Sharp Coronado Hospital and Healthcare Center Community Health Needs Assessment Fiscal Year 2016 ~ Committed to Improving the Health and Well-being of the Community ~ Sharp Coronado Hospital and Healthcare Center Community Health Needs Assessment Fiscal Year 2016 Table of Contents Preface ................................................................................................................................................... i Section 1: Overview ............................................................................................................................. 1 Section 2: Executive Summary ............................................................................................................ 3 Section 3: Methodology ..................................................................................................................... 13 Section 4: Community Defined .......................................................................................................... 36 Section 5: Findings............................................................................................................................. 42 Section 6: Description of Identified Community Health Needs and Social Determinants of Health . 83 Section 7: Conclusion/Community Assets ....................................................................................... 106 List of Appendices Appendix A: SCHHC Programs and Services ................................................................................... 117 Appendix B: An Overview of Sharp HealthCare ............................................................................... 118 Appendix C: Description of Partnering Organizations – HASD&IC and IPH..................................... 129 Appendix D: Vulnerable Populations Report ..................................................................................... 131 Appendix E: Description of Community Needs Index (CNI) .............................................................. 154 Appendix F: CNI Map of San Diego County ...................................................................................... 155 Appendix G: Health Access and Navigation Survey…………………………………………………….156 Appendix H: Key Informant Interview Questions ............................................................................... 161 Appendix I: Case Manager/Health Navigator Discussion Tool ......................................................... 163 Appendix J: Map of Community and Region Boundaries in San Diego County ............................... 165 Appendix K: SCHHC Behavioral Health Hospital Data ..................................................................... 166 Appendix L: SCHHC Cardiovascular Health Hospital Data .............................................................. 170 Appendix M: SCHHC Diabetes Hospital Data ................................................................................... 174 Appendix N: SCHHC Obesity Hospital Data ..................................................................................... 178 Appendix O: SCHHC Orthopedic Hospital Data ................................................................................ 181 Appendix P: SCHHC Senior Health Hospital Data ............................................................................ 185 Appendix Q: HASD&IC Health Access and Navigation Survey Demographics ................................ 192 Appendix R: SCHHC Health Access and Navigation Survey Demographics ................................... 194 Appendix S: 2-1-1 San Diego Directory of Services .......................................................................... 196 Appendix T: Health Need Profiles ...................................................................................................... 203 Appendix U: Map of Sharp HealthCare Locations ............................................................................. 212 Appendix V: List of Sharp HealthCare Involvement in Community Organizations ........................... 213 Appendix W: SCHHC FY 2017 – FY 2020 Implementation Plan ...................................................... 219 Appendix X: Glossary of Abbreviations ............................................................................................ 254 Preface Sharp Coronado Hospital and Healthcare Center (SCHHC) prepared this Community Health Needs Assessment (CHNA) for Fiscal Year 2016 (FY 2016) in accordance with the requirements of Section 501(r)(3) within Section 9007 of the Patient Protection and Affordable Care Act (Affordable Care Act) and Internal Revenue Service (IRS) Form 990, Schedule H for not-for-profit hospitals.1 Under the Affordable Care Act enacted in March, 2010, IRS Code Section 501(r)(3) requires not-for-profit hospitals to conduct a triennial assessment of prioritized health needs for the communities served by its hospital facilities, and to adopt an implementation plan to address health needs identified as a result of the CHNA. The Sharp Coronado Hospital and Healthcare Center 2016 Community Health Needs Assessment (SCHHC 2016 CHNA) and Implementation Plan received approval from the Sharp Coronado Hospital and Healthcare Center Board of Directors on August 22, 2016. Daniel L. Gross Executive Vice President, Hospital Operations Sharp HealthCare 1 See Section 9007(a) of the Patient Protection and Affordable Care Act (“Affordable Care Act”), Pub. L. No. 111-148, 124 Stat.119, enacted March 23, 2010. Notice 2011-52. Sharp Coronado Hospital and Healthcare Center Community Health Needs Assessment Page i Acknowledgements SCHHC’s 2016 CHNA process included the time, effort, insight and contributions of many members of the San Diego community. For both SCHHC’s 2016 CHNA and the Hospital Association of San Diego and Imperial Counties (HASD&IC) 2016 CHNA process, this included not only HASD&IC, the Institute for Public Health (IPH) at San Diego State University (SDSU), and other representatives from not-for-profit hospitals in San Diego County (SDC), but also hundreds of community members including physicians, health care practitioners and professionals, community health leaders, public health officials, academics, and other concerned residents who are dedicated to the care of vulnerable members of our community. We would like to express our profound appreciation for the contributions made by all who participated in this CHNA. In particular, we are grateful to those patients and community residents who shared their personal insight regarding health care access and navigation in SDC. These members of the community volunteered their time and effort to contribute to this CHNA in order to improve the care, health and well-being for themselves, their families, and the communities in which they live. For this commitment and caring, we extend our deepest thanks. Sharp Coronado Hospital and Healthcare Center Community Health Needs Assessment Page ii Background: Sharp HealthCare CHNA History For the past 20 years, Sharp HealthCare (Sharp) has been actively involved in a triennial CHNA process, in accordance with the requirements of Senate Bill 697, community benefit legislation that requires not-for-profit hospitals in California to file an annual report with the Office of Statewide Health Planning and Development (OSHPD) on activities undertaken to address high-priority community needs within their mission and financial capacity, as well as the financial value of those community benefit programs and services. In FY 2015, Sharp provided more than $289 million in community benefit programs and services. To view the most recent Sharp HealthCare Community Benefit Plan and Report, please visit: http://www.sharp.com/about/community/community-benefits-health-needs.cfm. Since 1995, Sharp has participated in a countywide collaborative that includes a broad range of hospitals, health care organizations, and community agencies to conduct a triennial CHNA. Findings from the CHNA, program and services expertise of each Sharp hospital, and knowledge of the populations and communities served by those hospitals provide a foundation for community benefit planning and program implementation. In 2013, Sharp participated in a collaborative, countywide CHNA effort under the auspices of HASD&IC and in contract with the IPH. This collaborative effort provided a strong base for Sharp’s individual hospital CHNAs and significantly informed both the process and findings for each of the CHNAs completed by Sharp’s hospitals. 2013 CHNA: Progress Update Upon completion of the 2013 CHNA, Sharp participated in a collaborative “Phase 2” effort also led by HASD&IC and in contract with the IPH. Phase 2 of the 2013 CHNA process was conducted from September to December 2014 and included community dialogues with San Diego residents from high need communities, as well as a community health leader/expert online survey. Goals of the Phase 2 process included: Collect feedback on the 2013 CHNA process from community stakeholders Collect input on hospital programs provided to address the identified community health needs from the 2013 CHNA (e.g., implementation plans) Findings from the 2013 CHNA Phase 2 provided critical guidance for the 2016 CHNA process, which will be detailed in the following pages, as well as valuable insight for the programs that Sharp provides to address identified community health needs. Please see Figure 8 for a summary of findings from the collaborative 2013 CHNA Phase 2 effort. Sharp Coronado Hospital and Healthcare Center Community Health Needs