial access point for local communities that York City Health and Hospitals Corporation and affiliated have historically been overlooked by private physicians and vol- with the Mount Sinai School of Medicine, is the major health- untary hospitals seeking optimal market share in an extremely care provider for nearly 900,000 residents of Western Queens competitive healthcare environment. HHC’s commitment to County. With over 27,000 admissions and more than 700,000 caring for patients regardless of their ability to pay gives it the ambulatory care and emergency visits annually, EHC is one of highest “market share” of low-income, uninsured patients across the city’s busiest healthcare facilities. EHC is a state-designated New York City. Level I Trauma Center, a state-designated Level III Intensive SAFETY NET BURDEN Care Center for Neonates, a state-designated AIDS Center, Utilization by Payer Mix as a Percent of Total a state-designated Center for the Sexual Assault Forensic NYC Voluntary Nonprofit All HHC Examiner Program, a state-designated Stroke Center, a 911 Hospitals Average* Hospitals Elmhurst Discharges Receiving Hospital, an Emergency Heart Station, a World Uninsured 3% 4% 6% Trade Center Environmental Health Center, and a Sickle Cell Medicaid 33% 38% 60% Anemia Center. It is also a member of the American Hospital Total Safety Net 36% 42% 66% ED Visits Association and the National Association of Public Hospitals Uninsured 16% 20% 27% (NAPH) and is accredited by The Joint Commission (TJC) Medicaid 39% 41% 51% and the New York State Department of Health. EHC is New Total Safety Net 55% 61% 78% Clinic Visits York State’s only public hospital with an Elective Percutaneous Uninsured 11% 19% 34% Coronary Intervention service. Medicaid 55% 52% 50% EHC is part of the New York City Health and Hospitals Total Safety Net 66% 71% 84% Corporation (HHC), a public benefit corporation whose mis- * Excludes HHC hospitals. Source: 2010 Hospital Institutional Cost Report, and 2010 Health Center Cost Report. sion has always been to provide comprehensive and high quality Includes all NYC acute, general care hospitals and any wholly owned or controlled community health centers, including HHC. health care to all, regardless of ability to pay, in an atmosphere Discharges exclude normal newborns. ED visits include treat and release, and visits that result in admission. of dignity and respect. HHC, the largest municipal healthcare Clinic visits include comprehensive care and primary care visits only. HHC’s uncompensated care costs are $698 million. organization in the country, is a $6.7 billion integrated health- care delivery system that provides medical, mental health and Based on 2010 New York State institutional and health substance abuse services through its 11 acute care hospitals, four center cost reports, HHC hospitals provided a far higher pro- skilled nursing facilities, six large diagnostic and treatment cen- portion of care to self-pay (or uninsured) patients than any other ters and more than 70 community based clinics. HHC Health single healthcare provider in New York City. In 2010, HHC and Home Care also provides in-home services to the local acute care hospitals were the source of 37% of all uninsured communities it serves. inpatient discharges, 43% of uninsured ED visits and 67% of ELMHURST HOSPITAL CENTER CHNA | 3 uninsured clinic visits among all New York City hospitals. This next door. The new building also houses a child daycare volume of uninsured care translates into approximately $698 center open to employees and the public. million in uncompensated care annually at HHC. EHC serves one of the most ethnically diverse communi- ties in the nation where more than 100 nationalities and lan- EHC’s History guages are represented and spoken. The area’s largest immigrant EHC has a long and distinguished history of advanc- groups are Hispanics from South America, the Caribbean, and ing its mission to provide quality healthcare to all, regard- Mexico, and Asians from China, Korea, Bangladesh, Pakistan, less of ability to pay. Opened on Blackwell’s Island (now and India. EHC’s catchment areas are 59% Hispanic, 19% Roosevelt Island) in 1832 as a hospital for the poor, EHC Asian, 11% White, 8% Black, and 3% Other. EHC serves a moved to its current Queens location in 1957 to meet the healthcare needs of the rapidly growing borough. Starting predominantly poor and medically underserved population that in the 1990s, EHC embarked on a $250,000,000 major faces a range of cultural, linguistic, economic and legal-status modernization program which has transformed