ASCENSION SETON: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ASCENSION SETON (EIN 74-1109643)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-09-21
- IRS object ID
- 201632659349300543
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-09-21T15:00:19-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 741109643 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Seton Family of Hospitals | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SETO | BusinessNameControlTxt |
| Phone | 5123241000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1345 Philomena Street | AddressLine1Txt |
| City | Austin | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78723 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Thomas E Gallagher | PersonNm |
| Person Title | Acting CFO | PersonTitleTxt |
| Signature | 2016-09-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rebecca Lyons | PreparerPersonNm |
| PTIN | P01487105 | PTIN |
| Phone | 5137847100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Seton Healthcare Network | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Thomas E Gallagher | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1345 Philomena Street | AddressLine1Txt |
| City | Austin | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78723 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,014,671,375 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://www.seton.net | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1900 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | Provision of healthcare services with a special concern for the poor and vulnerable. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 13115 | TotalEmployeeCnt |
| Total Volunteers | 2000 | TotalVolunteersCnt |
| Total Gross UBI | $1,638,495 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $21,986,649 | PYContributionsGrantsAmt |
| CY Contributions Grants | $31,675,532 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,690,378,342 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,874,419,067 | CYProgramServiceRevenueAmt |
| PY Investment Income | $39,742,399 | PYInvestmentIncomeAmt |
| CY Investment Income | $32,406,920 | CYInvestmentIncomeAmt |
| PY Other Revenue | $89,210,009 | PYOtherRevenueAmt |
| CY Other Revenue | $64,659,950 | CYOtherRevenueAmt |
| PY Total Revenue | $1,841,317,399 | PYTotalRevenueAmt |
| CY Total Revenue | $2,003,161,469 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $9,617,016 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,383,934 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $734,356,411 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $821,623,724 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $816,279,824 | PYOtherExpensesAmt |
| CY Other Expenses | $841,861,902 | CYOtherExpensesAmt |
| PY Total Expenses | $1,560,253,251 | PYTotalExpensesAmt |
| CY Total Expenses | $1,666,869,560 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $281,064,148 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $336,291,909 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,875,604,866 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,131,871,173 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $703,601,338 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $727,179,060 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,172,003,528 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,404,692,113 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Our mission inspires us to care for and improve the health of those we serve with a special concern for the sick and the poor. We are called to be a sign of God's unconditional love for all and believe that all persons by their creation are endowed with dignity. Seton continues the Catholic tradition of service established by our founders: Vincent de Paul, Louise de Marillac, and Elizabeth Ann Seton. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,426,497,749 | ExpenseAmt |
| Grant | $3,383,934 | GrantAmt |
| Revenue | $1,931,569,955 | RevenueAmt |
| Desc | As the leading provider of health services in Central Texas (an 11-county region), Seton Family of Hospitals (Seton) also provides a number of distinctive services to the community: the only Level I trauma facilities; the only free-standing children's hospital; the only free-standing inpatient behavioral health hospital; the only heart transplant center; and the only University of Texas medical residency programs. Seton contributes to the positive health status of the communities it serves and continues to build and strengthen sustainable collaborative efforts to benefit the health of individuals, families and society as a whole. Seton has a mission to care for the community it serves with a special concern for the poor and the vulnerable. (CONTINUED ON SCHEDULE O) | Desc |
| Total Program Service Expenses | $1,426,497,749 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 13115 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Thomas E Gallagher | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5123241000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1345 Philomena Street | AddressLine1Txt |
| City | Austin | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78723 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| TOM MCHORSE MD | ||||||||||
| CHAIRMAN | 1.00 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| CHRIS ZIEBELL MD | ||||||||||
| VICE CHAIRMAN | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| LEO DUNN | ||||||||||
| SECRETARY | 1.00 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MICHELLE ROBERTSON | ||||||||||
| ACTING PRESIDENT & CEO (START 11/14) (Sch. O) | 50.00 | 0 | Yes (X) | Yes (X) | $668,090 | $0 | $12,400 | |||
| JESUS GARZA | ||||||||||
| PRESIDENT & CEO SHF/TRUSTEE (SCH O) | 26.00 | 24.00 | Yes (X) | Yes (X) | $2,228,647 | $0 | $35,535 | |||
| THOMAS E GALLAGHER | ||||||||||
| ACTING CFO/TRUSTEE (SCH O) | 22.00 | 28.00 | Yes (X) | Yes (X) | $1,135,468 | $0 | $33,990 | |||
| SR HELEN BREWER DC | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GREGORY SHEFF MD | ||||||||||
| TRUSTEE (SCH O) | 47.00 | 3.00 | Yes (X) | $702,178 | $0 | $22,354 | ||||
| CHARLES J BARNETT | ||||||||||
| TRUSTEE (END 2/15) (SCH O) | 1.00 | 3.00 | Yes (X) | $2,178,321 | $0 | $40,246 | ||||
| DR CHAD DIETERICHS | ||||||||||
| TRUSTEE | 1.00 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| ED DORN | ||||||||||
| TRUSTEE | 1.00 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| TRAVIS FROEHLICH | ||||||||||
| TRUSTEE (SCH O) | 50.00 | 0 | Yes (X) | $450,452 | $0 | $19,626 | ||||
| TIMOTHY GEORGE MD | ||||||||||
| TRUSTEE (SCH. O) | 1.00 | 40.00 | Yes (X) | $0 | $1,267,108 | $28,300 | ||||
| JAMES O LINDSEY MD | ||||||||||
| TRUSTEE/VP MED AFFAIRS (SCH O) | 49.00 | 1.00 | Yes (X) | $469,665 | $0 | $13,107 | ||||
| IAN TURPIN | ||||||||||
| TRUSTEE | 1.00 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| YVONNE VANDYKE | ||||||||||
| TRUSTEE (SCH O) | 49.00 | 1.00 | Yes (X) | $425,991 | $0 | $21,193 | ||||
| SR JOANNE VASA | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ALAN STRAUSS | ||||||||||
| CFO (start 11/14) | 1.00 | 84.00 | Yes (X) | $5,065 | $1,179,871 | $19,005 | ||||
| JOHN BRINDLEY | ||||||||||
| PRES. & CEO SMCA & SSC | 50.00 | 0 | $900,414 | $0 | $29,990 | Yes (X) | ||||
| GREGORY HARTMAN | ||||||||||
| PRES. & CEO UMB/CEC/CAMP | 50.00 | 0 | $869,840 | $0 | $27,538 | Yes (X) | ||||
| ROBERT BONAR JR MD | ||||||||||
| PRESIDENT & CEO - SFH/DELL | 49.00 | 1.00 | $1,085,971 | $0 | $31,870 | Yes (X) | ||||
| CHRISTOPHER HARTLE | ||||||||||
| SR. VP MANAGED CARE | 49.00 | 1.00 | $696,228 | $0 | $26,349 | Yes (X) | ||||
| TRENNIS JONES | ||||||||||
| SR. VP/CHIEF ADMIN. OFFICER | 50.00 | 0 | $722,132 | $0 | $14,349 | Yes (X) | ||||
| TIMOTHY LEE LAFREY | ||||||||||
| CHIEF OPERATIONS OFFICER | 50.00 | 0.00 | $1,052,821 | $0 | $17,020 | Yes (X) | ||||
| FRANK MAZZA | ||||||||||
| ASSOC. CHIEF MED OFFICER | 45.00 | 0 | $679,846 | $0 | $19,295 | Yes (X) | ||||
| PAULA CAMPBELL | ||||||||||
| FORMER OFFICER (END 5/14) | 0.00 | 0.00 | $780,846 | $0 | $18,743 | Yes (X) | ||||
| GERALD HILL | ||||||||||
| FORMER OFFICER (END 6/11) | 0.00 | 40.00 | $0 | $120,855 | $14,217 | Yes (X) | ||||
| DOUGLAS D WAITE | ||||||||||
| FORMER OFFICER (END 6/13) | 0.00 | 0.00 | $576,713 | $0 | $12,826 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $15,628,688 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,567,834 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $457,953 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 554 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $25,937,310 | RelatedOrganizationsAmt |
| Government Grants | $3,621,297 | GovernmentGrantsAmt |
| All Other Contributions | $2,116,925 | AllOtherContributionsAmt |
| Total Contributions | $31,675,532 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 621400 | $1,792,282,493 | $1,792,282,493 | |
| Health & Med Insurance Revenue | 900099 | $59,554,759 | $59,554,759 | |
| I/C Management Fees | 900099 | $14,856,857 | $14,856,857 | |
| Contract Services Revenue | 900099 | $4,589,860 | $4,589,860 | |
| Lab Services Revenue | 900099 | $1,509,708 | $1,509,708 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,625,390 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,625,390 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,874,419,067 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,360,261 | TotalRevenueColumnAmt |
| Exclusion | $32,360,261 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,474,956 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $205,294 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,269,662 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,269,662 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $112,742 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,156,920 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $46,659 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $46,659 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,659 | TotalRevenueColumnAmt |
| Exclusion | $46,659 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Direct Expenses | $10,228,656 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,228,656 | TotalRevenueColumnAmt |
| Exclusion | -$10,228,656 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,710,090 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $1,075,956 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $634,134 | TotalRevenueColumnAmt |
| Exclusion | $634,134 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Ancillary Revenue | 900099 | $5,323,829 | $5,323,829 |
| cafeteria | 611430 | $5,070,130 | $5,070,130 |
| additional fees | 900099 | $3,848,925 | $3,848,925 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $58,741,926 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $58,660,596 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $16,045 | UnrelatedBusinessRevenueAmt |
| Exclusion | $65,285 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $72,984,810 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,003,161,469 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,931,569,955 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,638,495 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,277,487 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,275,934 | TotalAmt |
| Program Services | $3,275,934 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,000 | TotalAmt |
| Program Services | $108,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,290,110 | TotalAmt |
| Program Services | $9,492,337 | ProgramServicesAmt |
| Management And General | $797,773 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,389,128 | TotalAmt |
| Program Services | $1,281,432 | ProgramServicesAmt |
| Management And General | $107,696 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $653,765,622 | TotalAmt |
| Program Services | $548,180,312 | ProgramServicesAmt |
| Management And General | $105,585,310 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,751,680 | TotalAmt |
| Program Services | $106,838,044 | ProgramServicesAmt |
| Management And General | $3,913,636 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,427,184 | TotalAmt |
| Program Services | $42,535,787 | ProgramServicesAmt |
| Management And General | $2,891,397 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,471,122 | TotalAmt |
| Program Services | $158,868,729 | ProgramServicesAmt |
| Management And General | $21,602,393 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,718,740 | TotalAmt |
| Program Services | $11,435 | ProgramServicesAmt |
| Management And General | $1,707,305 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,401,891 | TotalAmt |
| Program Services | $2,401,891 | ProgramServicesAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,003,084 | TotalAmt |
| Management And General | $1,003,084 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,698,082 | TotalAmt |
| Program Services | $97,240,128 | ProgramServicesAmt |
| Management And General | $66,457,954 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,269,061 | TotalAmt |
| Program Services | $1,686,073 | ProgramServicesAmt |
| Management And General | $5,582,988 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,483,252 | TotalAmt |
| Program Services | $25,412,760 | ProgramServicesAmt |
| Management And General | $3,070,492 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,635,613 | TotalAmt |
| Program Services | $3,406,207 | ProgramServicesAmt |
| Management And General | $229,406 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,646,588 | TotalAmt |
| Program Services | $44,637,855 | ProgramServicesAmt |
| Management And General | $3,008,733 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,229,081 | TotalAmt |
| Program Services | $822,284 | ProgramServicesAmt |
| Management And General | $406,797 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,778,151 | TotalAmt |
| Program Services | $4,476,650 | ProgramServicesAmt |
| Management And General | $301,501 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,049,893 | TotalAmt |
| Program Services | $13,739,190 | ProgramServicesAmt |
| Management And General | $310,703 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,246,535 | TotalAmt |
| Program Services | $68,417,098 | ProgramServicesAmt |
| Management And General | $829,437 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,753,951 | TotalAmt |
| Program Services | $316,914 | ProgramServicesAmt |
| Management And General | $7,437,037 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $225,451,826 | $225,451,826 | $0 |
| Service Fees | $20,420,814 | $20,420,814 | |
| REMEDIATION EXPENSES | $5,815,680 | $5,239,174 | $576,506 |
| UBI TAX | -$41,985 | -$41,985 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,830,523 | TotalAmt |
| Program Services | $42,278,860 | ProgramServicesAmt |
| Management And General | $14,551,663 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,666,869,560 | TotalAmt |
| Program Services | $1,426,497,749 | ProgramServicesAmt |
| Management And General | $240,371,811 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,182,813 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,004,561 | BOYAmt |
| EOY | $276,053,576 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,334,157 | BOYAmt |
| EOY | $28,882,634 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,792,023 | BOYAmt |
| EOY | $7,045,844 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,550,881,386 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $740,701,107 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $801,829,680 | BOYAmt |
| EOY | $810,180,279 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,788,261 | BOYAmt |
| EOY | $19,336,260 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,233,483 | BOYAmt |
| EOY | $30,817,425 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,740,439,888 | BOYAmt |
| EOY | $1,959,555,155 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,875,604,866 | BOYAmt |
| EOY | $3,131,871,173 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,217,048 | BOYAmt |
| EOY | $183,050,357 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,459,303 | BOYAmt |
| EOY | $1,277,026 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,224,293 | BOYAmt |
| EOY | $5,505,816 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $515,700,694 | BOYAmt |
| EOY | $537,345,861 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $703,601,338 | BOYAmt |
| EOY | $727,179,060 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,159,215,267 | BOYAmt |
| EOY | $2,385,355,853 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,788,261 | BOYAmt |
| EOY | $19,336,260 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,172,003,528 | BOYAmt |
| EOY | $2,404,692,113 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,875,604,866 | BOYAmt |
| EOY | $3,131,871,173 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $336,291,909 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$41,064,474 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$62,538,850 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | Yes (true) | MailingsMembersInd |
| Mailings Members | $13,500 | MailingsMembersAmt |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $326,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $663,584 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,003,084 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | Seton Family of Hospitals may, to an insubstantial degree, make comments or statements concerning legislation which may affect the health care industry. Seton has not intervened in any political campaigns. Expenses incurred in lobbying activities were primarily composed of staff salary, some limited travel, and conference expenses. There were contacts with federal representatives and their staff regarding health care issues and various proposals. The contacts were made by mail, telephone, and in person. All contacts attempted to demonstrate how the proposals would impact residents and providers in Central Texas. These lobbying expenses amounted to $326,000 for FY15. Additional lobbying expenses of $677,084 represent the portion of dues paid to national and state hospital associations that are specifically allocable to lobbying. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $96,234,271 | BeginningYearBalanceAmt |
| Contributions | $3,172,353 | ContributionsAmt |
| Investment Earnings Or Losses | $310,792 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $4,994,543 | OtherExpendituresAmt |
| End Year Balance | $94,722,873 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,813,204 | BeginningYearBalanceAmt |
| Contributions | $5,726,699 | ContributionsAmt |
| Investment Earnings Or Losses | $11,292,475 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,598,107 | OtherExpendituresAmt |
| End Year Balance | $96,234,271 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $70,910,105 | BeginningYearBalanceAmt |
| Contributions | $2,638,419 | ContributionsAmt |
| Investment Earnings Or Losses | $8,546,076 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $281,396 | OtherExpendituresAmt |
| End Year Balance | $81,813,204 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $69,160,318 | BeginningYearBalanceAmt |
| Contributions | $3,299,465 | ContributionsAmt |
| Investment Earnings Or Losses | $122,465 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,672,143 | OtherExpendituresAmt |
| End Year Balance | $70,910,105 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $59,338,696 | BeginningYearBalanceAmt |
| Contributions | $3,198,570 | ContributionsAmt |
| Investment Earnings Or Losses | $9,485,599 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,862,547 | OtherExpendituresAmt |
| End Year Balance | $69,160,318 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.15 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.3241 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.5259 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $49,096,312 | OtherCostOrOtherBasisAmt |
| Book Value | $49,096,312 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $924,020,703 | OtherCostOrOtherBasisAmt |
| Depreciation | $347,868,591 | DepreciationAmt |
| Book Value | $576,152,112 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,381,898 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,568,126 | DepreciationAmt |
| Book Value | $16,813,772 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $462,377,595 | OtherCostOrOtherBasisAmt |
| Depreciation | $371,264,390 | DepreciationAmt |
| Book Value | $91,113,205 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $77,004,878 | OtherCostOrOtherBasisAmt |
| Book Value | $77,004,878 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $810,180,279 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| interest in investments held by ascension health alliance | $1,102,484,484 |
| due from network | $698,955,097 |
| other receivables | $94,146,663 |
| investments in unconsolidated entities | $28,451,448 |
| ah deferred compensation asset | $25,535,753 |
| other assets | $9,131,221 |
| physician asset guarantee | $850,489 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,959,555,155 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $119,000 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| intercompany debt with ascension health alliance | $354,214,229 |
| other liabilities | $179,265,028 |
| a/r credit balance | $3,747,604 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $537,345,861 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 Intended uses of endowment funds | For almost four hundred years, the Daughters of Charity have lived in service to help the sick and the poor. In partnership with others, they have met the challenges and needs of our growing community since the Seton Infirmary opened its doors in 1902. To continue to sustain this legacy, Seton Fund of the Daughters of Charity of St. Vincent de Paul, Inc. and CMC Foundation of Central Texas created endowment funds to support the healthcare ministry of Seton Family of Hospitals. The principal of an endowment is never touched. The distributions from an endowment provide a dependable source of income each year to help Seton continue to meet the community's healthcare needs. Permanent and board-designated endowments are strategic fundraising tools to help maximize endowment growth and financial returns to benefit Seton's healthcare ministry for the long-term. |
| Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | From the consolidated audited financial statements of Seton Healthcare Family, which include the activity of Seton Family of Hospitals: The member health care entities of Seton are primarily tax-exempt organizations under Internal Revenue Code Section 501(c)(3) or 501(c)(2), and their related income is exempt from federal income tax under Section 501(a). Seton accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. No liability for uncertain tax positions was reported for this organization. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 375 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $185,505,245 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,283,886 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $169,221,359 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1015 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $272,607,980 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $187,535,232 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $85,072,748 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0510 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $458,113,225 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $203,819,118 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $254,294,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1526 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,808,241 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $437,875 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,370,366 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0014 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,282,661 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,907,698 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $32,374,963 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0194 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $424,226,155 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $360,253,179 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $63,972,976 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0384 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,699,796 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $159,138 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,540,658 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0015 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,994,651 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $42,994,651 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0258 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $517,011,504 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $372,757,890 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $144,253,614 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0865 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $975,124,729 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $576,577,008 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $398,547,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.2391 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,950 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $40,410 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $40,410 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $51,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $51,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,750 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $84,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $84,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $261,860 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $261,860 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $194,030,375 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $32,079,231 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $180,248,491 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $291,815,904 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$111,567,413 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (4 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|
| AUSTIN CYBERKNIFE LLC | ||
| RADIATION OUTPATIENT TREATMENT PROCEDURE | 0.2 | 0.2 |
| CEDAR PARK HEALTH SYSTEM LP | ||
| OUTPATIENT SURGERY CENTER | 0.2 | 0.2 |
| STRICTLY PEDIATRICS SURGERY CENTER OF CENTRAL TEXAS LLC | ||
| PEDIATRIC AMBULATORY SURGERY CENTER | 0.2545 | 0.259 |
| CTRH LLC | ||
| OUTPATIENT CLINIC | 0.2 | 0.2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 14 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (14 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Research FacilityResearchFacilityInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Facility Reporting GroupFacilityReportingGroupCd | Teaching HospitalTeachingHospitalInd | Childrens HospitalChildrensHospitalInd | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Seton Medical Center Austin | ||||||||||||||
| 1 | 1201 West 38th Street | AUSTIN | TX | 78705 | www.seton.net | 000497 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | |||
| University Medical Center Brackenridge | ||||||||||||||
| 2 | 601 East 15th Street | AUSTIN | TX | 78701 | www.seton.net | 000335 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | Yes (X) | ||
| Dell Children's Medical Center of Central Texas | ||||||||||||||
| 3 | 4900 Mueller Blvd | AUSTIN | TX | 78723 | www.seton.net | 008520 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | Yes (X) | Yes (X) | |
| Seton Edgar B Davis Hospital | ||||||||||||||
| 4 | 130 Hays Street | LULING | TX | 78648 | www.seton.net | 000597 | Yes (X) | Yes (X) | Yes (X) | B | Yes (X) | |||
| Seton Highland Lakes Hospital | ||||||||||||||
| 5 | 3201 S Water Street | BURNET | TX | 78611 | www.seton.net | 000559 | Yes (X) | Yes (X) | Yes (X) | B | Yes (X) | |||
| Seton Northwest Hospital | ||||||||||||||
| 6 | 11113 Research Blvd | AUSTIN | TX | 78759 | www.seton.net | 007976 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | |||
| Seton Southwest Hospital | ||||||||||||||
| 7 | 7900 FM 1826 | AUSTIN | TX | 78737 | www.seton.net | 007975 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | |||
| Seton Shoal Creek Hospital | ||||||||||||||
| 8 | 3501 Mills Avenue | AUSTIN | TX | 78731 | www.seton.net | 000770 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | |||
| Seton Medical Center Williamson | ||||||||||||||
| 9 | 201 Seton Parkway | ROUND ROCK | TX | 78665 | www.seton.net | 008617 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | |||
| Seton Medical Center Hays | ||||||||||||||
| 10 | 6001 Kyle Parkway | KYLE | TX | 78640 | www.seton.net | 100029 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | |||
| Cedar Park Regional Medical Center | ||||||||||||||
| 11 | 1490 E Whitestone Blvd | CEDAR PARK | TX | 78613 | www.seton.net | 008583 | Yes (X) | Yes (X) | Yes (X) | A | ||||
| Central Texas Rehabilitation Hospital | ||||||||||||||
| 12 | 1201 West 38th Street | AUSTIN | TX | 78705 | www.seton.net | 100147 | Yes (X) | Yes (X) | Yes (X) | A | ||||
| Seton Medical Center Harker Heights | ||||||||||||||
| 13 | 850 W Central Expressway | HARKER HEIGHTS | TX | 76548 | www.seton.net | 100149 | Yes (X) | Yes (X) | Yes (X) | B | ||||
| Seton Smithville Regional Hospital | ||||||||||||||
| 14 | 800 East Highway 71 | SMITHVILLE | TX | 78957 | www.seton.net | 100103 | Yes (X) | Yes (X) | Yes (X) | B | ||||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)
| First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Information GapsInformationGapsInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Rpt Available Thru Other MethodRptAvailableThruOtherMethodInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy AttachedStrategyAttachedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Asset Level CriteriaAssetLevelCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd | FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd | FAP Notice DisplayedFAPNoticeDisplayedInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd | FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd | FAP Notified All PatientsFAPNotifiedAllPatientsInd | Documented Elig DeterminationDocumentedEligDeterminationInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Other Method UsedOtherMethodUsedInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd | FacilityFacilityNum |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| false | false | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 12 | Yes (true) | Yes (true) | Yes (true) | Yes (true) | Yes (X) | SEE STATEMENT | Yes (X) | Yes (X) | Yes (true) | 12 | false | Yes (true) | false | Yes (true) | Yes (X) | 1.0 | 3.75 | Yes (X) | Yes (true) | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | false | |
| B | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| false | false | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 12 | Yes (true) | false | false | Yes (true) | Yes (X) | See Statement | Yes (X) | Yes (X) | Yes (true) | 12 | false | Yes (true) | false | Yes (true) | Yes (X) | 1.0 | 3.75 | Yes (X) | Yes (true) | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | false | |
| Seton Shoal Creek Hospital | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| false | false | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 12 | Yes (true) | Yes (true) | Yes (true) | Yes (true) | Yes (X) | See Statement | Yes (X) | Yes (X) | Yes (true) | 13 | false | Yes (true) | false | Yes (true) | Yes (X) | 1.0 | 3.75 | Yes (X) | Yes (true) | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | false | 8 |
Supplemental Information SupplementalInformationGrp (110 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility A, 1 | Facility A, 1 - Facility 1 -- Seton Medical Center Austin. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive. |
| Schedule H, Part V, Section B, Line 5 Facility A, 2 | Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive. |
| Schedule H, Part V, Section B, Line 5 Facility A, 3 | Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive. |
| Schedule H, Part V, Section B, Line 5 Facility A, 4 | Facility A, 4 - Facility 6 -- Seton Northwest Hospital. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive. |
| Schedule H, Part V, Section B, Line 5 Facility A, 5 | Facility A, 5 - Facility 7 -- Seton Southwest Hospital. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive. |
| Schedule H, Part V, Section B, Line 5 Facility A, 6 | Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. The WilCo Wellness Alliance was formed as a result of Williamson County being designated as an ACHIEVE (Action Communities for Health, Innovation, and Environmental Change) community in 2009. The mission of the alliance is to empower the people of Williamson County to lead healthy lifestyles by promoting a safe environment through public and private initiatives. The Alliance, grassroots and volunteer organizations, civic groups, philanthropy and foundation, and other groups provide forums for community members and leaders to come together to discuss and plan action in communities. Alliance leadership identified the history of coalitions and other alliances as well as citizen and leadership support for health and quality of life measures as a major strength of Williamson County. Leadership also recognizes the county's interactive values for being helpful and resourceful, supportive, sharing and caring about each other, having intergenerational and close-knit communities, connectedness, being proactive and involved in issues, and having a common unity. |
| Schedule H, Part V, Section B, Line 5 Facility A, 7 | Facility A, 7 - Facility 10 -- Seton Medical Center Hays. The Seton Healthcare Family, in collaboration with the CommuniCare Health Centers of Central Texas, hosted a Community Health Needs Summit for Hays County. The Summit was designed as a way to update the community on progress that has been made since the last CHNA and to provide them with current data to engage in needs identification. The two goals for the summit were for the community to discuss current needs effecting Hays and then prioritize those needs in order of importance. The invitation to the Summit was sent out through local collaborations, partnership, and council list serves with targeted outreach to schools and other key community stakeholders. In attendance was representation from the public health department, hospitals, clinics, school districts, and other service providers that serve the community. A complete list of Summit participants can be found in Appendix 1 of the Community Health Needs Assessment. In order to identify the community's needs, Seton Healthcare Family presented current health and demographic data to the Summit participants. Participants then engaged in table discussions regarding what the data revealed to them as well as what other needs they see in the community that did not show up in the data. This collaborative process created a list of needs that were shared with the larger group and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants then used a dot voting method to express their opinion as to which category was the highest priority need and which sub group was most important within that need. After tallying the results, the participants reviewed the results and further added any remaining thoughts. The following information is a summation of the data analysis coupled with the feedback from the community. |
| Schedule H, Part V, Section B, Line 5 Facility A, 8 | Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. The WilCo Wellness Alliance was formed as a result of Williamson County being designated as an ACHIEVE (Action Communities for Health, Innovation, and Environmental Change) community in 2009. The mission of the alliance is to empower the people of Williamson County to lead healthy lifestyles by promoting a safe environment through public and private initiatives. The Alliance, grassroots and volunteer organizations, civic groups, philanthropy and foundation, and other groups provide forums for community members and leaders to come together to discuss and plan action in communities. Alliance leadership identified the history of coalitions and other alliances as well as citizen and leadership support for health and quality of life measures as a major strength of Williamson County. Leadership also recognizes the county's interactive values for being helpful and resourceful, supportive, sharing and caring about each other, having intergenerational and close-knit communities, connectedness, being proactive and involved in issues, and having a common unity. |
| Schedule H, Part V, Section B, Line 5 Facility A, 9 | Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive. |
| Schedule H, Part V, Section B, Line 6a Facility A, 1 | Facility A, 1 - Facility 1 -- Seton Medical Center Austin. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health |
| Schedule H, Part V, Section B, Line 6a Facility A, 2 | Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health |
| Schedule H, Part V, Section B, Line 6a Facility A, 3 | Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health |
| Schedule H, Part V, Section B, Line 6a Facility A, 4 | Facility A, 4 - Facility 6 -- Seton Northwest Hospital. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health |
| Schedule H, Part V, Section B, Line 6a Facility A, 5 | Facility A, 5 - Facility 7 -- Seton Southwest Hospital. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health |
| Schedule H, Part V, Section B, Line 6a Facility A, 6 | Facility A, 6 - Facility 12 -- Central Texas Rehabilitation Hospital. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health |
| Schedule H, Part V, Section B, Line 6b Facility A, 1 | Facility A, 1 - Facility 1 -- Seton Medical Center Austin. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation |
| Schedule H, Part V, Section B, Line 6b Facility A, 2 | Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation |
| Schedule H, Part V, Section B, Line 6b Facility A, 3 | Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation |
| Schedule H, Part V, Section B, Line 6b Facility A, 4 | Facility A, 4 - Facility 6 -- Seton Northwest Hospital. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation |
| Schedule H, Part V, Section B, Line 6b Facility A, 5 | Facility A, 5 - Facility 7 -- Seton Southwest Hospital. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation |
| Schedule H, Part V, Section B, Line 6b Facility A, 6 | Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. The other organizations with which the reporting hospital facility conducted its CHNA, include: - Baylor Scott and White Healthcare - St. David's Healthcare |
| Schedule H, Part V, Section B, Line 6b Facility A, 7 | Facility A, 7 - Facility 10 -- Seton Medical Center Hays. The CHNA was conducted with Communicare Health Centers of Central Texas. |
| Schedule H, Part V, Section B, Line 6b Facility A, 8 | Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. The other organizations with which the reporting hospital facility conducted its CHNA, include: - Baylor Scott and White Healthcare - St. David's Healthcare |
| Schedule H, Part V, Section B, Line 6b Facility A, 9 | Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation |
| Schedule H, Part V, Section B, Line 7 Facility A, 1 | Facility A, 1 - Facility 1 -- Seton Medical Center Austin. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf |
| Schedule H, Part V, Section B, Line 7 Facility A, 2 | Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf |
| Schedule H, Part V, Section B, Line 7 Facility A, 3 | Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf |
| Schedule H, Part V, Section B, Line 7 Facility A, 4 | Facility A, 4 - Facility 6 -- Seton Northwest Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf |
| Schedule H, Part V, Section B, Line 7 Facility A, 5 | Facility A, 5 - Facility 7 -- Seton Southwest Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf |
| Schedule H, Part V, Section B, Line 7 Facility A, 6 | Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Williamson-CHA_Final_Approved.pdf |
| Schedule H, Part V, Section B, Line 7 Facility A, 7 | Facility A, 7 - Facility 10 -- Seton Medical Center Hays. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Hays_Community_Needs_assessment.pdf |
| Schedule H, Part V, Section B, Line 7 Facility A, 8 | Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: http://www.cedarparkregional.com/Uploads/Public/Documents/Division%202/Cedar%20Park%20Regional%20Medical%20Center/2013Williamson-CHA.pdf |