the hospi- barriers to care. The majority of our patients are uninsured or tal into a completely modern, full-service, state-of-the-art on Medicaid, and many are undocumented immigrants. Our 545-bed hospital offering a complete array of high-quality catchment communities include some with the county’s and general medical/surgical, specialty, and diagnostic inpatient city’s poorest health indicators. Also, a large part of our area is a and outpatient services and programs. EHC additionally federally designated Health Professional Shortage Area. operates five community-based centers and two school- Accordingly, EHC has risen to the challenge. EHC‘s staff is based health centers which help to increase community reflective of our extraordinarily diverse community population access to primary care services. In 2008, EHC opened The and pursues vigorous outreach programs which provide health Hope Pavilion, a state-of-the-art cancer care facility. The screenings and education throughout local neighborhoods. Hope Pavilion at EHC will be home to some of the most EHC’s cultural competency has been recognized by both the innovative equipment in cancer care—all in addition to New York Times and the Joint Commission and has been hailed our new 64-slice CAT scan and a brachytherapy suite right as a “model of healthcare access for immigrants” by the New ELMHURST HOSPITAL CENTER CHNA | 4 York Immigration Coalition. According to national, state, and American, respectively. In West Central Queens, 13% of the resi- local agencies, EHC is a top ranker for Heart Attack & Heart dents live below the poverty level, 44% are foreign born; 22% are Failure Care, and infection prevention. The EHC reputation of Hispanic, while 17% are Asian American. clinical excellence and expertise has seen its staff invited to other EHC’s primary service area is represented by the neighbor- countries, as well as visited by foreign providers, and has won it hoods of Elmhurst (11373), Jackson Heights (11372), Corona grants from such prestigious organizations as the Robert Wood (11368) and Woodside (11377). The area had a 2010 population Johnson Foundation and the Commonwealth Fund. of 367,655, which represented an approximately 2% increase over EHC is also one of the founding members of the Interboro the 2000 population of 361,270. It is projected that the area’s Regional Health Information Organization (RHIO) which is a population will increase by five percent in five years. Ethnically, clinical data exchange serving New York City and surrounding 53.3% of the population is Hispanic, 12.1% is White, 4.1% is communities. The Interboro RHIO facilitates the sharing of pa- Black, 28.2% is Asian and 2.3% is other. tient information between authorized healthcare providers at the In 2010 there were 488,377 residents in the hospital’s point of care to improve quality, patient safety, care coordination secondary service area. This figure represented a slight decline and efficiency. (4,482) from the 2000 population of 492,859. It is projected Service Areas that the population in the secondary service area will increase by EHC’s overall service area encompasses the “local neigh- nearly four percent in five years. The ethnic breakdown for the borhoods” of Northwest Queens (Astoria, Long Island City, area in 2010 was Hispanic 35.4%, White 33.6%, Black 5.1%, Sunnyside), West Central Queens (Forest Hills, Glendale, Asian 23.2% and Other 2.7%. Middle Village, Rego Park, Ridgewood), and West Queens New York City Planning 2010 Population data indicate (Elmhurst, Jackson Heights, Woodside, Maspeth and that 71% of the residents in EHC’s overall service area pri- Corona). EHC service area includes zip codes 11368, 11373, marily speak a language other than English. The hospital uses 11372, 11377, 11369, 11370, 11385, 11104, 11106, 11103, language interpreters and CyraCom phones to provide linguis- 11355, 11101, 11378, 11102 and 11421. According to 2010 tically appropriate services to patients who primarily speak a census data, there were 856,032 residents in EHC’s service language other than English. area, which was only slightly greater than the 2000 popula- tion figure of 854,129. It is projected that the area’s popula- Service Volume/Occupancy tion will grow by about 4.3% over the next five years. According to EHC’s Fiscal Year 12 utilization data there were Nearly 3 in 5 (59%) of West Queen’s residents are foreign 537,345 outpatient and primary care visits; 146,362 emergency born, compared to the overall rates for Queens (25%) and NYC department visits; 27,654 discharges and an 83.1% occupancy (27%).