| Schedule H, Part V, Section B, Line 7 Facility A, 9 | Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: http://austintexas.gov/sites/default/files/files/Health/CHA-CHIP/cha_report_Dec2012.pdf |
| Schedule H, Part V, Section B, Line 11 Facility A, 1 | Facility A, 1 - SETON MEDICAL CENTER AUSTIN - PART 1. The SMCA Implementation Plan addresses the four health needs; access to care, behavioral health, chronic disease, and obesity in the order of priority identified through the Travis County CHNA. Also addressed in the SMCA plan is an overview of the hospital's policy of providing financial assistance to low income patients and a strategy for addressing community collaboration. Obesity The 2012 Travis County Community Health Needs Assessment identified obesity as one of the most pressing health issues. While obesity in Travis County is below the national average, childhood obesity was listed as a particular area of need as this condition is disproportionately evident among minority populations. With a 24% obesity rate in adults, Travis County falls below the state average of 29.6%. However, when that rate is broken down by ethnicity, the need to address obesity among minority populations becomes more obvious. 41.7% of the Black/African American adults in Travis County and 36.5% of Latino/Hispanic adults are considered obese compared to 19.4% for White residents. According to CHNA data and focus group respondents, this disparity may be attributed to the unequal distribution and affordability of fresh fruit and vegetable outlets throughout the County as well as an unequal distribution of obesity-related programs. The City of Austin Health Department, the local school districts, and many local non-profits are working to reduce the obesity rate in our community. One way that Seton is exploring to reduce obesity is through the Seton Healthcare Family Pre-Diabetes Program. This program is a pilot program associated with the Seton Health Centers located in Travis County. The program helps to transform the lives of vulnerable working poor patients - patients who have been identified as being at increased risk for developing diabetes - by providing an array of empowering and essential interventions including psychosocial assessment, health literacy assessment, spiritual counseling, weight loss counseling, diabetes prevention education, nutrition counseling, grocery store tours, social services referrals, and community resource referrals. The program provides poor, at-risk adults with the information, tools and support they need to achieve obesity risk-reduction to help prevent diabetes, and to move patients from having from pre-diabetes glucose levels to having normal glucose. Seton currently serves in a leadership role with the Mayor's Health and Fitness Council (MHFC). MHFC is a local non-profit organization in Travis County whose vision is to support and inspire people to improve their health by encouraging physical activity, improved nutrition and tobacco-free living. A Seton hospital Chief Operating Officer currently serves on the board as the Vice Chair for the Council and Seton will continue to participate in this collaborative effort to make Austin the healthiest city in America. The CHNA identified access to healthy foods as a high priority. With the number of visitors and community members who visit the SMCA cafeteria on a daily basis, SMCA is dedicated to improving the nutritional value of the food offered at the facility. SMCA will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Chronic Disease and Disease Management The 2012 Travis County Community Health Needs Assessment identified chronic disease and disease management as the second highest health issue facing residents of Travis County. For the past six years the top three causes of death in Travis County have been related to chronic disease. Many focus group participants and interviewees cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. Seton Network Oncology Services currently works with several Seton hospitals, including SMCA, providing access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. SMCA refers patients to the Seton Shivers Cancer Center, located within University Medical Center Brackenridge. The Shivers Cancer Center provides a variety of outpatient services for adult cancer patients in Central Texas regardless of ability to pay. In addition to clinical services, the Shivers health care professionals work closely with the Seton Cancer Care Team to provide vital case management services plus a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. SMCA will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, SMCA will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Seton also has established the Seton Total Health Transitions team as a prototype of disease management as patients leave the hospital setting. Based on a successful pilot, SMCA will enhance and expand the model to better coordinate care through a Care Transition Intervention. This approach includes a multi-disciplinary team that monitors and coordinates the care of patients with chronic diseases immediately following discharge from hospital to home, and from home to primary care. This project is expected to optimize the patient's recovery and avoid readmission. Services include home visits to provide short-term direct care, social services, behavioral health support, transportation, telehealth and patient training regarding self-care management of the chronic disease(s). SMCA is developing a Chronic Care Management program that provides direct health care and care coordination for adults who have been seriously injured and to those who have experienced a serious illness due to multiple chronic conditions. This will be an extension of the Seton Total Health Partners pilot established in January 2012. This program assists enrollees in finding and receiving the medical care they need to achieve optimal health and prevent avoidable hospitalization and inappropriate use of emergency departments. The program provides a number of patient care interventions, a structured and monitored hand-off process, training for optimal self-care, counseling, and facilitated integration with primary and specialty physicians responsible for each patient's care. SMCA proposes to develop and implement a process improvement methodology to improve outcomes for adult inpatients diagnosed with Diabetics Mellitus. Diabetes Chronic Care Management will implement small, straightforward evidence-based practices to implement a Diabetes Care Bundle that, when performed collectively and reliably, has been proven to improve patient outcomes. In addition, this project will establish an interdisciplinary diabetes team, led by an endocrinologists and a diabetes clinical nurse specialist, to address the clinical, safety, and psychosocial needs of inpatients with diabetes while preparing for a successful discharge. The project will also implement evidence-based practice (EBP) protocols to ensure improved clinical outcomes during and post-hospitalization. |
| Schedule H, Part V, Section B, Line 11 Facility A, 2 | Facility A, 2 - SETON MEDICAL CENTER AUSTIN - PART 2. SMCA will continue to offer Seton's Asthma Education program to Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Travis County residents. SMCA will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. SMCA will continue its support of various clinics that help provide care for patients suffering from heart related chronic diseases. Heart disease was identified in the CHNA as a top cause of death for the community and SMCA will continue to provide support through the Heart Specialty Care and Transplant Center and Cardiac Rehab Clinic as a means of addressing the increasing need for cardiology services. Behavioral Health The CHNA identified mental health as one of the foremost health concerns raised by Travis County residents. Focus group participants and interviewees alike mentioned the rising rates of mental health conditions among Travis County residents. This included areas such as substance abuse and inadequate mental health services. The CHNA identified that 20% of Travis County adults experienced five or more days of poor mental health in the past month, which is well above the national median. SMCA has expanded access to Psychiatric Telemedicine to the Emergency Department and Intensive Care Units and will continue to expand these behavioral health services to the Med Surg/Inpatient floors by the end of 2013. By providing 24/7 psychiatric consultations patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. Other programs targeted to improve the health and well-being of SMCA patients and the community includes: No One Dies Alone (NODA) and the Seton Cove Spirituality Center. NODA provides trained volunteer bedside companionship for patients who might otherwise be alone at the time of death while Seton Cove Spirituality Center provides spiritually healing discussion groups, classes and events led by a multidisciplinary faculty both on the SMCA campus and at the Spirituality Center. Programs are open to the community. To augment the public school health education curriculum, Seton Healthcare Family has purchased HealthTeacher, a comprehensive K-12 online health education curriculum for teachers in school districts within Travis, Williamson, and Hays County. The curriculum provides over 300 age-appropriate lessons across 10 content areas aligned with the National Health Education Standards (NHES). Lessons are designed for integration into core curriculum areas such as language arts, science and social studies, and have been aligned with the Texas TEKS. They provide skills-based instruction linked to assessments. Health educators in school districts in Travis County were trained by national HealthTeacher staff on how to integrate and implement the HealthTeacher curriculum in the classroom. Access to Care Access to health care was a predominant theme among residents, specifically the availability and accessibility of health care facilities and resources. Also mentioned were the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Community forum participants recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. The Seton Health Centers were established to provide accessible, comprehensive health services to medically underserved families in Austin. Primary care physicians, nurse practitioners and physician assistants provide quality primary care to community residents on a sliding scale based on family size and income. Medicare, Medicaid and CHIP are also accepted. Each of the three clinics offers primary care, laboratory, case management, and health education services. Comprehensive social services are part of the Centers' medical mission as well. SMCA has and will continue to refer unfunded patients without a medical home to the Seton Community Health Centers for primary care. The Travis County Medical Society, the Seton Healthcare Family and other members of the Integrated Care Collaboration have initiated a coordinated system of volunteer doctors called Project Access. They work with other local providers to provide medical, hospital, diagnostic and pharmacy assistance for the uninsured in Travis County. The mission of Project Access is to provide ready access to appropriate health care services for uninsured people in Travis County whose incomes are at or below 200% of the Federal poverty level and to improve the overall health of our community. Seton helped secure a grant to create the program. More than 1,000 volunteer physicians participate in Project Access and Seton will continue to support the work of this collaboration to improve access to care. To help underserved residents navigate the complicated and fragmented health care system, SMCA will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, Seton provides in person sign language contracted services at all of our facilities. As part of an integrated approach to administer care in a person centered, culturally competent manner, Seton Healthcare Family through SMCA, will develop a Language Services Resource Center and a Culturally Competent Care Curriculum. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. |
| Schedule H, Part V, Section B, Line 11 Facility A, 3 | Facility A, 3 - SETON MEDICAL CENTER AUSTIN - PART 3. Access to prenatal care in the first trimester was identified as a need especially among the Latino/Hispanic population. To address this, SMCA will expand it Obstetrics Navigation (OB Navigation) project to improve access to pre- and post-natal care for uninsured Hispanic women with limited English proficiency through comprehensive, effective patient navigation services. Currently the SMCA Navigators work with women after they have established prenatal care. The new navigation initiative will place navigators out in the community to help assist newly pregnant women with accessing care in their first trimester and following them throughout their pregnancy ensuring they receive a post-partum check-up and are connected to medical home for on-going primary care. The OB Navigation Program will use culturally and linguistically competent community health workers to serve as patient navigators. SMCA will continue to increase access to services by supporting the Seton League House, a 38-room bed-and-bath facility designed to provide families and caregivers with a place to stay while their loved ones are hospitalized in an Austin-area hospital. The subsidized rooms reduce the barrier of travel costs associated with treatment. Community Collaboration Despite many non-profit and social service organizations within Travis County, many focus group participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesiveness and focused vision leads residents to feel that there is more dialogue than there is action. More coordinated approaches would help maximize limited resources. In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. In 2012, Seton and the Travis County Healthcare District began development of a non-profit Community Care Collaborative (CCC) with the purpose of advancing the health of identified vulnerable populations in Travis County through high-quality, cost effective, person centered care. The essential elements of the CCC are: patient centered medical homes, developing a health information exchange for its patients, case management of a selected high risk population, pharmacy management, integrated outpatient/inpatient protocols, and transitional care. The CCC will be outcome driven and rely heavily on analytics to drive process improvement and innovation. Seton Healthcare Family is a partner of the Community Action Network (CAN) and will continue to support this local collaboration. CAN is a partnership of government, non-profit, private, and faith-based organizations who work together to enhance the social, health, educational, and economic well-being of Central Texas. As a partner of CAN, Seton has representatives on the Board of Directors and is committed to working with other CAN Partners to attain the mission of CAN. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SMCA screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SMCA patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. |
| Schedule H, Part V, Section B, Line 11 Facility A, 4 | Facility A, 4 - UNIVERSITY MEDICAL CENTER BRACKENRIDGE - PART 1. The UMCB Implementation Plan addresses the four health needs; access to care, behavioral health, chronic disease, and obesity in the order of priority identified through the Travis County CHNA. Also addressed in the UMCB plan is an overview of the hospital's policy of providing financial assistance to low income patients and a strategy for addressing community collaboration. Obesity The 2012 Travis County Community Health Needs Assessment identified obesity as one of the most pressing health issues. While obesity in Travis County is below the national average, childhood obesity was listed as a particular area of need as this condition is disproportionately evident among minority populations. With a 24% obesity rate in adults, Travis County falls below the state average of 29.6%. However, when that rate is broken down by ethnicity, the need to address obesity among minority populations becomes more obvious. 41.7% of the Black/African American adults in Travis County and 36.5% of Latino/Hispanic adults are considered obese compared to 19.4% for White residents. According to CHNA data and focus group respondents, this disparity may be attributed to the unequal distribution and affordability of fresh fruit and vegetable outlets throughout the County as well as an unequal distribution of obesity-related programs. The City of Austin Health Department, the local school districts, and many local non-profits are working to reduce the obesity rate in our community. One way that Seton is exploring to reduce obesity is through the Seton Healthcare Family Pre-Diabetes Program. This program is a pilot program associated with the Seton Health Centers located in Travis County. The program helps to transform the lives of vulnerable working poor patients - patients who have been identified as being at increased risk for developing diabetes - by providing an array of empowering and essential interventions including psychosocial assessment, health literacy assessment, spiritual counseling, weight loss counseling, diabetes prevention education, nutrition counseling, grocery store tours, social services referrals, and community resource referrals. The program provides poor, at-risk adults with the information, tools and support they need to achieve obesity risk-reduction to help prevent diabetes, and to move patients from having from pre-diabetes glucose levels to having normal glucose. Seton currently serves in a leadership role with the Mayor's Health and Fitness Council (MHFC). MHFC is a local non-profit organization in Travis County whose vision is to support and inspire people to improve their health by encouraging physical activity, improved nutrition and tobacco-free living. A Seton hospital Chief Operating Officer currently serves on the board as the Vice Chair for the Council and Seton will continue to participate in this collaborative effort to make Austin the healthiest city in America. The CHNA identified access to healthy foods as a high priority. With the number of visitors and community members who visit the UMCB cafeteria on a daily basis, UMCB is dedicated to improving the nutritional value of the food offered at the facility. UMCB will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Chronic Disease and Disease Management The 2012 Travis County Community Health Needs Assessment identified chronic disease and disease management as the second highest health issue facing residents of Travis County. For the past six years the top three causes of death in Travis County have been related to chronic disease. Many focus group participants and interviewees cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. Seton Network Oncology Services currently works with several Seton hospitals, including UMCB, providing access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. UMCB refers patients to the Seton Shivers Cancer Center, located within UMCB. The Shivers Cancer Center provides a variety of outpatient services for adult cancer patients in Central Texas regardless of ability to pay. In addition to clinical services, the Shivers health care professionals work closely with the Seton Cancer Care Team to provide vital case management services plus a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. UMCB will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, UMCB will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Looking to improve the health of patients with chronic disease, Seton has established the Seton Total Health Transitions team as a prototype of disease management as patients leave the hospital setting. Based on a successful pilot, UMCB will enhance and expand the model to better coordinate care through a Care Transition Intervention. This approach includes a multi-disciplinary team that monitors and coordinates the care of patients with chronic diseases immediately following discharge from hospital to home, and from home to primary care. This project is expected to optimize the patient's recovery and avoid readmission. Services include home visits to provide short-term direct care, social services, behavioral health support, transportation, telehealth and patient training regarding self-care management of the chronic disease(s). UMCB is developing a Chronic Care Management program that provides direct health care and care coordination for adults who have been seriously injured and to those who have experienced a serious illness due to multiple chronic conditions. This will be an extension of the Seton Total Health Partners pilot established in January 2012. This program assists enrollees in finding and receiving the medical care they need to achieve optimal health and prevent avoidable hospitalization and inappropriate use of emergency departments. The program provides a number of patient care interventions, a structured and monitored hand-off process, training for optimal self-care, counseling, and facilitated integration with primary and specialty physicians responsible for each patient's care. UMCB proposes to develop and implement a process improvement methodology to improve outcomes for adult inpatients diagnosed with Diabetics Mellitus. Diabetes Chronic Care Management will implement small, straightforward evidence-based practices to implement a Diabetes Care Bundle that, when performed collectively and reliably, has been proven to improve patient outcomes. In addition, this project will establish an interdisciplinary diabetes team, led by an endocrinologists and a diabetes clinical nurse specialist, to address the clinical, safety, and psychosocial needs of inpatients with diabetes while preparing for a successful discharge. The project will also implement evidence-based practice (EBP) protocols to ensure improved clinical outcomes during and post-hospitalization. |
| Schedule H, Part V, Section B, Line 11 Facility A, 5 | Facility A, 5 - UNIVERSITY MEDICAL CENTER BRACKENRIDGE - PART 2. UMCB will continue to offer Seton's Asthma Education program to Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Travis County residents. UMCB will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. Behavioral Health The Travis County CHNA identified a shortage of behavioral health providers. By expanding the behavioral health workforce, greater care can be provided to individuals with behavioral health needs in Travis County, especially those who are under- or uninsured. UMCB plans to expand Post Graduate Training for Psychiatric Specialties/Psychiatric Residency Programs. This project will expand the residency training programs in psychiatric specialties to increase the workforce of providers in our community treating psychiatric patients and increase access to behavior health services for the indigent and uninsured. Focus group participants and interviewees alike mentioned the rising number of mental health conditions among Travis County residents. This included areas such as substance abuse and inadequate mental health services. The CHNA identified that 20% of Travis County adults experienced five or more days of poor mental health in the past month, which is well above the national median. UMCB has expanded access to Psychiatric Telemedicine to the entire UMCB facility and will continue to support this behavioral health service. By providing 24/7 psychiatric consultations, including after hours, patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. With a need for timely mental health assessments, UMCB will explore the development of a Behavioral Health Assessment and Resource Navigation project. This will be a free comprehensive assessment of behavioral health needs that can then be used to connect patients to community resources. Substance abuse and Substance Use Disorder (SUD) were concerns for community members. UMCB will develop a Substance Abuse Navigation transition service for patients who are at risk for SUD. The program will direct individuals to early intervention and provide access to treatment opportunities and education for the indigent and uninsured. Other programs targeted to improve the health and well-being of UMCB patients and the community includes: No One Dies Alone (NODA) and the Seton Cove Spirituality Center. NODA provides trained volunteer bedside companionship for patients who might otherwise be alone at the time of death while Seton Cove Spirituality Center provides spiritually healing discussion groups, classes and events led by a multidisciplinary faculty both on the UMCB campus and at the Spirituality Center. Programs are open to the community. To augment the public school health education curriculum, Seton Healthcare Family has purchased HealthTeacher, a comprehensive K-12 online health education curriculum for teachers in school districts within Travis, Williamson, and Hays County. The curriculum provides over 300 age-appropriate lessons across 10 content areas aligned with the National Health Education Standards (NHES). Lessons are designed for integration into core curriculum areas such as language arts, science and social studies, and have been aligned with the Texas TEKS. They provide skills-based instruction linked to assessments. Health educators in school districts in Travis County were trained by national HealthTeacher staff on how to integrate and implement the HealthTeacher curriculum in the classroom. Access to Care Access to health care was a predominant theme among residents, specifically the availability and accessibility of health care facilities and resources. Also mentioned were the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Community forum participants recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. The Seton Health Centers were established to provide accessible, comprehensive health services to medically underserved families in Austin. Primary care physicians, nurse practitioners and physician assistants provide quality primary care to community residents on a sliding scale based on family size and income. Medicare, Medicaid and CHIP are also accepted. Each of the three clinics offers primary care, laboratory, case management, and health education services. Comprehensive social services are part of the Centers' medical mission as well. UMCB has and will continue to refer unfunded patients without a medical home to the Seton Community Health Centers for primary care. UMCB will also continue to maintain its close relationship to the Paul Bass Clinic located at the hospital. Paul Bass Clinic serves as the medical home for more than 1,500 individuals. It provides additional capacity for residents with multiple diagnoses and no established medical home. In addition to the primary care services, the clinic will offer quality specialty care in such specialties as cardiology, pulmonology, gastroenterology, orthopedics, otolaryngology, endocrinology, and rheumatology. The Travis County Medical Society, the Seton Healthcare Family and other members of the Integrated Care Collaboration have initiated a coordinated system of volunteer doctors called Project Access. They work with other local providers to provide medical, hospital, diagnostic and pharmacy assistance for the uninsured in Travis County. The mission of Project Access is to provide ready access to appropriate health care services for uninsured people in Travis County whose incomes are at or below 200% of the Federal poverty level and to improve the overall health of our community. Seton helped secure a grant to create the program. More than 1,000 volunteer physicians participate in Project Access and Seton will continue to support the work of this collaboration to improve access to care. UMCB will continue to support the Clinic at Brackenridge, an outpatient department of UMCB that provides specialty evaluation, treatment, and follow-up care to adults on an outpatient basis. Referrals come from the Austin/Travis county community health clinics and some other community agencies, labor and delivery, and the emergency department according to referral guidelines. The clinics are transitional in nature and after consultation the patient is sent back to the referring entity for primary care. This clinic provides specialty care to un/underinsured patients and sees over 25,000 individuals a year. |
| Schedule H, Part V, Section B, Line 11 Facility A, 6 | Facility A, 6 - UNIVERSITY MEDICAL CENTER BRACKENRIDGE - PART 3. To help underserved residents navigate the complicated and fragmented health care system, UMCB will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, we provide in person sign language contracted services at all of our facilities as well as Spanish in person interpreters at UMCB. As part of an integrated approach to administer care in a person centered, culturally competent manner, Seton Healthcare Family through UMCB, will develop a Language Services Resource Center and a Culturally Competent Care Curriculum. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. Access to prenatal care in the first trimester was identified as a need especially among the Latino/Hispanic population. To address this, UMCB will expand it Obstetrics Navigation (OB Navigation) project to improve access to pre- and post-natal care for uninsured Hispanic women with limited English proficiency through comprehensive, effective patient navigation services. Currently the UMCB Navigators work with women after they have established prenatal care. The new navigation initiative will place navigators out in the community to help assist newly pregnant women with accessing care in their first trimester and following them throughout their pregnancy ensuring they receive a post-partum check-up and are connected to medical home for on-going primary care. The OB Navigation Program will use culturally and linguistically competent community health workers to serve as patient navigators. UMCB will continue to increase access to services by supporting the Seton League House, a 38-room bed-and-bath facility designed to provide families and caregivers with a place to stay while their loved ones are hospitalized in an Austin-area hospital. The subsidized rooms reduce the barrier of travel costs associated with treatment. Community Collaboration Despite many non-profit and social service organizations within Travis County, many focus group participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesiveness and focused vision leads residents to feel that there is more dialogue than there is action. More coordinated approaches would help maximize limited resources. In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. In 2012, Seton and the Travis County Healthcare District began development of a non-profit Community Care Collaborative (CCC) with the purpose of advancing the health of identified vulnerable populations in Travis County through high-quality, cost effective, person centered care. The essential elements of the CCC are: patient centered medical homes, developing a health information exchange for its patients, case management of a selected high risk population, pharmacy management, integrated outpatient/inpatient protocols, and transitional care. The CCC will be outcome driven and rely heavily on analytics to drive process improvement and innovation. Seton Healthcare Family is a partner of the Community Action Network (CAN) and will continue to support this local collaboration. CAN is a partnership of government, non-profit, private, and faith-based organizations who work together to enhance the social, health, educational, and economic well-being of Central Texas. As a partner of CAN, Seton has representatives on the Board of Directors and is committed to working with other CAN Partners to attain the mission of CAN. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. UMCB screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers UMCB patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. |
| Schedule H, Part V, Section B, Line 11 Facility A, 7 | Facility A, 7 - DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS - PART 1. Due to its large service area, the identified health needs from all seven CHNA's were taken into account when creating the Implementation Plan for DCMC. The three health needs; behavioral health, chronic disease, and obesity were identified in every CHNA. Another gap identified consistently across all counties was access to care. This large need bucket includes a multitude of factors including lack of providers for the un/underinsured; the high cost of care; education on service navigation; limited specialty care or services; lack of insurance coverage, and transportation-related issues. Additional needs identified in the communities that DCMC serves were increased community collaboration and addressing accident-related injuries/deaths. Obesity A majority of key informants, including Central Health Connection interviewees, considered obesity to be a pressing health issue, particularly among children and in relation to other chronic diseases such as diabetes and heart disease. Interview participants identified disparities among racial/ethnic groups impacted by obesity, especially Blacks/African Americans and Latinos/Hispanics. While obesity was only mentioned as a community concern in a few focus groups, the importance of and challenges around nutrition and exercise were frequently discussed. Quantitative results show that in 2008-2010, the percentage of obese youth at the county level was below that of Texas overall (15.6%) and the national HP2020 target (14.6%), yet higher among Blacks/African Americans (12.0%) and Latinos/Hispanics (13.0%). Additionally male youth (13.8%) were more than twice as likely to be obese than female youth (6.0%). DCMC has implemented various community outreach programs and educational opportunities to help educate children and their families about living a healthy lifestyle. In response to the growing trend of obese children, DCMC established the Texas Center for the Prevention and Treatment of Childhood Obesity (TCPTCO) in 2010. The aim of TCPTCO was to provide children and their families an opportunity to learn from a multidisciplinary team through classes, nutrition education, and counseling to achieve a healthy lifestyle. In addition, DCMC collaborates with dozens of community organizations and advocacy groups whose goal is to turn the curve on the obesity trend in Central Texas. During 2013 - 2015, DCMC will incorporate a Multi-level Family and Child Obesity Initiative into the currently established programs available at the TCPTCO. This program will be a comprehensive childhood obesity intervention with a tiered approach, increasing the intensity of the intervention depending upon the unique needs of the child. This initiative will address the lack of: 1) Accessible information on local programming and resources that help support healthy active living; 2) Primary care provider's ability to effectively address childhood obesity in their offices; and 3) Access to services for the dramatic number of morbidly obese children in Travis County. The CHNA identified access to healthy foods as a high priority. With the number of visitors and community members who visit the DCMC cafeteria on a daily basis, DCMC is dedicated to improving the nutritional value of the food offered at the facility. DCMC will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Chronic Disease and Disease Management The 2012 Travis County Community Health Needs Assessment identified chronic disease and disease management as the second highest health issue facing residents of Travis County. For the past six years the top three causes of death in Travis County have been related to chronic disease. During the CHNA process many focus group participants and interviewees cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. DCMC will expand a pilot to manage the comprehensive care of children with complex, chronic disease in the outpatient setting with its Care Management for Chronically Ill Children and Adolescents project. The purpose of this project is to identify and manage a population of children with a very high disease complexity and multiple co-morbid conditions to deliver comprehensive integrated care that can improve outcomes. The proposed model creates an outpatient clinic to deliver comprehensive integrated primary and specialty care to these children. Multidisciplinary services such as palliative care, behavioral medicine and psychiatric care are embedded in the care structure in a manner that affirms the family as a unit of concern and designs processes that maximize well days for the entire family unit. While communicable disease was not discussed during focus groups or interviews, effective population health management through immunizations for diseases has been proven to drastically decrease and eradicate these life-threatening illnesses. In the CHNA parents mentioned the importance of immunizations for their children. DCMC has helped AISD meet the state milestone of having 100% of the schools with 95% of students fully vaccinated. DCMC will continue to support AISD in meeting this standard of immunization but in recognizing that immunization challenges still exist, DCMC will conduct Immunization Clinics at schools with the greatest need. These immunizations will be given free of charge and will provide students access to the necessary immunizations earlier in the school year cycle. DCMC will continue to offer Seton's Asthma Education program to Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Behavioral Health The CHNA identified mental health as one of the foremost health concerns raised by Travis County residents. Focus group participants and interviewees alike mentioned the rising rates of mental health conditions among Travis County residents. Through the Children's/AISD Student Health Services collaboration, DCMC has been able to build a collaborative approach for responding to student behavioral and mental health needs. The school nurses, which are employees of DCMC, provide identified students with individualized care plans for significant ongoing behavioral and mental health needs. DCMC will increase professional development for these school based nurses to aid in identifying and addressing behavioral health issues in addition to improving its electronic system for capturing and reporting care plans, with the hope of improved identification and documentation of student behavioral health needs. As a result of the SHS data analysis and the CHNA, DCMC and SHS will work to improve information sharing on campus safety and student behavioral health issues between SHS, Child Study Teams, and community partners. Additionally, through this collaborative DCMC will support the implementation of the Social Emotional Learning (SEL) by AISD. SEL is a curriculum-based, evidence -based approach to teaching skills that support student behavioral health. |
| Schedule H, Part V, Section B, Line 11 Facility A, 8 | Facility A, 8 - DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS - PART 2. To augment the public school health education curriculum, Dell Children's has purchased HealthTeacher, a comprehensive K-12 online health education curriculum for teachers in school districts within Travis, Williamson, and Hays County. The curriculum provides over 300 age-appropriate lessons across 10 content areas aligned with the National Health Education Standards (NHES). Lessons are designed for integration into core curriculum areas such as language arts, science and social studies, and have been aligned with the Texas TEKS. They provide skills-based instruction linked to assessments. AISD Health educators were trained by national HealthTeacher staff on how to integrate and implement the HealthTeacher curriculum in the classroom. DCMC is home to the Texas Child Study Center, a collaboration between Dell Children's Medical Center of Central Texas and the College of Educational Psychology of The University of Texas. The Texas Child Study Center provides evidence based treatment for children and adolescents with emotional, behavioral, and developmental disabilities. In addition, Texas Child Study Center provides assessment and treatment for those children with acute or chronic medical illnesses, epilepsy, cystic fibrosis, diabetes, obesity, and traumatic injuries to address co-occurring mental health issues that these youth often face. DCMC proposes to increase access to behavioral health services through the delivery of psychotherapy, psychiatric assessments and medication management on school campuses to children and adolescents through a Campus Based Counseling Referral Center. This project will provide psychotherapy and medication management on campuses of select AISD schools, especially targeting students who have difficulty accessing services due to funding, transportation, or access to providers. Each school year, this project will establish and operate one or more school-based behavioral health clinics; thereafter the established clinic(s) will be operated by Lone Star Circle of Care in collaboration with AISD under the direction of DCMC. Early identification of mental health needs and access to services is crucial to preventing the unnecessary use of crisis services, utilization of the DCMC Emergency Department and use of inpatient resources. By providing services on the school campus, less classroom time is lost and transportation burdens are alleviated as students will not need to leave the school campus. Access to Care Access to health care was a predominant theme among residents, specifically the availability and accessibility of health care facilities and resources. Also mentioned were the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Community forum participants recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. Dell Children's and Lone Star Circle of Care, a Federally Qualified Health Center, have partnered to increase access to care for children by opening five Dell Circle of Care pediatric clinics. The clinics will provide greater access to high-quality health care for underserved children in Williamson County, providing a combined capacity to serve 40,000 children each year. Over the next three years Dell Children's will continue to work with Lone Star to expand access to other counties. As the population of central Texas grows and to increase the availability of pediatric specialty services, DCMC has committed to hire additional physicians in the following specialties: pediatric gastroenterology, pediatric endocrinology, pediatric neurology, adolescent medicine, pediatric pain management and medical pediatrics/transitional medicine. With the addition of these specialists, DCMC will not only be able to better serve children in central Texas, we will be able to serve those in rural communities in Williamson County, Waco and Bryan/College/Station. In continuing with the charge that all children deserve quality health care, DCMC will continue to provide primary care services for uninsured children and their teen parents through its mobile health unit, Children's Health Express. The mission of Children's Health Express is to address the health needs of children who do not have a medical home. This mobile health team delivers primary care and preventative pediatric health care at several school sites and community based organizations around the County. The Children's Health express will work with community partners to identify additional potential stops for the mobile clinic as the access needs change over time. To help underserved residents navigate the complicated and fragmented health care system, DCMC will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. In addition to providing access to primary care, DCMC is committed to providing access to specialty care through its Specialty Care Center. The specialty care center is made up of a neurosurgery center, a craniofacial plastic surgery center, pediatric orthopedics, and a cystic fibrosis center in an effort to increase the availability and access of specialty services in Central Texas. DCMC will support exploring opportunities to expand and increase specialty services to medically underserved areas of their community. Financial Assistance Being uninsured can be a barrier to access. In order to help connect residents with publically available assistance programs, insure-a-kid, a Seton Healthcare Family department, is available to help community members apply for publically subsidized health care coverage. Insure-a-kid staff is located in the community and within DCMC to help families with uninsured children apply for and enroll in Medicaid and CHIP. Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. DCMC screens all uninsured patients and if a patient is not eligible for a government funded program, Seton's financial assistance policy covers DCMC patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. Accidents Accidents and injury prevention were needs that came up in some of the rural CHNA's. Dell Children's has created an Injury Prevention Program whose mission is to lessen the burden of pediatric injury by identifying and addressing injury risks that affect the lives of patients and families at DCMC and throughout our Central Texas communities. The DCMC injury prevention program will accomplish this by strengthening individual knowledge and skills, providing community education and access to resources, educating providers, fostering coalitions and networks, influencing organizational practices, and advocating at all levels of policy and legislation that protect children from injury. |
| Schedule H, Part V, Section B, Line 11 Facility A, 9 | Facility A, 9 - DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS - PART 3. The Austin Area Safe Kids Coalition will also continue to be supported by DCMC. Safe Kids Austin, led by Dell Children's Medical Center of Central Texas, is a member of Safe Kids Worldwide, the nation's first non-profit organization dedicated solely to the prevention of accidental childhood injury. Safe Kids Worldwide is made up of more than 600 state and local Safe Kids coalitions in all 50 states, the District of Columbia and Puerto Rico. Safe Kids Austin consists of more than 30 community, civic, and state organizations. The Coalitions' initiatives include classroom-based programs and educational events for families. The Coalition focuses on promoting safety in vehicles, around water and while walking and biking. Safe Kids Austin promotes changes in attitudes, behaviors, laws and the environment to prevent accidental injury to children. In the United States, Safe Kids partnerships have contributed to a 45 percent reduction in the child fatality rate from accidental injury - saving an estimated 38,000 children's lives. Locally, this is done thru community partnerships, advocacy, public awareness and distribution of, and education on the proper uses of, safety equipment. The Childhood Transportation Safety Committee is a group of stakeholders committed to reducing the incidence of unintentional injuries in the City of Austin by raising awareness of injury risks and encouraging behavioral, environmental and policy changes that prevent injury related to child motor vehicle occupants, child pedestrians, and child cyclist in targeted geographic areas. There are multiple workgroups under the committee attempting to develop a Childhood Transportation Safety Strategy (i.e. plan) for specific geographic areas in the Austin City limits. Community Collaboration Despite the formation of individual county collaborations and children's collaborations focused on improving the health and well-being of the community, several of the CHNA's identified a need to improve on strengthening community partnerships. DCMC will continue to support Children's Optimal Health as a community collaboration that aims to pull community based organizations together in an effort to identify and address the community needs of childhood obesity, access to prenatal care, motor vehicle collisions, and access to primary care. Through this collaboration DCMC will assist in the review of geo mapping data regarding where there are volumes of families with uninsured children and no nearby public health clinics. Through this collaborative, DCMC's Injury Prevention Program has identified "hot spots" or areas of Travis County where child passenger seats are underutilized. The Program has moved child passenger seat fitting stations to the "hot spot" areas to improve access and education to those communities. In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers that serve the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on providing quality healthcare to children and adults in specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. In 2012, Seton and the Travis County Healthcare District began development of a non-profit Community Care Collaborative (CCC) with the purpose of advancing the health of identified vulnerable populations in Travis County through high-quality, cost effective, person centered care. The essential elements of the CCC are: patient centered medical homes, developing a health information exchange for its patients, case management of a selected high risk population, pharmacy management, integrated outpatient/inpatient protocols, and transitional care. The CCC will be outcome driven and rely heavily on analytics to drive process improvement and innovation. |
| Schedule H, Part V, Section B, Line 11 Facility A, 10 | Facility A, 10 - SETON NORTHWEST HOSPITAL - PART 1. THE SNW IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE TRAVIS COUNTY CHNA. ALSO ADDRESSED IN THE SNW PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. OBESITY THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE MOST PRESSING HEALTH ISSUES. WHILE OBESITY IN TRAVIS COUNTY IS BELOW THE NATIONAL AVERAGE, CHILDHOOD OBESITY WAS LISTED AS A PARTICULAR AREA OF NEED AS THIS CONDITION IS DISPROPORTIONATELY EVIDENT AMONG MINORITY POPULATIONS. WITH A 24% OBESITY RATE IN ADULTS, TRAVIS COUNTY FALLS BELOW THE STATE AVERAGE OF 29.6%. HOWEVER, WHEN THAT RATE IS BROKEN DOWN BY ETHNICITY, THE NEED TO ADDRESS OBESITY AMONG MINORITY POPULATIONS BECOMES MORE OBVIOUS. 41.7% OF THE BLACK/AFRICAN AMERICAN ADULTS IN TRAVIS COUNTY AND 36.5% OF LATINO/HISPANIC ADULTS ARE CONSIDERED OBESE COMPARED TO 19.4% FOR WHITE RESIDENTS. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY-RELATED PROGRAMS. THE CITY OF AUSTIN HEALTH DEPARTMENT, THE LOCAL SCHOOL DISTRICTS, AND MANY LOCAL NON-PROFITS ARE WORKING TO REDUCE THE OBESITY RATE IN OUR COMMUNITY. ONE WAY THAT SETON IS EXPLORING TO REDUCE OBESITY IS THROUGH THE SETON HEALTHCARE FAMILY PRE-DIABETES PROGRAM. THIS PROGRAM IS A PILOT PROGRAM ASSOCIATED WITH THE SETON HEALTH CENTERS LOCATED IN TRAVIS COUNTY. THE PROGRAM HELPS TO TRANSFORM THE LIVES OF VULNERABLE WORKING POOR PATIENTS - PATIENTS WHO HAVE BEEN IDENTIFIED AS BEING AT INCREASED RISK FOR DEVELOPING DIABETES - BY PROVIDING AN ARRAY OF EMPOWERING AND ESSENTIAL INTERVENTIONS INCLUDING PSYCHOSOCIAL ASSESSMENT, HEALTH LITERACY ASSESSMENT, SPIRITUAL COUNSELING, WEIGHT LOSS COUNSELING, DIABETES PREVENTION EDUCATION, NUTRITION COUNSELING, GROCERY STORE TOURS, SOCIAL SERVICES REFERRALS, AND COMMUNITY RESOURCE REFERRALS. THE PROGRAM PROVIDES POOR, AT-RISK ADULTS WITH THE INFORMATION, TOOLS AND SUPPORT THEY NEED TO ACHIEVE OBESITY RISK-REDUCTION TO HELP PREVENT DIABETES, AND TO MOVE PATIENTS FROM HAVING FROM PRE- DIABETES GLUCOSE LEVELS TO HAVING NORMAL GLUCOSE. SETON CURRENTLY SERVES IN A LEADERSHIP ROLE WITH THE MAYOR'S HEALTH AND FITNESS COUNCIL (MHFC). MHFC IS A LOCAL NON-PROFIT ORGANIZATION IN TRAVIS COUNTY WHOSE VISION IS TO SUPPORT AND INSPIRE PEOPLE TO IMPROVE THEIR HEALTH BY ENCOURAGING PHYSICAL ACTIVITY, IMPROVED NUTRITION AND TOBACCO-FREE LIVING. A SETON HOSPITAL CHIEF OPERATING OFFICER CURRENTLY SERVES ON THE BOARD AS THE VICE CHAIRFOR THE COUNCIL AND SETON WILL CONTINUE TO PARTICIPATE IN THIS COLLABORATIVE EFFORT TO MAKE AUSTIN THE HEALTHIEST CITY IN AMERICA. THE CHNA IDENTIFIED ACCESS TO HEALTHY FOODS AS A HIGH PRIORITY. WITH THE NUMBER OF VISITORS AND COMMUNITY MEMBERS WHO VISIT THE SNW CAFETERIA ON A DAILY BASIS, SNW IS DEDICATED TO IMPROVING THE NUTRITIONAL VALUE OF THE FOOD OFFERED AT THE FACILITY. SNW WILL WORK WITH TOUCHPOINT, ITS FOOD SERVICE VENDOR, TO IMPROVE THE NUTRITIONAL CONTENT IN THE FOOD SERVED THROUGH A HEALTHY DINING PROGRAM TO ENSURE THAT OUR DAILY OFFERINGS ARE GEARED TOWARD PROVIDING HEALTHY CHOICES AND OPTIONS FOR OUR GUESTS. THIS WILL NOT ONLY BENEFIT PATIENTS BUT ALSO VISITORS, PHYSICIANS, AND COMMUNITY MEMBERS WHO FREQUENT THE HOSPITAL. SNW IS COMMITTED TO ITS SUPPORT OF THE IGNITE WOMEN'S HEALTH PROGRAM WHICH IS DEDICATED TO PROVIDING WOMEN WITH A CONTINUUM OF SUPPORT REGARDING THEIR HEALTH AND WELLNESS, AND OPPORTUNITIES TO LIGHT UP THEIR LIVES. IGNITE OFFERS AN ARRAY OF PROGRAMS FROM PREVENTATIVE WELLNESS TO RESTORATIVE HEALTH CARE, TO EDUCATE AND ENCOURAGE WOMEN IN A HEALTHY LIFESTYLE AND IN TURN - A HEALTHY COMMUNITY. PROGRAMS INCLUDE FREE FITNESS, ZUMBA, YOGA, AND SELF- DEFENSE CLASSES, IN ADDITION TO FREE CARDIAC SCREENINGS, BMI, BLOOD PRESSURE, AND MANY MORE TESTS THAT HELP WOMEN MEASURE THEIR OVERALL HEALTH. IGNITE ALSO OFFERS NUTRITION AND COOKING CLASSES TO HELP PROMOTE HEALTHY EATING HABITS. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF TRAVIS COUNTY. FOR THE PAST SIX YEARS THE TOP THREE CAUSES OF DEATH IN TRAVIS COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. SETON NETWORK ONCOLOGY SERVICES CURRENTLY WORKS WITH SEVERAL SETON HOSPITALS, INCLUDING SNW, PROVIDING ACCESS TO THE SETON CANCER PREVENTION AND EARLY DETECTION PROGRAM, THE ONCOLOGY NURSE REGISTRY, THE SURVIVORSHIP PROGRAM, THE MULTIDISCIPLINARY CANCER CONFERENCE AND CLINICS AND NAVIGATION SERVICE. SETON'S COMPREHENSIVE ONCOLOGY PROGRAMS PROVIDE RESIDENTS OF CENTRAL TEXAS ACCESS TO CANCER SERVICES THAT PROMOTE EARLY DETECTION AND A COORDINATED APPROACH TO CARE THROUGHOUT THE CONTINUUM WHICH INCLUDES SCREENING, DIAGNOSIS, TREATMENT AND SURVIVORSHIP. SNW REFERS PATIENTS TO THE SETON SHIVERS CANCER CENTER. THE SHIVERS CANCER CENTER PROVIDES A VARIETY OF OUTPATIENT SERVICES FOR ADULT CANCER PATIENTS IN CENTRAL TEXAS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO CLINICAL SERVICES, THE SHIVERS HEALTH CARE PROFESSIONALS WORK CLOSELY WITH THE SETON CANCER CARE TEAM TO PROVIDE VITAL CASE MANAGEMENT SERVICES PLUS A VARIETY OF PHYSICAL, EMOTIONAL, AND SPIRITUAL SUPPORT PROGRAMS TO ADULT CANCER PATIENTS AND THEIR FAMILIES. SNW WILL WORK WITH THE NEW WOMEN'S ONCOLOGY CARE SCREENING PROGRAM. THIS PROGRAM EXPANDS TIMELY ACCESS TO BREAST AND CERVICAL CANCER SCREENING VIA A MOBILE UNIT FOR UNINSURED AND UNDERINSURED WOMEN IN CENTRAL TEXAS WHO, WITHOUT THIS EXPANSION, LIKELY WOULD NOT RECEIVE THESE LIFE-SAVING SERVICES. THIS EXPANSION IN SCREENING IS PART OF SETON'S DIGITAL MAMMOGRAPHY MOBILE UNIT KNOWN AS THE BIG PINK BUS. ACCESS TO CERVICAL CANCER SCREENINGS ARE NOW EXPANDED TO MOBILE MAMMOGRAPHY PROGRAM PARTICIPANTS BY USING ADVANCED PRACTICE NURSES ON THE MOBILE UNIT OR AT OUR COMMUNITY CLINICS THAT PROVIDE INDIGENT CARE. IN ADDITION TO THE SCREENING, SNW WILL INCORPORATE WOMEN'S ONCOLOGY NAVIGATION AS A METHOD OF EXPANDING EXISTING PATIENT NAVIGATION SERVICES THAT CONNECT WOMEN WITH CANCER DIAGNOSIS TO TREATMENT AND/OR SURVIVORSHIP SUPPORT SERVICES. LOOKING TO IMPROVE THE HEALTH OF PATIENTS WITH CHRONIC DISEASE, SETON HAS ESTABLISHED THE SETON TOTAL HEALTH TRANSITIONS TEAM AS A PROTOTYPE OF DISEASE MANAGEMENT AS PATIENTS LEAVE THE HOSPITAL SETTING. BASED ON A SUCCESSFUL PILOT, SNW WILL ENHANCE AND EXPAND THE MODEL TO BETTER COORDINATE CARE THROUGH A CARE TRANSITION INTERVENTION. THIS APPROACH INCLUDES A MULTI-DISCIPLINARY TEAM THAT MONITORS AND COORDINATES THE CARE OF PATIENTS WITH CHRONIC DISEASES IMMEDIATELY FOLLOWING DISCHARGE FROM HOSPITAL TO HOME, AND FROM HOME TO PRIMARY CARE. THIS PROJECT IS EXPECTED TO OPTIMIZE THE PATIENT'S RECOVERY AND AVOID READMISSION. SERVICES INCLUDE HOME VISITS TO PROVIDE SHORT-TERM DIRECT CARE, SOCIAL SERVICES, BEHAVIORAL HEALTH SUPPORT, TRANSPORTATION, TELEHEALTH AND PATIENT TRAINING REGARDING SELF-CARE MANAGEMENT OF THE CHRONIC DISEASE(S). SNW IS DEVELOPING A CHRONIC CARE MANAGEMENT PROGRAM THAT PROVIDES DIRECT HEALTH CARE AND CARE COORDINATION FOR ADULTS WHO HAVE BEEN SERIOUSLY INJURED AND TO THOSE WHO HAVE EXPERIENCED A SERIOUS ILLNESS DUE TO MULTIPLE CHRONIC CONDITIONS. THIS WILL BE AN EXTENSION OF THE SETON TOTAL HEALTH PARTNERS PILOT ESTABLISHED IN JANUARY 2012. THIS PROGRAM ASSISTS ENROLLEES IN FINDING AND RECEIVING THE MEDICAL CARE THEY NEED TO ACHIEVE OPTIMAL HEALTH AND PREVENT AVOIDABLE HOSPITALIZATION AND INAPPROPRIATE USE OF EMERGENCY DEPARTMENTS. THE PROGRAM PROVIDES A NUMBER OF PATIENT CARE INTERVENTIONS, A STRUCTURED AND MONITORED HAND-OFF PROCESS, TRAINING FOR OPTIMAL SELF-CARE, COUNSELING, AND FACILITATED INTEGRATION WITH PRIMARY AND SPECIALTY PHYSICIANS RESPONSIBLE FOR EACH PATIENT'S CARE. |
| Schedule H, Part V, Section B, Line 11 Facility A, 11 | Facility A, 11 - SETON NORTHWEST HOSPITAL - PART 2. SNW PROPOSES TO DEVELOP AND IMPLEMENT A PROCESS IMPROVEMENT METHODOLOGY TO IMPROVE OUTCOMES FOR ADULT INPATIENTS DIAGNOSED WITH DIABETICS MELLITUS. DIABETES CHRONIC CARE MANAGEMENT WILL IMPLEMENT SMALL, STRAIGHTFORWARD EVIDENCE-BASED PRACTICES TO IMPLEMENT A DIABETES CARE BUNDLE THAT, WHEN PERFORMED COLLECTIVELY AND RELIABLY, HAS BEEN PROVEN TO IMPROVE PATIENT OUTCOMES. IN ADDITION, THIS PROJECT WILL ESTABLISH AN INTERDISCIPLINARY DIABETES TEAM, LED BY AN ENDOCRINOLOGISTS AND A DIABETES CLINICAL NURSE SPECIALIST, TO ADDRESS THE CLINICAL, SAFETY, AND PSYCHOSOCIAL NEEDS OF INPATIENTS WITH DIABETES WHILE PREPARING FOR A SUCCESSFUL DISCHARGE. THE PROJECT WILL ALSO IMPLEMENT EVIDENCE-BASED PRACTICE (EBP) PROTOCOLS TO ENSURE IMPROVED CLINICAL OUTCOMES DURING AND POST-HOSPITALIZATION. SNW WILL CONTINUE TO OFFER SETON'S ASTHMA EDUCATION PROGRAM TO CENTRAL TEXAS RESIDENTS. THIS PROGRAM PROVIDES HOME VISITS FOR ASTHMA EDUCATION TO NEARLY 1,000 UNINSURED AND UNDERINSURED FAMILIES PER YEAR. BY PROVIDING EDUCATION ABOUT SERVICES IN THE HOME, RESIDENTS OVERCOME TRANSPORTATION BARRIERS THAT OFTEN ACCOMPANY THIS TARGET POPULATION. THE SETON ASTHMA & COPD CENTER PROVIDES A COMPREHENSIVE DISEASE MANAGEMENT PROGRAM DESIGNED TO PROVIDE CARE COORDINATION, SOCIAL SERVICES, AND ASTHMA/COPD EDUCATION FOR ALL AGES. SETON HEALTHCARE FAMILY FACILITIES ARE A TOBACCO FREE ENVIRONMENT, PROHIBITING TOBACCO USE AT ALL OF ITS HOSPITALS AND PLACES OF WORK. SETON IS AN ACTIVE PARTICIPANT IN COMMUNITY EFFORTS TO COMBAT TOBACCO USE, PROVIDING TOBACCO CESSATION SERVICES TO TRAVIS COUNTY RESIDENTS. SNW WILL CONTINUE TO SUPPORT THE TOBACCO CESSATION PROGRAM THAT PROVIDES COMMUNITY-WIDE TRAINING FOR PHYSICIANS AND LOCAL CLINICS BASED ON BEST PRACTICES FOR TREATING NICOTINE ADDICTION. IN ADDITION, THE SETON TOBACCO EDUCATION RESOURCE CENTER OFFERS A COMPREHENSIVE TOBACCO EDUCATION PROGRAM WHICH PROVIDES CESSATION CLASSES THAT ARE BASED ON THE MAYO CLINIC MODEL FOR TREATING TOBACCO DEPENDENCE. SESSIONS FOLLOW A SUPPORT GROUP SETTING AND ARE FACILITATED BY CERTIFIED TOBACCO TREATMENT SPECIALIST. THROUGH MOTIVATIONAL INTERVIEWING TECHNIQUES CTTS ARE ABLE TO CONDUCT SESSIONS THAT AIM AT MAXIMIZING & PROMOTING PARTICIPANT DIALOGUE. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS RAISED BY TRAVIS COUNTY RESIDENTS. FOCUS GROUP PARTICIPANTS AND INTERVIEWEES ALIKE MENTIONED THE RISING RATES OF MENTAL HEALTH CONDITIONS AMONG TRAVIS COUNTY RESIDENTS. THIS INCLUDED AREAS SUCH AS SUBSTANCE ABUSE AND INADEQUATE MENTAL HEALTH SERVICES. THE CHNA IDENTIFIED THAT 20% OF TRAVIS COUNTY ADULTS EXPERIENCED FIVE OR MORE DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH, WHICH IS WELL ABOVE THE NATIONAL MEDIAN. SNW WILL EXPANDED ACCESS TO PSYCHIATRIC TELEMEDICINE TO THE EMERGENCY DEPARTMENT IN AUGUST 2013 AND WILL CONTINUE TO EXPAND THESE BEHAVIORAL HEALTH SERVICES TO REMAINDER OF THE HOSPITAL FLOORS BY THE END OF 2014. BY PROVIDING 24/7 PSYCHIATRIC CONSULTATIONS PATIENTS IN PSYCHIATRIC CRISIS WILL BE ABLE TO BE EVALUATED AND TREATED IN A TIMELY MANNER. TYPICALLY PATIENTS WOULD HAVE TO WAIT UNTIL THE NEXT DAY FOR APPROPRIATE PSYCHIATRIC ASSESSMENT. THIS NEW APPROACH TO PSYCHIATRIC TELEMEDICINE CAN LEAD TO TIMELY ASSESSMENT, EARLIER DISPOSITION AND LESS COSTLY LEVEL OF CARE. OTHER PROGRAMS TARGETED TO IMPROVE THE MENTAL HEALTH AND WELL- BEING OF SNW PATIENTS AND COMMUNITY MEMBERS INCLUDE THE SETON COVE SPIRITUALITY CENTER. THE SETON COVE SPIRITUALITY CENTER PROVIDES SPIRITUALLY HEALING DISCUSSION GROUPS, CLASSES AND EVENTS LED BY A MULTIDISCIPLINARY FACULTY BOTH ON THE SNW CAMPUS AND AT THE SPIRITUALITY CENTER. PROGRAMS ARE OPEN TO THE COMMUNITY. TO AUGMENT THE PUBLIC SCHOOL HEALTH EDUCATION CURRICULUM, SETON HEALTHCARE FAMILY HAS PURCHASED HEALTHTEACHER, A COMPREHENSIVE K-12 ONLINE HEALTH EDUCATION CURRICULUM FOR TEACHERS IN SCHOOL DISTRICTS WITHIN TRAVIS, WILLIAMSON, AND HAYS COUNTY. THE CURRICULUM PROVIDES OVER 300 AGE-APPROPRIATE LESSONS ACROSS 10 CONTENT AREAS ALIGNED WITH THE NATIONAL HEALTH EDUCATION STANDARDS (NHES). LESSONS ARE DESIGNED FOR INTEGRATION INTO CORE CURRICULUM AREAS SUCH AS LANGUAGE ARTS, SCIENCE AND SOCIAL STUDIES, AND HAVE BEEN ALIGNED WITH THE TEXAS TEKS. THEY PROVIDE SKILLS-BASED INSTRUCTION LINKED TO ASSESSMENTS. HEALTH EDUCATORS IN SCHOOL DISTRICTS IN TRAVIS COUNTY WERE TRAINED BY NATIONAL HEALTHTEACHER STAFF ON HOW TO INTEGRATE AND IMPLEMENT THE HEALTHTEACHER CURRICULUM IN THE CLASSROOM. ACCESS TO CARE ACCESS TO HEALTH CARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE FACILITIES AND RESOURCES. ALSO MENTIONED WERE THE DIFFICULTY OF NAVIGATING THE HEALTH CARE SYSTEM, THE HIGH COST OF CARE, AND THE INABILITY TO GAIN AND RETAIN HEALTH INSURANCE. COMMUNITY FORUM PARTICIPANTS RECOGNIZED A PRESENCE OF FACILITIES AND PROGRAMMING BUT THE MAJORITY NOTED THAT HEALTH CARE RESOURCES ARE GREATLY LACKING, ESPECIALLY FOR LOW-INCOME AND AGING POPULATIONS. THE SETON HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. SNW HAS AND WILL CONTINUE TO REFER UNFUNDED PATIENTS WITHOUT A MEDICAL HOME TO THE SETON COMMUNITY HEALTH CENTERS FOR PRIMARY CARE. |
| Schedule H, Part V, Section B, Line 11 Facility A, 12 | Facility A, 12 - SETON NORTHWEST HOSPITAL - PART 3. THE TRAVIS COUNTY MEDICAL SOCIETY, THE SETON HEALTHCARE FAMILY AND OTHER MEMBERS OF THE INTEGRATED CARE COLLABORATION HAVE INITIATED A COORDINATED SYSTEM OF VOLUNTEER DOCTORS CALLED PROJECT ACCESS. THEY WORK WITH OTHER LOCAL PROVIDERS TO PROVIDE MEDICAL, HOSPITAL, DIAGNOSTIC AND PHARMACY ASSISTANCE FOR THE UNINSURED IN TRAVIS COUNTY. THE MISSION OF PROJECT ACCESS IS TO PROVIDE READY ACCESS TO APPROPRIATE HEALTH CARE SERVICES FOR UNINSURED PEOPLE IN TRAVIS COUNTY WHOSE INCOMES ARE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL AND TO IMPROVE THE OVERALL HEALTH OF OUR COMMUNITY. SETON HELPED SECURE A GRANT TO CREATE THE PROGRAM. MORE THAN 1,000 VOLUNTEER PHYSICIANS PARTICIPATE IN PROJECT ACCESS AND SETON WILL CONTINUE TO SUPPORT THE WORK OF THIS COLLABORATION TO IMPROVE ACCESS TO CARE. SNW IS CURRENTLY ENGAGED IN A PARTNERSHIP WITH LONE STAR CIRCLE OF CARE TO BRING OBSTETRIC AND GYNECOLOGICAL SERVICES TO LOW INCOME WOMEN AND PEDIATRIC SERVICES TO CHILDREN IN NORTHWEST TRAVIS COUNTY TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SNW WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY THE SETON HEALTHCARE NETWORK, THE SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE CHNA IDENTIFIED HEALTH DISPARITIES AND INEQUITIES IN THE ABILITY OF DIFFERENT ETHNIC GROUPS TO ACCESS CARE. THE REASONS ARE COMPLEX. RESEARCH SHOWS PROVIDING PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE REDUCES READMISSIONS WITHIN 30 DAYS, REDUCES PATIENT BED DAYS, IMPROVES MEDICATION ADHERENCE AND LEADS TO BETTER HEALTH OUTCOMES. IN ADDITION, RESEARCH ALSO SHOWS PROVIDING CULTURAL COMPETENCE TRAINING TO OUR CLINICAL CARE TEAMS IMPROVES COMMUNICATION BETWEEN PATIENTS AND THEIR CLINICAL CARE TEAM INCLUDING THEIR DOCTORS AND NURSES AS MEASURED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS ("HCAHPS") SURVEY, THE FIRST NATIONAL, STANDARDIZED, PUBLICLY REPORTED SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. CURRENTLY SETON PROVIDES TELEPHONE INTERPRETATION SERVICES IN OVER 140 LANGUAGES, 24 HOURS, 7 DAYS A WEEK, 365 DAYS A YEAR. IN ADDITION, SETON PROVIDES IN PERSON SIGN LANGUAGE CONTRACTED SERVICES AT ALL OF OUR FACILITIES. AS PART OF AN INTEGRATED APPROACH TO ADMINISTER CARE IN A PERSON CENTERED, CULTURALLY COMPETENT MANNER, SETON HEALTHCARE FAMILY THROUGH SNW, WILL DEVELOP A LANGUAGE SERVICES RESOURCE CENTER AND A CULTURALLY COMPETENT CARE CURRICULUM. THE LANGUAGE SERVICES RESOURCE CENTER IS A NEW PROJECT WHICH WILL PROVIDE PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE BY CENTRALIZING INTERPRETATION & TRANSLATION SERVICES, AND INCREASING THE NUMBER OF PROFESSIONAL MEDICAL INTERPRETERS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY INCLUDING BUT NOT LIMITED TO SPANISH AND SIGN LANGUAGE. THE CULTURALLY COMPETENT CARE CURRICULUM IS EXPECTED TO INCREASE THE QUALITY OF COMMUNICATION BETWEEN THE CLINICAL CARE TEAM AND THE PATIENT IN ORDER TO ACHIEVE GREATER PATIENT INVOLVEMENT IN SHARED DECISION MAKING. THE DIVERSITY DEPARTMENT THROUGH THE CULTURALLY COMPETENT CARE CURRICULUM WILL PROVIDE TRAINING AND EDUCATION TO THE CLINICAL CARE TEAM TO INCREASE THE LIKELIHOOD OF SAFE AND EFFECTIVE PERSON CENTERED CARE IN A CULTURALLY COMPETENT MANNER AND LEADS TO BETTER HEALTH OUTCOMES. THE NUMBER OF SPANISH SPEAKING ONLY PATIENTS DELIVERING AT SNW IS GROWING. MANY OF THESE WOMEN ARE LOW INCOME AND ARE ENROLLED IN PUBLICALLY FUNDED HEALTHCARE COVERAGE; CHIP PERINATE OR MEDICAID. IN ORDER TO ENSURE THESE PATIENTS HAVE AN EASY TRANSITION FROM THE CLINIC TO THE HOSPITAL, SNW HAS EMPLOYED A CULTURALLY AND LINGUISTICALLY COMPETENT OB NAVIGATOR TO CONNECT WITH THESE PREGNANT PATIENTS PRIOR TO DELIVERY. THE OB NAVIGATOR ENSURES THE PATIENT IS PRE-REGISTERED WITH THE HOSPITAL AND RECEIVES A TOUR OF THE FACILITY. THE NAVIGATOR ASSISTS THE PATIENT WITH THEIR INSURANCE NEEDS AND EXPLAINS THE PROCESS OF ENROLLING THEIR NEWBORNS INTO MEDICAID. THE NAVIGATOR IS A PATIENT RESOURCE, ANSWERING ALL NON- CLINICAL QUESTIONS THE PATIENT MAY HAVE. SNW WILL CONTINUE TO INCREASE ACCESS TO SERVICES BY SUPPORTING THE SETON LEAGUE HOUSE, A 38-ROOM BED-AND-BATH FACILITY DESIGNED TO PROVIDE FAMILIES AND CAREGIVERS WITH A PLACE TO STAY WHILE THEIR LOVED ONES ARE HOSPITALIZED IN AN AUSTIN-AREA HOSPITAL. THE SUBSIDIZED ROOMS REDUCE THE BARRIER OF TRAVEL COSTS ASSOCIATED WITH TREATMENT. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN TRAVIS COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. MORE COORDINATED APPROACHES WOULD HELP MAXIMIZE LIMITED RESOURCES. IN 1997, SETON LED THE FORMATION OF THE INTEGRATED CARE COLLABORATION (ICC), AN ALLIANCE OF COMMUNITY PROVIDERS FOR THE MEDICALLY INDIGENT, INCLUDING HEALTH CARE ORGANIZATIONS, GOVERNMENT ENTITIES AND VOLUNTEER CLINICS. KNOWN AS THE ICC, THE GROUP'S GOAL WAS TO WORK TOGETHER TO INCREASE ACCESS, IMPROVE QUALITY AND FIND CREATIVE FINANCING SOLUTIONS FOR THE PROVISION OF HEALTH CARE FOR THE REGION'S UNINSURED. THE ICC HAS DEVELOPED AN AREA WIDE HEALTH INFORMATION EXCHANGE (HIE) FOR THE UN- AND UNDERINSURED THAT IS USED TO INFORM PROVIDERS ON THE CARE A SPECIFIC INDIVIDUAL HAS RECEIVED WHILE ALSO PROVIDING COMMUNITY WIDE ANALYTICS ON HEALTHCARE USAGE AND DIAGNOSTIC TRENDS. SINCE ITS INCEPTION THE ICC HAS BROKEN INTO MULTIPLE COLLABORATIONS, FOCUSING ON SPECIFIC GEOGRAPHIC AREAS. THE SETON HEALTHCARE FAMILY CONTINUES TO FUND THE ICC INFRASTRUCTURE. IN 2012, SETON AND THE TRAVIS COUNTY HEALTHCARE DISTRICT BEGAN DEVELOPMENT OF A NON-PROFIT COMMUNITY CARE COLLABORATIVE (CCC) WITH THE PURPOSE OF ADVANCING THE HEALTH OF IDENTIFIED VULNERABLE POPULATIONS IN TRAVIS COUNTY THROUGH HIGH-QUALITY, COST EFFECTIVE, PERSON CENTERED CARE. THE ESSENTIAL ELEMENTS OF THE CCC ARE: PATIENT CENTERED MEDICAL HOMES, DEVELOPING A HEALTH INFORMATION EXCHANGE FOR ITS PATIENTS, CASE MANAGEMENT OF A SELECTED HIGH RISK POPULATION, PHARMACY MANAGEMENT, INTEGRATED OUTPATIENT/INPATIENT PROTOCOLS, AND TRANSITIONAL CARE. THE CCC WILL BE OUTCOME DRIVEN AND RELY HEAVILY ON ANALYTICS TO DRIVE PROCESS IMPROVEMENT AND INNOVATION. SETON HEALTHCARE FAMILY IS A PARTNER OF THE COMMUNITY ACTION NETWORK (CAN) AND WILL CONTINUE TO SUPPORT THIS LOCAL COLLABORATION. CAN IS A PARTNERSHIP OF GOVERNMENT, NON-PROFIT, PRIVATE, AND FAITH-BASED ORGANIZATIONS WHO WORK TOGETHER TO ENHANCE THE SOCIAL, HEALTH, EDUCATIONAL, AND ECONOMIC WELL-BEING OF CENTRAL TEXAS. AS A PARTNER OF CAN, SETON HAS REPRESENTATIVES ON THE BOARD OF DIRECTORS AND IS COMMITTED TO WORKING WITH OTHER CAN PARTNERS TO ATTAIN THE MISSION OF CAN. FINANCIAL ASSISTANCE SETON IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. SNW SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS SNW PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL. |
| Schedule H, Part V, Section B, Line 11 Facility A, 13 | Facility A, 13 - SETON SOUTHWEST HOSPITAL - PART 1. THE SSW IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE TRAVIS COUNTY CHNA. ALSO ADDRESSED IN THE SSW PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. OBESITY THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE MOST PRESSING HEALTH ISSUES. WHILE OBESITY IN TRAVIS COUNTY IS BELOW THE NATIONAL AVERAGE, CHILDHOOD OBESITY WAS LISTED AS A PARTICULAR AREA OF NEED AS THIS CONDITION IS DISPROPORTIONATELY EVIDENT AMONG MINORITY POPULATIONS. WITH A 24% OBESITY RATE IN ADULTS, TRAVIS COUNTY FALLS BELOW THE STATE AVERAGE OF 29.6%. HOWEVER, WHEN THAT RATE IS BROKEN DOWN BY ETHNICITY, THE NEED TO ADDRESS OBESITY AMONG MINORITY POPULATIONS BECOMES MORE OBVIOUS. 41.7% OF THE BLACK/AFRICAN AMERICAN ADULTS IN TRAVIS COUNTY AND 36.5% OF LATINO/HISPANIC ADULTS ARE CONSIDERED OBESE COMPARED TO 19.4% FOR WHITE RESIDENTS. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY-RELATED PROGRAMS. THE CITY OF AUSTIN HEALTH DEPARTMENT, THE LOCAL SCHOOL DISTRICTS, AND MANY LOCAL NON-PROFITS ARE WORKING TO REDUCE THE OBESITY RATE IN OUR COMMUNITY. ONE WAY THAT SETON IS EXPLORING TO REDUCE OBESITY IS THROUGH THE SETON HEALTHCARE FAMILY PRE-DIABETES PROGRAM. THIS PROGRAM IS A PILOT PROGRAM ASSOCIATED WITH THE SETON HEALTH CENTERS LOCATED IN TRAVIS COUNTY. THE PROGRAM HELPS TO TRANSFORM THE LIVES OF VULNERABLE, WORKING POOR PATIENTS - PATIENTS WHO HAVE BEEN IDENTIFIED AS BEING AT INCREASED RISK FOR DEVELOPING DIABETES - BY PROVIDING AN ARRAY OF EMPOWERING AND ESSENTIAL INTERVENTIONS INCLUDING PSYCHOSOCIAL ASSESSMENT, HEALTH LITERACY ASSESSMENT, SPIRITUAL COUNSELING, WEIGHT LOSS COUNSELING, DIABETES PREVENTION EDUCATION, NUTRITION COUNSELING, GROCERY STORE TOURS, SOCIAL SERVICES REFERRALS, AND COMMUNITY RESOURCE REFERRALS. THE PROGRAM PROVIDES POOR, AT-RISK ADULTS WITH THE INFORMATION, TOOLS AND SUPPORT THEY NEED TO ACHIEVE OBESITY RISK-REDUCTION TO HELP PREVENT DIABETES, AND TO MOVE PATIENTS FROM HAVING FROM PRE- DIABETES GLUCOSE LEVELS TO HAVING NORMAL GLUCOSE. IN ORDER TO INCREASE THE PHYSICAL FITNESS ACTIVITIES IN THE COMMUNITY, SSW SERVES AS THE SPONSOR FOR VARIOUS COMMUNITY EVENTS AIMED AT PROVIDING ACTIVE LIFESTYLE OPPORTUNITIES FOR COMMUNITY MEMBERS. SSW WILL CONTINUE THE RUN/WALK PROGRAM AIMED AT HELPING RESIDENTS TRAIN TO RUN A LOCAL 5K OR 10K. IN ADDITION, SSW WILL CONTINUE TO BE ONE OF THE LEADING SPONSORS IN THE MANY LOCAL RACES SUCH AS THE DOGGIE DASH, DONKEY DASH, AND RUN FOR THE WATER (10 MILE RACE WITH KIDS 1K). SSW CURRENTLY SERVES IN A LEADERSHIP ROLE WITH THE MAYOR'S HEALTH AND FITNESS COUNCIL (MHFC). MHFC IS A LOCAL NON-PROFIT ORGANIZATION WHOSE VISION IS TO SUPPORT AND INSPIRE PEOPLE TO IMPROVE THEIR HEALTH BY ENCOURAGING PHYSICAL ACTIVITY, IMPROVED NUTRITION AND TOBACCO-FREE LIVING. THE SSW CHIEF OPERATING OFFICER CURRENTLY SERVES ON THE BOARD AS THE VICE CHAIR FOR THE COUNCIL AND SSW WILL CONTINUE TO PARTICIPATE IN THIS COLLABORATIVE EFFORT TO MAKE AUSTIN THE HEALTHIEST CITY IN AMERICA. SETON HEALTHCARE FAMILY IS RECOGNIZED BY THE MHFC AS A CERTIFIED HEALTHY EMPLOYER. SSW WILL CONTINUE ITS PARTNERSHIP WITH THE AUSTIN INDEPENDENT SCHOOL DISTRICT (AISD) AFTER SCHOOL PROGRAMS AND THEIR MICRO- SOCIETY PROGRAM. SSW CURRENTLY PROVIDES EDUCATION RELATED TO THE SUPPORT OF COMMUNITY HEALTH AND NUTRITION TO STUDENTS WHO HAVE CREATED A MICRO-COMMUNITY THAT THEY ARE RESPONSIBLE FOR MAINTAINING. SSW WILL CONTINUE TO WORK WITH THE SOUTHWEST AUSTIN AISD PROGRAMS AND OTHER ADDITIONAL OPPORTUNITIES RELATED TO IMPROVING THE HEALTH OF CHILDREN IN THE SOUTHWEST AUSTIN COMMUNITY. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF TRAVIS COUNTY. FOR THE PAST SIX YEARS THE TOP THREE CAUSES OF DEATH IN TRAVIS COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. SETON NETWORK ONCOLOGY SERVICES CURRENTLY WORKS WITH SEVERAL SETON HOSPITALS, INCLUDING SSW, PROVIDING ACCESS TO THE SETON CANCER PREVENTION AND EARLY DETECTION PROGRAM, THE ONCOLOGY NURSE REGISTRY, THE SURVIVORSHIP PROGRAM, THE MULTIDISCIPLINARY CANCER CONFERENCE AND CLINICS, AND NAVIGATION SERVICE. SETON'S COMPREHENSIVE ONCOLOGY PROGRAMS PROVIDE RESIDENTS OF CENTRAL TEXAS ACCESS TO CANCER SERVICES THAT PROMOTE EARLY DETECTION AND A COORDINATED APPROACH TO CARE THROUGHOUT THE CONTINUUM WHICH INCLUDES SCREENING, DIAGNOSIS, TREATMENT AND SURVIVORSHIP. SSW REFERS PATIENTS TO THE SETON SHIVERS CANCER CENTER. THE SHIVERS CANCER CENTER PROVIDES A VARIETY OF OUTPATIENT SERVICES FOR ADULT CANCER PATIENTS IN CENTRAL TEXAS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO CLINICAL SERVICES, SHIVERS HEALTH CARE PROFESSIONALS WORK CLOSELY WITH THE SETON CANCER CARE TEAM TO PROVIDE VITAL CASE MANAGEMENT SERVICES PLUS A VARIETY OF PHYSICAL, EMOTIONAL, AND SPIRITUAL SUPPORT PROGRAMS TO ADULT CANCER PATIENTS AND THEIR FAMILIES. SSW WILL WORK WITH THE NEW WOMEN'S ONCOLOGY CARE SCREENING PROGRAM. THIS PROGRAM EXPANDS TIMELY ACCESS TO BREAST AND CERVICAL CANCER SCREENING VIA A MOBILE UNIT FOR UNINSURED AND UNDERINSURED WOMEN IN CENTRAL TEXAS WHO, WITHOUT THIS EXPANSION, LIKELY WOULD NOT RECEIVE THESE LIFE-SAVING SERVICES. THIS EXPANSION IN SCREENING IS PART OF SETON'S DIGITAL MAMMOGRAPHY MOBILE UNIT KNOWN AS THE BIG PINK BUS. ACCESS TO CERVICAL CANCER SCREENINGS ARE NOW EXPANDED TO MOBILE MAMMOGRAPHY PROGRAM PARTICIPANTS BY USING ADVANCED PRACTICE NURSES ON THE MOBILE UNIT OR AT OUR COMMUNITY CLINICS THAT PROVIDE INDIGENT CARE. IN ADDITION TO THE SCREENING, SSW WILL INCORPORATE WOMEN'S ONCOLOGY NAVIGATION AS A METHOD OF EXPANDING EXISTING PATIENT NAVIGATION SERVICES THAT CONNECT WOMEN WITH CANCER DIAGNOSIS TO TREATMENT AND/OR SURVIVORSHIP SUPPORT SERVICES. LOOKING TO IMPROVE THE HEALTH OF PATIENTS WITH CHRONIC DISEASE, SSW WILL CONTINUE TO OFFER SETON'S ASTHMA EDUCATION PROGRAM TO CENTRAL TEXAS RESIDENTS. THIS PROGRAM PROVIDES HOME VISITS FOR ASTHMA EDUCATION TO NEARLY 1,000 UNINSURED AND UNDERINSURED FAMILIES PER YEAR. BY PROVIDING EDUCATION ABOUT SERVICES IN THE HOME, RESIDENTS OVERCOME TRANSPORTATION BARRIERS THAT OFTEN ACCOMPANY THIS TARGET POPULATION. THE SETON ASTHMA & COPD CENTER PROVIDES A COMPREHENSIVE DISEASE MANAGEMENT PROGRAM DESIGNED TO PROVIDE CARE COORDINATION, SOCIAL SERVICES, AND ASTHMA/COPD EDUCATION FOR ALL AGES. SETON HEALTHCARE FAMILY FACILITIES ARE A TOBACCO FREE ENVIRONMENT, PROHIBITING TOBACCO USE AT ALL OF ITS HOSPITALS AND PLACES OF WORK. SETON IS AN ACTIVE PARTICIPANT IN COMMUNITY EFFORTS TO COMBAT TOBACCO USE, PROVIDING TOBACCO CESSATION SERVICES TO TRAVIS COUNTY RESIDENTS. SSW WILL CONTINUE TO SUPPORT THE TOBACCO CESSATION PROGRAM THAT PROVIDES COMMUNITY-WIDE TRAINING FOR PHYSICIANS AND LOCAL CLINICS BASED ON BEST PRACTICES FOR TREATING NICOTINE ADDICTION. IN ADDITION, THE SETON TOBACCO EDUCATION RESOURCE CENTER OFFERS A COMPREHENSIVE TOBACCO EDUCATION PROGRAM WHICH PROVIDES CESSATION CLASSES THAT ARE BASED ON THE MAYO CLINIC MODEL FOR TREATING TOBACCO DEPENDENCE. SESSIONS FOLLOW A SUPPORT GROUP SETTING AND ARE FACILITATED BY CERTIFIED TOBACCO TREATMENT SPECIALIST. THROUGH MOTIVATIONAL INTERVIEWING TECHNIQUES CTTS ARE ABLE TO CONDUCT SESSIONS THAT AIM AT MAXIMIZING & PROMOTING PARTICIPANT DIALOGUE. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS RAISED BY TRAVIS COUNTY RESIDENTS. FOCUS GROUP PARTICIPANTS AND INTERVIEWEES ALIKE MENTIONED THE RISING RATES OF MENTAL HEALTH CONDITIONS AMONG TRAVIS COUNTY RESIDENTS. THIS INCLUDED AREAS SUCH AS SUBSTANCE ABUSE AND INADEQUATE MENTAL HEALTH SERVICES. THE CHNA IDENTIFIED THAT 20% OF TRAVIS COUNTY ADULTS EXPERIENCED FIVE OR MORE DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH, WHICH IS WELL ABOVE THE NATIONAL MEDIAN. |
| Schedule H, Part V, Section B, Line 11 Facility A, 14 | Facility A, 14 - SETON SOUTHWEST HOSPITAL - PART 2. SSW HAS EXPANDED ACCESS TO PSYCHIATRIC TELEMEDICINE TO THE ENTIRE SSW FACILITY AND WILL CONTINUE TO SUPPORT THIS BEHAVIORAL HEALTH SERVICE. BY PROVIDING 24/7 PSYCHIATRIC CONSULTATIONS, INCLUDING AFTER HOURS, PATIENTS IN PSYCHIATRIC CRISIS WILL BE ABLE TO BE EVALUATED AND TREATED IN A TIMELY MANNER. TYPICALLY PATIENTS WOULD HAVE TO WAIT UNTIL THE NEXT DAY FOR APPROPRIATE PSYCHIATRIC ASSESSMENT. THIS NEW APPROACH TO PSYCHIATRIC TELEMEDICINE CAN LEAD TO TIMELY ASSESSMENT, EARLIER DISPOSITION AND LESS COSTLY LEVEL OF CARE. OTHER PROGRAMS TARGETED TO IMPROVE THE MENTAL HEALTH AND WELL- BEING OF SSW PATIENTS AND COMMUNITY MEMBERS INCLUDE THE SETON COVE SPIRITUALITY CENTER. THE SETON COVE SPIRITUALITY CENTER PROVIDES SPIRITUALLY HEALING DISCUSSION GROUPS, CLASSES AND EVENTS LED BY A MULTIDISCIPLINARY FACULTY BOTH ON THE SSW CAMPUS AND AT THE SPIRITUALITY CENTER. PROGRAMS ARE OPEN TO THE COMMUNITY. TO AUGMENT THE PUBLIC SCHOOL HEALTH EDUCATION CURRICULUM, SETON HEALTHCARE FAMILY HAS PURCHASED HEALTHTEACHER, A COMPREHENSIVE K-12 ONLINE HEALTH EDUCATION CURRICULUM FOR TEACHERS IN SCHOOL DISTRICTS WITHIN TRAVIS, WILLIAMSON, AND HAYS COUNTY. THE CURRICULUM PROVIDES OVER 300 AGE-APPROPRIATE LESSONS ACROSS 10 CONTENT AREAS ALIGNED WITH THE NATIONAL HEALTH EDUCATION STANDARDS (NHES). LESSONS ARE DESIGNED FOR INTEGRATION INTO CORE CURRICULUM AREAS SUCH AS LANGUAGE ARTS, SCIENCE AND SOCIAL STUDIES, AND HAVE BEEN ALIGNED WITH THE TEXAS TEKS. THEY PROVIDE SKILLS-BASED INSTRUCTION LINKED TO ASSESSMENTS. HEALTH EDUCATORS IN SCHOOL DISTRICTS IN TRAVIS COUNTY WERE TRAINED BY NATIONAL HEALTHTEACHER STAFF ON HOW TO INTEGRATE AND IMPLEMENT THE HEALTHTEACHER CURRICULUM IN THE CLASSROOM. ACCESS TO CARE ACCESS TO HEALTH CARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE FACILITIES AND RESOURCES. ALSO MENTIONED WAS THE DIFFICULTY OF NAVIGATING THE HEALTH CARE SYSTEM, THE HIGH COST OF CARE, AND THE INABILITY TO GAIN AND RETAIN HEALTH INSURANCE. COMMUNITY FORUM PARTICIPANTS RECOGNIZED A PRESENCE OF FACILITIES AND PROGRAMMING BUT THE MAJORITY NOTED THAT HEALTH CARE RESOURCES ARE GREATLY LACKING, ESPECIALLY FOR LOW-INCOME AND AGING POPULATIONS. THE SETON HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. SSW HAS AND WILL CONTINUE TO REFER UNFUNDED PATIENTS WITHOUT A MEDICAL HOME TO THE SETON COMMUNITY HEALTH CENTERS FOR PRIMARY CARE. THE TRAVIS COUNTY MEDICAL SOCIETY, THE SETON HEALTHCARE FAMILY AND OTHER MEMBERS OF THE INTEGRATED CARE COLLABORATION HAVE INITIATED A COORDINATED SYSTEM OF VOLUNTEER DOCTORS CALLED PROJECT ACCESS. THEY WORK WITH LOCAL PROVIDERS TO PROVIDE MEDICAL, HOSPITAL, DIAGNOSTIC AND PHARMACY ASSISTANCE FOR THE UNINSURED IN TRAVIS COUNTY. THE MISSION OF PROJECT ACCESS IS TO PROVIDE READY ACCESS TO APPROPRIATE HEALTH CARE SERVICES FOR UNINSURED PEOPLE IN TRAVIS COUNTY WHOSE INCOMES ARE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL AND TO IMPROVE THE OVERALL HEALTH OF OUR COMMUNITY. SETON HELPED SECURE A GRANT TO CREATE THE PROGRAM. MORE THAN 1,000 VOLUNTEER PHYSICIANS PARTICIPATE IN PROJECT ACCESS AND SETON WILL CONTINUE TO SUPPORT THE WORK OF THIS COLLABORATION TO IMPROVE ACCESS TO CARE. TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SSW WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY THE SETON HEALTHCARE NETWORK, THE SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE CHNA IDENTIFIED HEALTH DISPARITIES AND INEQUITIES IN THE ABILITY OF DIFFERENT ETHNIC GROUPS TO ACCESS CARE. THE REASONS ARE COMPLEX. RESEARCH SHOWS PROVIDING PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE REDUCES READMISSIONS WITHIN 30 DAYS, REDUCES PATIENT BED DAYS, IMPROVES MEDICATION ADHERENCE AND LEADS TO BETTER HEALTH OUTCOMES. IN ADDITION, RESEARCH ALSO SHOWS PROVIDING CULTURAL COMPETENCE TRAINING TO OUR CLINICAL CARE TEAMS IMPROVES COMMUNICATION BETWEEN PATIENTS AND THEIR CLINICAL CARE TEAM INCLUDING THEIR DOCTORS AND NURSES AS MEASURED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS ("HCAHPS") SURVEY, THE FIRST NATIONAL, STANDARDIZED, PUBLICLY REPORTED SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. CURRENTLY SETON PROVIDES TELEPHONE INTERPRETATION SERVICES IN OVER 140 LANGUAGES, 24 HOURS, 7 DAYS A WEEK, 365 DAYS A YEAR. IN ADDITION, SETON PROVIDES IN PERSON SIGN LANGUAGE CONTRACTED SERVICES AT ALL OF OUR FACILITIES. AS PART OF AN INTEGRATED APPROACH TO ADMINISTER CARE IN A PERSON CENTERED, CULTURALLY COMPETENT MANNER, SETON HEALTHCARE FAMILY THROUGH SSW, WILL DEVELOP A LANGUAGE SERVICES RESOURCE CENTER AND A CULTURALLY COMPETENT CARE CURRICULUM. THE LANGUAGE SERVICES RESOURCE CENTER IS A NEW PROJECT WHICH WILL PROVIDE PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE BY CENTRALIZING INTERPRETATION & TRANSLATION SERVICES, AND INCREASING THE NUMBER OF PROFESSIONAL MEDICAL INTERPRETERS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY INCLUDING BUT NOT LIMITED TO SPANISH AND SIGN LANGUAGE. THE CULTURALLY COMPETENT CARE CURRICULUM IS EXPECTED TO INCREASE THE QUALITY OF COMMUNICATION BETWEEN THE CLINICAL CARE TEAM AND THE PATIENT IN ORDER TO ACHIEVE GREATER PATIENT INVOLVEMENT IN SHARED DECISION MAKING. THE DIVERSITY DEPARTMENT THROUGH THE CULTURALLY COMPETENT CARE CURRICULUM WILL PROVIDE TRAINING AND EDUCATION TO THE CLINICAL CARE TEAM TO INCREASE THE LIKELIHOOD OF SAFE AND EFFECTIVE PERSON CENTERED CARE IN A CULTURALLY COMPETENT MANNER AND LEADS TO BETTER HEALTH OUTCOMES. |
| Schedule H, Part V, Section B, Line 11 Facility A, 15 | Facility A, 15 - SETON SOUTHWEST HOSPITAL - PART 3. SSW WILL CONTINUE TO INCREASE ACCESS TO SERVICES BY SUPPORTING THE SETON LEAGUE HOUSE, A 38-ROOM BED-AND-BATH FACILITY DESIGNED TO PROVIDE FAMILIES AND CAREGIVERS WITH A PLACE TO STAY WHILE THEIR LOVED ONES ARE HOSPITALIZED IN AN AUSTIN-AREA HOSPITAL. THE SUBSIDIZED ROOMS REDUCE THE BARRIER OF TRAVEL COSTS ASSOCIATED WITH TREATMENT. SSW HAS DEVELOPED A RELATIONSHIP WITH BETHANY LUTHERAN CHURCH (BLC) IN SOUTHWEST AUSTIN TO HELP SPONSOR A COMMUNITY HEALTH FAIR. SSW HAS PROVIDED A HOST OF SERVICES SUCH AS HEART AND STROKE EDUCATION, SKIN CANCER SCREENINGS, DIET AND EXERCISE AWARENESS, AND VACCINATIONS. THESE HEALTH FAIRS HELP REACH MEMBERS OF THE COMMUNITY WHO MAY NOT TRADITIONALLY ACCESS CARE DUE TO TRANSPORTATION, SCHEDULE, OR OTHER PERCEIVED CONFLICTS. SSW WILL CONTINUE TO FOSTER THIS RELATIONSHIP WITH BLC AND PROVIDE RESOURCES FOR THIS ANNUAL HEALTH FAIR. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN TRAVIS COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. MORE COORDINATED APPROACHES WOULD HELP MAXIMIZE LIMITED RESOURCES. IN 1997, SETON LED THE FORMATION OF THE INTEGRATED CARE COLLABORATION (ICC), AN ALLIANCE OF COMMUNITY PROVIDERS FOR THE MEDICALLY INDIGENT, INCLUDING HEALTH CARE ORGANIZATIONS, GOVERNMENT ENTITIES AND VOLUNTEER CLINICS. KNOWN AS THE ICC, THE GROUP'S GOAL WAS TO WORK TOGETHER TO INCREASE ACCESS, IMPROVE QUALITY AND FIND CREATIVE FINANCING SOLUTIONS FOR THE PROVISION OF HEALTH CARE FOR THE REGION'S UNINSURED. THE ICC HAS DEVELOPED AN AREA WIDE HEALTH INFORMATION EXCHANGE (HIE) FOR THE UN- AND UNDERINSURED THAT IS USED TO INFORM PROVIDERS ON THE CARE A SPECIFIC INDIVIDUAL HAS RECEIVED WHILE ALSO PROVIDING COMMUNITY WIDE ANALYTICS ON HEALTHCARE USAGE AND DIAGNOSTIC TRENDS. SINCE ITS INCEPTION THE ICC HAS BROKEN INTO MULTIPLE COLLABORATIONS, FOCUSING ON SPECIFIC GEOGRAPHIC AREAS. THE SETON HEALTHCARE FAMILY CONTINUES TO FUND THE ICC INFRASTRUCTURE. IN 2012, SETON AND THE TRAVIS COUNTY HEALTHCARE DISTRICT BEGAN DEVELOPMENT OF A NON-PROFIT COMMUNITY CARE COLLABORATIVE (CCC) WITH THE PURPOSE OF ADVANCING THE HEALTH OF IDENTIFIED VULNERABLE POPULATIONS IN TRAVIS COUNTY THROUGH HIGH-QUALITY, COST EFFECTIVE, PERSON CENTERED CARE. THE ESSENTIAL ELEMENTS OF THE CCC ARE: PATIENT CENTERED MEDICAL HOMES, DEVELOPING A HEALTH INFORMATION EXCHANGE FOR ITS PATIENTS, CASE MANAGEMENT OF A SELECTED HIGH RISK POPULATION, PHARMACY MANAGEMENT, INTEGRATED OUTPATIENT/INPATIENT PROTOCOLS, AND TRANSITIONAL CARE. THE CCC WILL BE OUTCOME DRIVEN AND RELY HEAVILY ON ANALYTICS TO DRIVE PROCESS IMPROVEMENT AND INNOVATION. SETON HEALTHCARE FAMILY IS A PARTNER OF THE COMMUNITY ACTION NETWORK (CAN) AND WILL CONTINUE TO SUPPORT THIS LOCAL COLLABORATION. CAN IS A PARTNERSHIP OF GOVERNMENT, NON-PROFIT, PRIVATE, AND FAITH-BASED ORGANIZATIONS WHO WORK TOGETHER TO ENHANCE THE SOCIAL, HEALTH, EDUCATIONAL, AND ECONOMIC WELL-BEING OF CENTRAL TEXAS. AS A PARTNER OF CAN, SETON HAS REPRESENTATIVES ON THE BOARD OF DIRECTORS AND IS COMMITTED TO WORKING WITH OTHER CAN PARTNERS TO ATTAIN THE MISSION OF CAN. FINANCIAL ASSISTANCE SETON IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. SSW SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS SSW PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL. |
| Schedule H, Part V, Section B, Line 11 Facility A, 16 | Facility A, 16 - SETON MEDICAL CENTER WILLIAMSON - PART 1. THE SMCW IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE WILLIAMSON COUNTY CHNA. ALSO ADDRESSED IN THE SMCW PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. ACCESS TO CARE ACCESS TO HEALTHCARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE HIGH COST OF PREVENTATIVE CARE AND THE NEED FOR EDUCATION ON SERVICES AND APPROPRIATE UTILIZATION. ALSO MENTION WAS THE DIFFICULTY NAVIGATING THE HEALTH CARE SYSTEM FOR THE UN- AND UNDERINSURED. WITH 81% OF ADULTS WITH HEALTH INSURANCE AND 89% OF CHILDREN WITH HEALTH INSURANCE, BOTH FALL BELOW THE DESIRED CENTRAL TENDENCY. THE CHNA IDENTIFIED A PRESENCE OF FACILITIES AND PROVIDERS BUT WITH A HIGH UNINSURED RATE AND TRANSPORTATION ISSUES, THESE FACILITIES MAY NOT BE ACCESSIBLE FOR ALL RESIDENTS. SMCW SPONSORED THE PRIMARY CARE CLINIC MANAGED BY LONE STAR CIRCLE OF CARE AT THE TEXAS A&M UNIVERSITY HEALTH SCIENCE CENTER IN ROUND ROCK AS WELL AS AN ADDITIONAL PRIMARY CARE CLINIC ON GATTIS SCHOOL ROAD. THESE CLINICS PROVIDE PRIMARY CARE FOR RESIDENTS OF WILLIAMSON COUNTY. LONE STAR'S DESIGNATION AS A FEDERALLY QUALIFIED HEALTH CENTER PROVIDES CARE FOR THE UN- AND UNDERINSURED. SMCW WILL CONTINUE TO WORK CLOSELY WITH LONE STAR CIRCLE OF CARE (LSCC) AND IS COMMITTED TO EXPLORING OPPORTUNITIES TO INCREASE PRIMARY AND SPECIALTY CARE ACCESS ACROSS WILLIAMSON COUNTY. SMCW IS COMMITTED TO THE CONTINUED SUPPORT OF THE SACRED HEART CLINIC IN ROUND ROCK. THIS CLINIC PROVIDES PRIMARY CARE SERVICES FOR THE UNINSURED RESIDENTS OF WILLIAMSON COUNTY AND SMCW PROVIDES THE LAB AND RADIOLOGY FUNCTIONS FOR SACRED HEART. SMCW WILL CONTINUE TO SUPPORT THE SACRED HEART CLINIC IN THIS MANNER IN ORDER TO FURTHER THE WORK OF THE CLINIC. SMCW WILL WORK WITH COMMUNITY PARTNERS IN ITS REGION TO EXPLORE POTENTIAL COLLABORATIONS AND DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROJECTS THAT MAY BE AVAILABLE IN THE FUTURE TO ADDRESS THE DIFFICULTIES RESIDENTS HAVE ACCESSING CARE. TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SMCW WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY THE SETON HEALTHCARE NETWORK, THE SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE CHNA IDENTIFIED HEALTH DISPARITIES AND INEQUITIES IN THE ABILITY OF DIFFERENT ETHNIC GROUPS TO ACCESS CARE. THE REASONS ARE COMPLEX. RESEARCH SHOWS PROVIDING PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE REDUCES READMISSIONS WITHIN 30 DAYS, REDUCES PATIENT BED DAYS, IMPROVES MEDICATION ADHERENCE AND LEADS TO BETTER HEALTH OUTCOMES. IN ADDITION, RESEARCH ALSO SHOWS PROVIDING CULTURAL COMPETENCE TRAINING TO OUR CLINICAL CARE TEAMS IMPROVES COMMUNICATION BETWEEN PATIENTS AND THEIR CLINICAL CARE TEAM INCLUDING THEIR DOCTORS AND NURSES AS MEASURED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS ("HCAHPS") SURVEY, THE FIRST NATIONAL, STANDARDIZED, PUBLICLY REPORTED SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. CURRENTLY SETON PROVIDES TELEPHONE INTERPRETATION SERVICES IN OVER 140 LANGUAGES, 24 HOURS, 7 DAYS A WEEK, 365 DAYS A YEAR. IN ADDITION, SETON PROVIDES IN PERSON SIGN LANGUAGE CONTRACTED SERVICES AT ALL OF OUR FACILITIES. AS PART OF AN INTEGRATED APPROACH TO ADMINISTER CARE IN A PERSON CENTERED, CULTURALLY COMPETENT MANNER, THE SETON HEALTHCARE FAMILY WILL DEVELOP A LANGUAGE SERVICES RESOURCE CENTER AND A CULTURALLY COMPETENT CARE CURRICULUM AT FOUR SETON HOSPITALS AND WILL IMPLEMENT THE LEARNINGS AND BEST PRACTICES AT SMCW. THE LANGUAGE SERVICES RESOURCE CENTER IS A NEW PROJECT WHICH WILL PROVIDE PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE BY CENTRALIZING INTERPRETATION & TRANSLATION SERVICES, AND INCREASING THE NUMBER OF PROFESSIONAL MEDICAL INTERPRETERS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY INCLUDING BUT NOT LIMITED TO SPANISH AND SIGN LANGUAGE. THE CULTURALLY COMPETENT CARE CURRICULUM IS EXPECTED TO INCREASE THE QUALITY OF COMMUNICATION BETWEEN THE CLINICAL CARE TEAM AND THE PATIENT IN ORDER TO ACHIEVE GREATER PATIENT INVOLVEMENT IN SHARED DECISION MAKING. THE DIVERSITY DEPARTMENT THROUGH THE CULTURALLY COMPETENT CARE CURRICULUM WILL PROVIDE TRAINING AND EDUCATION TO THE CLINICAL CARE TEAM TO INCREASE THE LIKELIHOOD OF SAFE AND EFFECTIVE PERSON CENTERED CARE IN A CULTURALLY COMPETENT MANNER AND LEADS TO BETTER HEALTH OUTCOMES. ACCESS TO PRENATAL CARE IN THE FIRST TRIMESTER WAS IDENTIFIED AS A NEED ESPECIALLY AMONG THE LATINO/HISPANIC POPULATION. TO ADDRESS THIS, SMCW WILL EXPAND ITS OBSTETRICS NAVIGATION (OB NAVIGATION) PROJECT TO IMPROVE ACCESS TO PRE AND POSTNATAL CARE FOR UNINSURED HISPANIC WOMEN WITH LIMITED ENGLISH PROFICIENCY THROUGH COMPREHENSIVE, EFFECTIVE PATIENT NAVIGATION SERVICES. CURRENTLY THE SMCW NAVIGATORS WORK WITH WOMEN AFTER THEY HAVE ESTABLISHED PRENATAL CARE. THE NEW NAVIGATION INITIATIVE WILL PLACE NAVIGATORS OUT IN THE COMMUNITY TO HELP ASSIST NEWLY PREGNANT WOMEN WITH ACCESSING CARE IN THEIR FIRST TRIMESTER AND FOLLOWING THEM THROUGHOUT THEIR PREGNANCY ENSURING THEY RECEIVE A POST-PARTUM CHECK-UP AND ARE CONNECTED TO MEDICAL HOME FOR ON-GOING PRIMARY CARE. THE OB NAVIGATION PROGRAM WILL USE CULTURALLY AND LINGUISTICALLY COMPETENT COMMUNITY HEALTH WORKERS TO SERVE AS PATIENT NAVIGATORS. THE NUMBER OF SPANISH SPEAKING ONLY PATIENTS, MANY OF THEM FIRST GENERATION IMMIGRANTS, DELIVERING AT SMCW ARE GROWING. IN ORDER TO ENSURE THEY UNDERSTAND THE HOSPITAL PROCESS. SMCW HAS EMPLOYED A CULTURALLY AND LINGUISTICALLY COMPETENT OB NAVIGATOR TO CONNECT WITH MEDICAID AND CHIP PERINATE PREGNANT PATIENTS DUE TO THEIR DELIVERY AT SMCW. THE NAVIGATOR ENSURES THE PATIENT IS PRE- REGISTERED WITH THE HOSPITAL AND RECEIVES A TOUR OF THE FACILITY. THE NAVIGATOR ASSISTS THE PATIENT WITH THEIR INSURANCE NEEDS AND EXPLAINS THE PROCESS OF ENROLLING THEIR NEWBORNS INTO MEDICAID. THE NAVIGATOR WILL FOLLOW THE BABY UNTIL THEY ARE ENROLLED IN MEDICAID TROUBLESHOOTING OF BEHALF OF THE PATIENT ANY ISSUES THAT MAY ARISE. OBESITY THE 2012 WILLIAMSON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE PRESSING HEALTH ISSUES. THIS INCLUDED THE HIGH RATE OF OVERWEIGHT AND OBESE ADULTS LIVING IN THE COMMUNITY AS WELL AS THE CONCERN FOR CHILDHOOD OBESITY. IN ADDITION TO THE STAKE HOLDER COMMENTS DIRECTLY RELATED TO OBESITY, THE FOCUS GROUPS FREQUENTLY DISCUSSED THE CHALLENGES OF NUTRITION AND EXERCISE IN WILLIAMSON COUNTY. WHILE WE CERTAINLY NEED TO ADDRESS THE IMPACT OF OBESITY IN OUR COMMUNITY, IT IS ALSO CRUCIAL THAT WE TAKE STEPS TO ADDRESS THE ISSUE PRIOR TO INDIVIDUALS BECOMING OBESE. WITH 67% OF WILLIAMSON COUNTY ADULTS CLASSIFIED AS OVERWEIGHT AND OBESE, WILLIAMSON COUNTY FALLS IS ABOVE STATE AND NATIONAL BENCHMARK. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY RELATED PROGRAMS. THE CHNA IDENTIFIED ACCESS TO HEALTHY FOODS AS A HIGH PRIORITY. WITH THE NUMBER OF VISITORS AND COMMUNITY MEMBERS WHO VISIT THE SMCW CAFETERIA ON A DAILY BASIS, SMCW IS DEDICATED TO IMPROVING THE NUTRITIONAL VALUE OF THE FOOD OFFERED AT THE FACILITY. SMCW WILL WORK WITH TOUCHPOINT, ITS FOOD SERVICE VENDOR, TO IMPROVE THE NUTRITIONAL CONTENT IN THE FOOD SERVED THROUGH A HEALTHY DINING PROGRAM TO ENSURE THAT OUR DAILY OFFERINGS ARE GEARED TOWARD PROVIDING HEALTHY CHOICES AND OPTIONS FOR OUR GUESTS. THIS WILL NOT ONLY BENEFIT PATIENTS BUT ALSO VISITORS, PHYSICIANS, AND COMMUNITY MEMBERS WHO FREQUENT THE HOSPITAL. SMCW IS COMMITTED TO ITS SUPPORT OF THE IGNITE WOMEN'S HEALTH PROGRAM WHICH IS DEDICATED TO PROVIDING WOMEN WITH A CONTINUUM OF SUPPORT REGARDING THEIR HEALTH AND WELLNESS, AND OPPORTUNITIES TO LIGHT UP THEIR LIVES. IGNITE OFFERS AN ARRAY OF PROGRAMS FROM PREVENTATIVE WELLNESS TO RESTORATIVE HEALTH CARE, TO EDUCATE AND ENCOURAGE WOMEN IN A HEALTHY LIFESTYLE AND IN TURN - A HEALTHY COMMUNITY. PROGRAMS INCLUDE FREE FITNESS, ZUMBA, YOGA, AND SELF- DEFENSE CLASSES, IN ADDITION TO FREE CARDIAC SCREENINGS, BMI, BLOOD PRESSURE, AND MANY MORE TESTS THAT HELP WOMEN MEASURE THEIR OVERALL HEALTH. IGNITE ALSO OFFERS NUTRITION AND COOKING CLASSES TO HELP PROMOTE HEALTHY EATING HABITS. |
| Schedule H, Part V, Section B, Line 11 Facility A, 17 | Facility A, 17 - SETON MEDICAL CENTER WILLIAMSON - PART 2. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 WILLIAMSON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF WILLIAMSON COUNTY. FOR THE PAST SIX YEARS THE TOP THREE CAUSES OF DEATH IN WILLIAMSON COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. WITH THE LONG-TERM DEVELOPMENTS OF CHRONIC DISEASE AND THE LIFESTYLE ATTRIBUTES THAT CONTRIBUTE TO THESE DISEASES, IT IS IMPERATIVE THAT A CONCERTED EFFORT BE MADE BY THE COMMUNITY TO PROMOTE HEALTHY CHOICES WHERE RESIDENTS LIVE, WORK, PLAY, AND WORSHIP. SETON NETWORK ONCOLOGY SERVICES CURRENTLY WORKS WITH SEVERAL SETON HOSPITALS, INCLUDING SMCW, PROVIDING ACCESS TO THE SETON CANCER PREVENTION AND EARLY DETECTION PROGRAM, THE ONCOLOGY NURSE REGISTRY, THE SURVIVORSHIP PROGRAM, THE MULTIDISCIPLINARY CANCER CONFERENCE AND CLINICS, AND NAVIGATION SERVICE. SETON'S COMPREHENSIVE ONCOLOGY PROGRAMS PROVIDE RESIDENTS OF CENTRAL TEXAS ACCESS TO CANCER SERVICES THAT PROMOTE EARLY DETECTION AND A COORDINATED APPROACH TO CARE THROUGHOUT THE CONTINUUM WHICH INCLUDES SCREENING, DIAGNOSIS, TREATMENT AND SURVIVORSHIP. SMCW REFERS PATIENTS TO THE SETON SHIVERS CANCER CENTER. THE SHIVERS CANCER CENTER PROVIDES A VARIETY OF OUTPATIENT SERVICES FOR ADULT CANCER PATIENTS IN CENTRAL TEXAS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO CLINICAL SERVICES, THE SHIVERS HEALTH CARE PROFESSIONALS WORK CLOSELY WITH THE SETON CANCER CARE TEAM TO PROVIDE VITAL CASE MANAGEMENT SERVICES PLUS A VARIETY OF PHYSICAL, EMOTIONAL, AND SPIRITUAL SUPPORT PROGRAMS TO ADULT CANCER PATIENTS AND THEIR FAMILIES. SMCW WILL WORK WITH THE NEW WOMEN'S ONCOLOGY CARE SCREENING PROGRAM. THIS PROGRAM EXPANDS TIMELY ACCESS TO BREAST AND CERVICAL CANCER SCREENING VIA A MOBILE UNIT FOR UNINSURED AND UNDERINSURED WOMEN IN CENTRAL TEXAS WHO, WITHOUT THIS EXPANSION, LIKELY WOULD NOT RECEIVE THESE LIFE-SAVING SERVICES. THIS EXPANSION IN SCREENING IS PART OF SETON'S DIGITAL MAMMOGRAPHY MOBILE UNIT KNOWN AS THE BIG PINK BUS. ACCESS TO CERVICAL CANCER SCREENINGS ARE NOW EXPANDED TO MOBILE MAMMOGRAPHY PROGRAM PARTICIPANTS BY USING ADVANCED PRACTICE NURSES ON THE MOBILE UNIT OR AT OUR COMMUNITY CLINICS THAT PROVIDE INDIGENT CARE. IN ADDITION TO THE SCREENING, SMCW WILL INCORPORATE WOMEN'S ONCOLOGY NAVIGATION AS A METHOD OF EXPANDING EXISTING PATIENT NAVIGATION SERVICES THAT CONNECT WOMEN WITH CANCER DIAGNOSIS TO TREATMENT AND/OR SURVIVORSHIP SUPPORT SERVICES. LOOKING TO IMPROVE THE HEALTH OF PATIENTS WITH CHRONIC DISEASE, SETON ALSO HAS ESTABLISHED THE SETON TOTAL HEALTH TRANSITIONS TEAM AS A PROTOTYPE OF DISEASE MANAGEMENT AS PATIENTS LEAVE THE HOSPITAL SETTING. BASED ON A SUCCESSFUL PILOT, THE SETON TOTAL HEALTH TRANSITIONS TEAM WILL EXPAND TO SMCW IN THE COMING YEARS TO ENHANCE AND EXPAND THE MODEL TO BETTER COORDINATE CARE THROUGH A CARE TRANSITION INTERVENTION. THIS APPROACH INCLUDES A MULTI- DISCIPLINARY TEAM THAT MONITORS AND COORDINATES THE CARE OF PATIENTS WITH CHRONIC DISEASES IMMEDIATELY FOLLOWING DISCHARGE FROM HOSPITAL TO HOME, AND FROM HOME TO PRIMARY CARE. THIS PROJECT IS EXPECTED TO OPTIMIZE THE PATIENT'S RECOVERY AND AVOID READMISSION. SERVICES INCLUDE HOME VISITS TO PROVIDE SHORT-TERM DIRECT CARE, SOCIAL SERVICES, BEHAVIORAL HEALTH SUPPORT, TRANSPORTATION, TELEHEALTH AND PATIENT TRAINING REGARDING SELF- CARE MANAGEMENT OF THE CHRONIC DISEASE(S). SMCW WILL SERVE AS A LOCATION OF POTENTIAL EXPANSION FOR THE CHRONIC CARE MANAGEMENT PROGRAM THAT PROVIDES DIRECT HEALTH CARE AND CARE COORDINATION FOR ADULTS WHO HAVE BEEN SERIOUSLY INJURED AND TO THOSE WHO HAVE EXPERIENCED A SERIOUS ILLNESS DUE TO MULTIPLE CHRONIC CONDITIONS. THIS WILL BE AN EXTENSION OF THE SETON TOTAL HEALTH PARTNERS PILOT ESTABLISHED IN JANUARY 2012. THIS PROGRAM ASSISTS ENROLLEES IN FINDING AND RECEIVING THE MEDICAL CARE THEY NEED TO ACHIEVE OPTIMAL HEALTH AND PREVENT AVOIDABLE HOSPITALIZATION AND INAPPROPRIATE USE OF EMERGENCY DEPARTMENTS. THE PROGRAM PROVIDES A NUMBER OF PATIENT CARE INTERVENTIONS, A STRUCTURED AND MONITORED HAND-OFF PROCESS, TRAINING FOR OPTIMAL SELF-CARE, COUNSELING, AND FACILITATED INTEGRATION WITH PRIMARY AND SPECIALTY PHYSICIANS RESPONSIBLE FOR EACH PATIENT'S CARE. THIS PROJECT WILL START IN TRAVIS COUNTY HOSPITALS AND THEN EXPAND TO SMCW IN THE COMING YEARS. SMCW WILL POSITION ITSELF AS AN EXPANSION SITE FOR THE NEWLY DEVELOPED AND IMPLEMENTED PROCESS IMPROVEMENT METHODOLOGY TO IMPROVE OUTCOMES FOR ADULT INPATIENTS DIAGNOSED WITH DIABETICS MELLITUS. THE DIABETES CHRONIC CARE MANAGEMENT WILL IMPLEMENT SMALL, STRAIGHTFORWARD EVIDENCE-BASED PRACTICES TO IMPLEMENT A DIABETES CARE BUNDLE THAT, WHEN PERFORMED COLLECTIVELY AND RELIABLY, HAS BEEN PROVEN TO IMPROVE PATIENT OUTCOMES. IN ADDITION, THIS PROJECT WILL ESTABLISH AN INTERDISCIPLINARY DIABETES TEAM, LED BY AN ENDOCRINOLOGISTS AND A DIABETES CLINICAL NURSE SPECIALIST, TO ADDRESS THE CLINICAL, SAFETY, AND PSYCHOSOCIAL NEEDS OF INPATIENTS WITH DIABETES WHILE PREPARING FOR A SUCCESSFUL DISCHARGE. THE PROJECT WILL ALSO IMPLEMENT EVIDENCE-BASED PRACTICE (EBP) PROTOCOLS TO ENSURE IMPROVED CLINICAL OUTCOMES DURING AND POST-HOSPITALIZATION. THIS PROJECT IS GEARED TO START IN TRAVIS COUNTY AND THEN EXPAND TO SMCW. SMCW WILL CONTINUE TO OFFER SETON'S ASTHMA EDUCATION PROGRAM TO CENTRAL TEXAS RESIDENTS. THIS PROGRAM PROVIDES HOME VISITS FOR ASTHMA EDUCATION TO NEARLY 1,000 UNINSURED AND UNDERINSURED FAMILIES PER YEAR. BY PROVIDING EDUCATION ABOUT SERVICES IN THE HOME, RESIDENTS OVERCOME TRANSPORTATION BARRIERS THAT OFTEN ACCOMPANY THIS TARGET POPULATION. THE SETON ASTHMA & COPD CENTER PROVIDES A COMPREHENSIVE DISEASE MANAGEMENT PROGRAM DESIGNED TO PROVIDE CARE COORDINATION, SOCIAL SERVICES, AND ASTHMA/COPD EDUCATION FOR ALL AGES. |
| Schedule H, Part V, Section B, Line 11 Facility A, 18 | Facility A, 18 - SETON MEDICAL CENTER WILLIAMSON - PART 3. SETON HEALTHCARE FAMILY FACILITIES ARE A TOBACCO FREE ENVIRONMENT, PROHIBITING TOBACCO USE AT ALL OF ITS HOSPITALS AND PLACES OF WORK. SETON IS AN ACTIVE PARTICIPANT IN COMMUNITY EFFORTS TO COMBAT TOBACCO USE, PROVIDING TOBACCO CESSATION SERVICES TO WILLIAMSON COUNTY RESIDENTS. SMCW WILL CONTINUE TO SUPPORT THE TOBACCO CESSATION PROGRAM THAT PROVIDES COMMUNITY-WIDE TRAINING FOR PHYSICIANS AND LOCAL CLINICS BASED ON BEST PRACTICES FOR TREATING NICOTINE ADDICTION. IN ADDITION, THE SETON TOBACCO EDUCATION RESOURCE CENTER OFFERS A COMPREHENSIVE TOBACCO EDUCATION PROGRAM WHICH PROVIDES CESSATION CLASSES THAT ARE BASED ON THE MAYO CLINIC MODEL FOR TREATING TOBACCO DEPENDENCE. SESSIONS FOLLOW A SUPPORT GROUP SETTING AND ARE FACILITATED BY CERTIFIED TOBACCO TREATMENT SPECIALIST. THROUGH MOTIVATIONAL INTERVIEWING TECHNIQUES CTTS ARE ABLE TO CONDUCT SESSIONS THAT AIM AT MAXIMIZING & PROMOTING PARTICIPANT DIALOGUE. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS IDENTIFIED IN WILLIAMSON COUNTY. THE ASSESSMENT EXPOSED HIGH RATES OF POOR MENTAL HEALTH AND SUBSTANCE ABUSE. 12% OF ADULTS REPORTED TO HAVING 5 OR MORE POOR MENTAL HEALTH DAYS PER MONTH WHICH PLACE WILLIAMSON BELOW THE NATIONAL AVERAGE. THESE STATISTICS COUPLED WITH THE ABOVE AVERAGE RATE OF ADULTS WHO DRINK EXCESSIVELY, REVEALS WHY BEHAVIORAL HEALTH WAS IDENTIFIED AS THE SECOND HIGHEST PRIORITY FOR WILLIAMSON COUNTY. SMCW HAS DEVELOPED A CLINICAL PSYCHIATRY PROGRAM THROUGH PARTNERSHIP WITH LONE STAR CIRCLE OF CARE (LSCC). THIS IS AIMED AT INCREASING BEHAVIORAL HEALTH SERVICES IN WILLIAMSON COUNTY AND SETON IS COMMITTED TO ITS CONTINUED SUPPORT. SMCW HAS EXPANDED ACCESS TO PSYCHIATRIC TELEMEDICINE TO THE ENTIRE SMCW FACILITY DURING DAYTIME HOURS THROUGH A PARTNERSHIP WITH THE SETON MIND INSTITUTE. SMCW WILL CONTINUE TO SUPPORT THIS BEHAVIORAL HEALTH SERVICE AND WILL EXPAND TO WEEKEND AND EVENING PSYCHIATRIC TELEMEDICINE DURING THE FALL OF 2013. BY PROVIDING 24/7 PSYCHIATRIC CONSULTATIONS, INCLUDING AFTER HOURS, PATIENTS IN PSYCHIATRIC CRISIS WILL BE ABLE TO BE EVALUATED AND TREATED IN A TIMELY MANNER. TYPICALLY PATIENTS WOULD HAVE TO WAIT UNTIL THE NEXT DAY FOR APPROPRIATE PSYCHIATRIC ASSESSMENT. THIS NEW APPROACH TO PSYCHIATRIC TELEMEDICINE CAN LEAD TO TIMELY ASSESSMENT, EARLIER DISPOSITION AND LESS COSTLY LEVEL OF CARE. OTHER PROGRAMS TARGETED TO IMPROVE THE MENTAL HEALTH AND WELL- BEING OF SMCW PATIENTS AND COMMUNITY MEMBERS INCLUDE THE SETON COVE SPIRITUALITY CENTER AND THE PROPOSED EXPANSION TO SMCW OF THE NO ONE DIES ALONE (NODA) PROGRAM. NODA PROVIDES TRAINED VOLUNTEER BEDSIDE COMPANIONSHIP FOR PATIENTS WHO MIGHT OTHERWISE BE ALONE AT THE TIME OF DEATH WHILE THE SETON COVE SPIRITUALITY CENTER PROVIDES SPIRITUALLY HEALING DISCUSSION GROUPS, CLASSES AND EVENTS LED BY A MULTIDISCIPLINARY FACULTY BOTH ON THE SMCW CAMPUS AND AT THE SPIRITUALITY CENTER. PROGRAMS ARE OPEN TO THE COMMUNITY. TO AUGMENT THE PUBLIC SCHOOL HEALTH EDUCATION CURRICULUM, SETON HEALTHCARE FAMILY HAS PURCHASED HEALTHTEACHER, A COMPREHENSIVE K-12 ONLINE HEALTH EDUCATION CURRICULUM FOR TEACHERS IN SCHOOL DISTRICTS WITHIN TRAVIS, WILLIAMSON, AND HAYS COUNTY. THE CURRICULUM PROVIDES OVER 300 AGE-APPROPRIATE LESSONS ACROSS 10 CONTENT AREAS ALIGNED WITH THE NATIONAL HEALTH EDUCATION STANDARDS (NHES). LESSONS ARE DESIGNED FOR INTEGRATION INTO CORE CURRICULUM AREAS SUCH AS LANGUAGE ARTS, SCIENCE AND SOCIAL STUDIES, AND HAVE BEEN ALIGNED WITH THE TEXAS TEKS. THEY PROVIDE SKILLS-BASED INSTRUCTION LINKED TO ASSESSMENTS. HEALTH EDUCATORS IN SCHOOL DISTRICTS IN WILLIAMSON COUNTY WERE TRAINED BY NATIONAL HEALTHTEACHER STAFF ON HOW TO INTEGRATE AND IMPLEMENT THE HEALTHTEACHER CURRICULUM IN THE CLASSROOM. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN WILLIAMSON COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. MORE COORDINATED APPROACHES WOULD HELP MAXIMIZE LIMITED RESOURCES. IN 1997, SETON LED THE FORMATION OF THE INTEGRATED CARE COLLABORATION (ICC), AN ALLIANCE OF COMMUNITY PROVIDERS FOR THE MEDICALLY INDIGENT, INCLUDING HEALTH CARE ORGANIZATIONS, GOVERNMENT ENTITIES AND VOLUNTEER CLINICS. KNOWN AS THE ICC, THE GROUP'S GOAL WAS TO WORK TOGETHER TO INCREASE ACCESS, IMPROVE QUALITY AND FIND CREATIVE FINANCING SOLUTIONS FOR THE PROVISION OF HEALTH CARE FOR THE REGION'S UNINSURED. THE ICC HAS DEVELOPED AN AREA WIDE HEALTH INFORMATION EXCHANGE (HIE) FOR THE UN- AND UNDERINSURED THAT IS USED TO INFORM PROVIDERS ON THE CARE A SPECIFIC INDIVIDUAL HAS RECEIVED WHILE ALSO PROVIDING COMMUNITY WIDE ANALYTICS ON HEALTHCARE USAGE AND DIAGNOSTIC TRENDS. SINCE ITS INCEPTION THE ICC HAS BROKEN INTO MULTIPLE COLLABORATIONS, FOCUSING ON SPECIFIC GEOGRAPHIC AREAS. THE SETON HEALTHCARE FAMILY CONTINUES TO FUND THE ICC INFRASTRUCTURE. FINANCIAL ASSISTANCE SETON IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. SMCW SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS SMCW PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL. |
| Schedule H, Part V, Section B, Line 11 Facility A, 19 | Facility A, 19 - SETON MEDICAL CENTER HAYS - part 1. THE SMCH IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE HAYS COUNTY CHNA. ALSO ADDRESSED IN THE SMCH PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. OBESITY THE 2013 HAYS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE PRESSING HEALTH ISSUES. WHILE OVERALL, OBESITY IN HAYS COUNTY IS BELOW THE NATIONAL AVERAGE, NEIGHBORHOOD WELLNESS PROGRAMS AND ACCESS TO HEALTHY FOODS WERE AREAS OF PARTICULAR FOCUS. IN ADDITION TO THESE COMMENTS ON OBESITY, THE DATA REVEALED THAT COMMUNITY MEMBERS EXPERIENCE CHALLENGES MAINTAINING AN ACTIVE LIFESTYLE. WHILE WE CERTAINLY NEED TO ADDRESS THE IMPACT OF OBESITY IN OUR COMMUNITY, IT IS CRUCIAL THAT WE TAKE STEPS TO ADDRESS THE ISSUE PRIOR TO INDIVIDUALS BECOMING OBESE. WITH A 30% OBESITY RATE IN ADULTS, HAYS COUNTY IS SLIGHTLY ABOVE THE STATE AVERAGE OF 29.6%. SMCH IS DEDICATED TO IMPROVING THE NUTRITIONAL VALUE OF THE FOOD OFFERED AT THE FACILITY. SMCH WILL WORK WITH TOUCHPOINT, ITS FOOD SERVICE VENDOR, TO IMPROVE THE NUTRITIONAL CONTENT IN THE FOOD SERVED THROUGH A HEALTHY DINING PROGRAM TO ENSURE THAT OUR DAILY OFFERINGS ARE GEARED TOWARD PROVIDING HEALTHY CHOICES AND OPTIONS FOR OUR GUESTS. THIS WILL NOT ONLY BENEFIT PATIENTS BUT ALSO VISITORS, PHYSICIANS, AND COMMUNITY MEMBERS WHO FREQUENT THE HOSPITAL. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 HAYS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH RELATED PRIORITY FACING RESIDENTS OF HAYS COUNTY. FOR THE PAST 6 YEARS THE TOP THREE CAUSES OF DEATH IN HAYS COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY SUMMIT PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. SETON NETWORK ONCOLOGY SERVICES CURRENTLY WORKS WITH SEVERAL SETON HOSPITALS, INCLUDING SMCH, PROVIDING ACCESS TO THE SETON CANCER PREVENTION AND EARLY DETECTION PROGRAM, THE ONCOLOGY NURSE REGISTRY, THE SURVIVORSHIP PROGRAM, THE MULTIDISCIPLINARY CANCER CONFERENCE AND CLINICS, AND NAVIGATION SERVICE. SETON'S COMPREHENSIVE ONCOLOGY PROGRAMS PROVIDE RESIDENTS OF CENTRAL TEXAS ACCESS TO CANCER SERVICES THAT PROMOTE EARLY DETECTION AND A COORDINATED APPROACH TO CARE THROUGHOUT THE CONTINUUM WHICH INCLUDES SCREENING, DIAGNOSIS, TREATMENT AND SURVIVORSHIP. SMCH REFERS PATIENTS TO THE SETON SHIVERS CANCER CENTER. THE SHIVERS CANCER CENTER PROVIDES A VARIETY OF OUTPATIENT SERVICES FOR ADULT CANCER PATIENTS IN CENTRAL TEXAS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO CLINICAL SERVICES, THE SHIVERS HEALTH CARE PROFESSIONALS WORK CLOSELY WITH THE SETON CANCER CARE TEAM TO PROVIDE VITAL CASE MANAGEMENT SERVICES PLUS A VARIETY OF PHYSICAL, EMOTIONAL, AND SPIRITUAL SUPPORT PROGRAMS TO ADULT CANCER PATIENTS AND THEIR FAMILIES. SMCH WILL WORK WITH THE NEW WOMEN'S ONCOLOGY CARE SCREENING PROGRAM. THIS PROGRAM EXPANDS TIMELY ACCESS TO BREAST AND CERVICAL CANCER SCREENING VIA A MOBILE UNIT FOR UNINSURED AND UNDERINSURED WOMEN IN CENTRAL TEXAS WHO, WITHOUT THIS EXPANSION, LIKELY WOULD NOT RECEIVE THESE LIFE-SAVING SERVICES. THIS EXPANSION IN SCREENING IS PART OF SETON'S DIGITAL MAMMOGRAPHY MOBILE UNIT KNOWN AS THE BIG PINK BUS. ACCESS TO CERVICAL CANCER SCREENINGS ARE NOW EXPANDED TO MOBILE MAMMOGRAPHY PROGRAM PARTICIPANTS BY USING ADVANCED PRACTICE NURSES ON THE MOBILE UNIT OR AT OUR COMMUNITY CLINICS THAT PROVIDE INDIGENT CARE. IN ADDITION TO THE SCREENING, SMCH WILL INCORPORATE WOMEN'S ONCOLOGY NAVIGATION AS A METHOD OF EXPANDING EXISTING PATIENT NAVIGATION SERVICES THAT CONNECT WOMEN WITH CANCER DIAGNOSIS TO TREATMENT AND/OR SURVIVORSHIP SUPPORT SERVICES. LOOKING TO IMPROVE THE HEALTH OF PATIENTS WITH CHRONIC DISEASE, SETON ALSO HAS ESTABLISHED THE SETON TOTAL HEALTH TRANSITIONS TEAM AS A PROTOTYPE OF DISEASE MANAGEMENT AS PATIENTS LEAVE THE HOSPITAL SETTING. BASED ON A SUCCESSFUL PILOT, THE SETON TOTAL HEALTH TRANSITIONS TEAM WILL EXPAND TO SMCH IN THE COMING YEARS TO ENHANCE AND EXPAND THE MODEL TO BETTER COORDINATE CARE THROUGH A CARE TRANSITION INTERVENTION. THIS APPROACH INCLUDES A MULTI- DISCIPLINARY TEAM THAT MONITORS AND COORDINATES THE CARE OF PATIENTS WITH CHRONIC DISEASES IMMEDIATELY FOLLOWING DISCHARGE FROM HOSPITAL TO HOME, AND FROM HOME TO PRIMARY CARE. THIS PROJECT IS EXPECTED TO OPTIMIZE THE PATIENT'S RECOVERY AND AVOID READMISSION. SERVICES INCLUDE HOME VISITS TO PROVIDE SHORT-TERM DIRECT CARE, SOCIAL SERVICES, BEHAVIORAL HEALTH SUPPORT, TRANSPORTATION, TELEHEALTH AND PATIENT TRAINING REGARDING SELF- CARE MANAGEMENT OF THE CHRONIC DISEASE(S). SMCH WILL SERVE AS A LOCATION OF POTENTIAL EXPANSION FOR THE CHRONIC CARE MANAGEMENT PROGRAM THAT PROVIDES DIRECT HEALTH CARE AND CARE COORDINATION FOR ADULTS WHO HAVE BEEN SERIOUSLY INJURED AND TO THOSE WHO HAVE EXPERIENCED A SERIOUS ILLNESS DUE TO MULTIPLE CHRONIC CONDITIONS. THIS WILL BE AN EXTENSION OF THE SETON TOTAL HEALTH PARTNERS PILOT ESTABLISHED IN JANUARY 2012. THIS PROGRAM ASSISTS ENROLLEES IN FINDING AND RECEIVING THE MEDICAL CARE THEY NEED TO ACHIEVE OPTIMAL HEALTH AND PREVENT AVOIDABLE HOSPITALIZATION AND INAPPROPRIATE USE OF EMERGENCY DEPARTMENTS. THE PROGRAM PROVIDES A NUMBER OF PATIENT CARE INTERVENTIONS, A STRUCTURED AND MONITORED HAND-OFF PROCESS, TRAINING FOR OPTIMAL SELF-CARE, COUNSELING, AND FACILITATED INTEGRATION WITH PRIMARY AND SPECIALTY PHYSICIANS RESPONSIBLE FOR EACH PATIENT'S CARE. THIS PROJECT WILL LAUNCH IN TRAVIS COUNTY HOSPITALS AND THEN EXPAND TO SMCH IN THE COMING YEARS. SMCH WILL POSITION ITSELF AS AN EXPANSION SITE FOR THE NEWLY DEVELOPED AND IMPLEMENTED PROCESS IMPROVEMENT METHODOLOGY TO IMPROVE OUTCOMES FOR ADULT INPATIENTS DIAGNOSED WITH DIABETICS MELLITUS. THE DIABETES CHRONIC CARE MANAGEMENT WILL IMPLEMENT SMALL, STRAIGHTFORWARD EVIDENCE-BASED PRACTICES TO IMPLEMENT A DIABETES CARE BUNDLE THAT, WHEN PERFORMED COLLECTIVELY AND RELIABLY, HAS BEEN PROVEN TO IMPROVE PATIENT OUTCOMES. IN ADDITION, THIS PROJECT WILL ESTABLISH AN INTERDISCIPLINARY DIABETES TEAM, LED BY AN ENDOCRINOLOGISTS AND A DIABETES CLINICAL NURSE SPECIALIST, TO ADDRESS THE CLINICAL, SAFETY, AND PSYCHOSOCIAL NEEDS OF INPATIENTS WITH DIABETES WHILE PREPARING FOR A SUCCESSFUL DISCHARGE. THE PROJECT WILL ALSO IMPLEMENT EVIDENCE-BASED PRACTICE (EBP) PROTOCOLS TO ENSURE IMPROVED CLINICAL OUTCOMES DURING AND POST- HOSPITALIZATION. THIS PROJECT IS GEARED TO START SETON TRAVIS COUNTY HOSPITALS AND THEN WILL EXPAND TO SMCH. SMCH WILL CONTINUE TO OFFER SETON'S ASTHMA EDUCATION PROGRAM TO CENTRAL TEXAS RESIDENTS. THIS PROGRAM PROVIDES HOME VISITS FOR ASTHMA EDUCATION TO NEARLY 1,000 UNINSURED AND UNDERINSURED FAMILIES PER YEAR. BY PROVIDING EDUCATION ABOUT SERVICES IN THE HOME, RESIDENTS OVERCOME TRANSPORTATION BARRIERS THAT OFTEN ACCOMPANY THIS TARGET POPULATION. THE SETON ASTHMA & COPD CENTER PROVIDES A COMPREHENSIVE DISEASE MANAGEMENT PROGRAM DESIGNED TO PROVIDE CARE COORDINATION, SOCIAL SERVICES, AND ASTHMA/COPD EDUCATION FOR ALL AGES. |
| Schedule H, Part V, Section B, Line 11 Facility A, 20 | Facility A, 20 - SETON MEDICAL CENTER HAYS - part 2. SETON HEALTHCARE FAMILY FACILITIES ARE A TOBACCO FREE ENVIRONMENT, PROHIBITING TOBACCO USE AT ALL OF ITS HOSPITALS AND PLACES OF WORK. SETON IS AN ACTIVE PARTICIPANT IN COMMUNITY EFFORTS TO COMBAT TOBACCO USE, PROVIDING TOBACCO CESSATION SERVICES TO WILLIAMSON COUNTY RESIDENTS. SMCH WILL CONTINUE TO SUPPORT THE TOBACCO CESSATION PROGRAM THAT PROVIDES COMMUNITY-WIDE TRAINING FOR PHYSICIANS AND LOCAL CLINICS BASED ON BEST PRACTICES FOR TREATING NICOTINE ADDICTION. IN ADDITION, THE SETON TOBACCO EDUCATION RESOURCE CENTER OFFERS A COMPREHENSIVE TOBACCO EDUCATION PROGRAM WHICH PROVIDES CESSATION CLASSES THAT ARE BASED ON THE MAYO CLINIC MODEL FOR TREATING TOBACCO DEPENDENCE. SESSIONS FOLLOW A SUPPORT GROUP SETTING AND ARE FACILITATED BY CERTIFIED TOBACCO TREATMENT SPECIALIST. THROUGH MOTIVATIONAL INTERVIEWING TECHNIQUES CTTS ARE ABLE TO CONDUCT SESSIONS THAT AIM AT MAXIMIZING & PROMOTING PARTICIPANT DIALOGUE. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE THIRD GREATEST HEALTH CONCERNS RAISED BY HAYS COUNTY RESIDENTS. SUMMIT PARTICIPANTS AND STAKEHOLDERS ALIKE BOTH MENTIONED THE RISING RATES OF MENTAL HEALTH CONDITIONS AMONG RESIDENTS IN THE COUNTY. THIS INCLUDED AREAS SUCH AS SUBSTANCE ABUSE AND AN INADEQUATE NUMBER OF MENTAL HEALTH PROVIDERS WHO COULD PRESCRIBE MEDICATION. THE CHNA IDENTIFIED THAT HAYS COUNTY ADULTS EXPERIENCED ON AVERAGE 4 POOR MENTAL HEALTH DAYS IN THE PAST MONTH WHICH WAS MUCH HIGHER THAN THE NATIONAL BENCHMARK OF 2.6. SMCH WILL EXPLORE HOW THEY CAN WORK WITH HILL COUNTY MHMR AND COMMUNICARE HEALTH CENTERS TO EXPAND SERVICES TO MEET THE BEHAVIORAL HEALTH NEEDS IN HAYS COUNTY. IT IS UNCLEAR HOW THIS COLLABORATIVE EFFORT MAY UNFOLD, BUT SMCH IS WILLING TO WORK WITH LOCAL PARTNERS TO IDENTIFY WAYS TO ADDRESS THE BEHAVIORAL HEALTH NEEDS. SMCH HAS EXPANDED ACCESS TO PSYCHIATRIC TELEMEDICINE TO THE ENTIRE SMCH FACILITY DURING DAYTIME HOURS THROUGH A PARTNERSHIP WITH THE SETON MIND INSTITUTE. SMCH WILL CONTINUE TO SUPPORT THIS BEHAVIORAL HEALTH SERVICE AND WILL EXPAND TO WEEKEND AND EVENING PSYCHIATRIC TELEMEDICINE DURING THE FALL OF 2013. BY PROVIDING 24/7 PSYCHIATRIC CONSULTATIONS, INCLUDING AFTER HOURS, PATIENTS IN PSYCHIATRIC CRISIS WILL BE ABLE TO BE EVALUATED AND TREATED IN A TIMELY MANNER. TYPICALLY PATIENTS WOULD HAVE TO WAIT UNTIL THE NEXT DAY FOR APPROPRIATE PSYCHIATRIC ASSESSMENT. THIS NEW APPROACH TO PSYCHIATRIC TELEMEDICINE CAN LEAD TO TIMELY ASSESSMENT, EARLIER DISPOSITION AND LESS COSTLY LEVEL OF CARE. TO AUGMENT THE PUBLIC SCHOOL HEALTH EDUCATION CURRICULUM, SETON HEALTHCARE FAMILY HAS PURCHASED HEALTHTEACHER, A COMPREHENSIVE K-12 ONLINE HEALTH EDUCATION CURRICULUM FOR TEACHERS IN SCHOOL DISTRICTS WITHIN TRAVIS, WILLIAMSON, AND HAYS COUNTY. THE CURRICULUM PROVIDES OVER 300 AGE-APPROPRIATE LESSONS ACROSS 10 CONTENT AREAS ALIGNED WITH THE NATIONAL HEALTH EDUCATION STANDARDS (NHES). LESSONS ARE DESIGNED FOR INTEGRATION INTO CORE CURRICULUM AREAS SUCH AS LANGUAGE ARTS, SCIENCE AND SOCIAL STUDIES, AND HAVE BEEN ALIGNED WITH THE TEXAS TEKS. THEY PROVIDE SKILLS-BASED INSTRUCTION LINKED TO ASSESSMENTS. HEALTH EDUCATORS WERE TRAINED BY NATIONAL HEALTHTEACHER STAFF ON HOW TO INTEGRATE AND IMPLEMENT THE HEALTHTEACHER CURRICULUM IN THE CLASSROOM. ACCESS TO CARE ACCESS TO HEALTHCARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE EDUCATION AND OUTREACH OF SERVICES IN THE COMMUNITY. IN ADDITION, THE DECREASE IN FUNDING FOR WOMEN'S HEALTH AND FAMILY PLANNING SERVICES HAS LEFT A LARGE UNMET NEED IN THE COMMUNITY. SUMMIT PARTICIPANTS RECOGNIZED A PRESENCE OF FACILITIES AND PROGRAMMING BUT THE MAJORITY OF PARTICIPANTS NOTED THAT ACCESS TO THESE PROGRAMS IS DIFFICULT, ESPECIALLY FOR THOSE LOW- INCOME AND AGING POPULATIONS. SMCH HAS, AND WILL CONTINUE TO ENGAGE IN ITS PARTNERSHIP WITH COMMUNICARE HEALTH CENTERS OF CENTRAL TEXAS AS A WAY OF INCREASING PRIMARY CARE ACCESS FOR THE UN- AND UNDERINSURED RESIDENTS OF HAYS COUNTY. CURRENTLY, SMCH PROVIDES FUNDING FOR COMMUNICARE STAFF TO COME TO VARIOUS PARTS OF THE COUNTY MULTIPLE TIMES PER WEEK AND SMCH WILL LOOK TO EXPAND THE SCOPE OF THIS PARTNERSHIP IN THE FUTURE. SMCH IS WITHIN CLOSE PROXIMITY TO SOUTH AUSTIN AND PATIENTS COME TO SMCH FROM NOT ONLY FROM HAYS COUNTY BUT ALSO SOUTHERN TRAVIS COUNTY. THE SETON HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED. |
| Schedule H, Part V, Section B, Line 11 Facility A, 21 | Facility A, 21 - SETON MEDICAL CENTER HAYS - part 3. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. SMCH HAS AND WILL CONTINUE TO REFER UNFUNDED PATIENTS WITHOUT A MEDICAL HOME TO THE SETON COMMUNITY HEALTH CENTERS FOR PRIMARY CARE. TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SMCH WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY THE SETON HEALTHCARE NETWORK, THE SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE CHNA IDENTIFIED HEALTH DISPARITIES AND INEQUITIES IN THE ABILITY OF DIFFERENT ETHNIC GROUPS TO ACCESS CARE. THE REASONS ARE COMPLEX. RESEARCH SHOWS PROVIDING PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE REDUCES READMISSIONS WITHIN 30 DAYS, REDUCES PATIENT BED DAYS, IMPROVES MEDICATION ADHERENCE AND LEADS TO BETTER HEALTH OUTCOMES. IN ADDITION, RESEARCH ALSO SHOWS PROVIDING CULTURAL COMPETENCE TRAINING TO OUR CLINICAL CARE TEAMS IMPROVES COMMUNICATION BETWEEN PATIENTS AND THEIR CLINICAL CARE TEAM INCLUDING THEIR DOCTORS AND NURSES AS MEASURED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS ("HCAHPS") SURVEY, THE FIRST NATIONAL, STANDARDIZED, PUBLICLY REPORTED SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. CURRENTLY SETON PROVIDES TELEPHONE INTERPRETATION SERVICES IN OVER 140 LANGUAGES, 24 HOURS, 7 DAYS A WEEK, 365 DAYS A YEAR. IN ADDITION, SETON PROVIDES IN PERSON SIGN LANGUAGE CONTRACTED SERVICES AT ALL OF OUR FACILITIES AND IN PERSON SPANISH TRANSLATION AT SMCH. AS PART OF AN INTEGRATED APPROACH TO ADMINISTER CARE IN A PERSON CENTERED, CULTURALLY COMPETENT MANNER, THE SETON HEALTHCARE FAMILY WILL DEVELOP A LANGUAGE SERVICES RESOURCE CENTER AND A CULTURALLY COMPETENT CARE CURRICULUM AT FOUR SETON HOSPITALS AND WILL IMPLEMENT THE LEARNINGS AND BEST PRACTICES AT SMCH. THE LANGUAGE SERVICES RESOURCE CENTER IS A NEW PROJECT WHICH WILL PROVIDE PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE BY CENTRALIZING INTERPRETATION & TRANSLATION SERVICES, AND INCREASING THE NUMBER OF PROFESSIONAL MEDICAL INTERPRETERS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY INCLUDING BUT NOT LIMITED TO SPANISH AND SIGN LANGUAGE. THE CULTURALLY COMPETENT CARE CURRICULUM IS EXPECTED TO INCREASE THE QUALITY OF COMMUNICATION BETWEEN THE CLINICAL CARE TEAM AND THE PATIENT IN ORDER TO ACHIEVE GREATER PATIENT INVOLVEMENT IN SHARED DECISION MAKING. THE DIVERSITY DEPARTMENT THROUGH THE CULTURALLY COMPETENT CARE CURRICULUM WILL PROVIDE TRAINING AND EDUCATION TO THE CLINICAL CARE TEAM TO INCREASE THE LIKELIHOOD OF SAFE AND EFFECTIVE PERSON CENTERED CARE IN A CULTURALLY COMPETENT MANNER AND LEADS TO BETTER HEALTH OUTCOMES. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN HAYS COUNTY, SUMMIT PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESION AND FOCUSED VISION LEAD PARTICIPANTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. THE DESIRE FOR A MORE COORDINATED APPROACH WAS IDENTIFIED AS AN AREA OF NEED IN ORDER TO MAXIMIZE THE LIMITED RESOURCES OF THE AREA. SMCH AND THE SETON HEALTHCARE FAMILY PROVIDED STRONG SUPPORT IN THE CREATION OF THE HEALTHY COMMUNITY COLLABORATIVE. THIS COLLABORATION COMPRISED OF VARIOUS COMMUNITY STAKEHOLDERS IS A LOCAL COLLABORATION THAT REMAINS AS A SUBGROUP OF THE INTEGRATED CARE COLLABORATION (ICC). IN 1997, SETON LED THE FORMATION OF THE INTEGRATED CARE COLLABORATION (ICC), AN ALLIANCE OF COMMUNITY PROVIDERS FOR THE MEDICALLY INDIGENT, INCLUDING HEALTH CARE ORGANIZATIONS, GOVERNMENT ENTITIES AND VOLUNTEER CLINICS. KNOWN AS THE ICC, THE GROUP'S GOAL WAS TO WORK TOGETHER TO INCREASE ACCESS, IMPROVE QUALITY AND FIND CREATIVE FINANCING SOLUTIONS FOR THE PROVISION OF HEALTH CARE FOR THE REGION'S UNINSURED. THE ICC HAS DEVELOPED AN AREA WIDE HEALTH INFORMATION EXCHANGE (HIE) FOR THE UN- AND UNDERINSURED THAT IS USED TO INFORM PROVIDERS ON THE CARE A SPECIFIC INDIVIDUAL HAS RECEIVED WHILE ALSO PROVIDING COMMUNITY WIDE ANALYTICS ON HEALTHCARE USAGE AND DIAGNOSTIC TRENDS. SINCE ITS INCEPTION THE ICC HAS BROKEN INTO MULTIPLE COLLABORATIONS, FOCUSING ON SPECIFIC GEOGRAPHIC AREAS. THE SETON HEALTHCARE FAMILY CONTINUES TO FUND THE ICC INFRASTRUCTURE. FINANCIAL ASSISTANCE SETON IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. SMCH SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS SMCH PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL. |
| Schedule H, Part V, Section B, Line 11 Facility A, 22 | Facility A, 22 - CEDAR PARK REGIONAL MEDICAL CENTER - part 1. THE CPRMC IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE WILLIAMSON COUNTY CHNA. ALSO ADDRESSED IN THE CPRMC PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. ACCESS TO CARE ACCESS TO HEALTHCARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE HIGH COST OF PREVENTATIVE CARE AND THE NEED FOR EDUCATION ON SERVICES AND APPROPRIATE UTILIZATION. IN ADDITION TO THE HIGH COST OF CARE, THE DIFFICULTY OF NAVIGATING THE HEALTH CARE SYSTEM FOR THE UNINSURED AND UNDERINSURED ALSO PROVED TO BE BARRIERS TO ACCESS. WITH 81% OF ADULTS HAVING HEALTH INSURANCE AND 89% OF CHILDREN WITH HEALTH INSURANCE, BOTH CATEGORIES CURRENTLY FALL BELOW THE DESIRED CENTRAL TENDENCY. THE CHNA IDENTIFIED A PRESENCE OF FACILITIES AND PROVIDERS BUT WITH A HIGH UNINSURED RATE AND TRANSPORTATION ISSUES, THESE FACILITIES MAY NOT BE ACCESSIBLE FOR ALL RESIDENTS. CPRMC WORKS CLOSELY WITH THE LEANDER INDEPENDENT SCHOOL DISTRICT TO INCREASE ACCESS TO HEALTH SCREENINGS AND HEALTH EDUCATION WHILE AT THE SAME TIME PROMOTE THE HEALTH OBJECTIVES OF STUDENTS, ASSOCIATES AND PARENTS OF THE DISTRICT. AN ANNUAL LISD HEALTH EXPO IS PROVIDED FOR APPROXIMATELY 4,500 DISTRICT EMPLOYEES. HEALTH SCREENINGS, ONE-ON-ONE INFORMATION AND WELLNESS SEMINARS ARE PROVIDED AT THE EVENT. TOPICS INCLUDE THE PREVENTION AND TREATMENT OF CHRONIC DISEASES, HEALTHY NUTRITION AND THE PREVENTION OF OBESITY. CPRMC ALSO PROVIDES SPEAKERS ON HEALTH-RELATED TOPICS FOR AN ANNUAL CONFERENCE FOR THE PARENTS OF LISD, CALLED CONNECTING U. CPRMC HAS WORKED ON MULTIPLE INITIATIVES TO IMPROVE PATIENTS' ACCESS TO CARE. CPRMC WILL WORK WITH PRIMARY CARE CLINIC PARTNERS WHO HAVE OPENED AND ARE PLANNED TO OPEN FACILITIES IN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. THOUGH MANY AREA PROVIDERS NO LONGER ACCEPT MEDICAID AND MEDICARE, PATIENTS ON THESE PLANS CAN RECEIVE CARE AT THESE CLINICS. IN AN EFFORT TO INCREASE ACCESS TO SPECIALTY CARE, CPRMC PLANS FOR EXPANSION INCLUDE A HEART AND VASCULAR CENTER, PEDIATRIC UNIT AND A FREESTANDING EMERGENCY CENTER. OBESITY THE 2012 WILLIAMSON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE PRESSING HEALTH ISSUES. THIS INCLUDED THE HIGH RATE OF OVERWEIGHT AND OBESE ADULTS LIVING IN THE COMMUNITY AS WELL AS THE CONCERN FOR CHILDHOOD OBESITY. IN ADDITION TO THE STAKE HOLDER COMMENTS DIRECTLY RELATED TO OBESITY, THE FOCUS GROUPS FREQUENTLY DISCUSSED THE CHALLENGES OF NUTRITION AND EXERCISE IN WILLIAMSON COUNTY. WHILE WE CERTAINLY NEED TO ADDRESS THE IMPACT OF OBESITY IN OUR COMMUNITY, IT IS ALSO CRUCIAL THAT WE TAKE STEPS TO ADDRESS THE ISSUE PRIOR TO INDIVIDUALS BECOMING OBESE. WITH 67% OF WILLIAMSON COUNTY ADULTS CLASSIFIED AS OVERWEIGHT AND OBESE, WILLIAMSON COUNTY FALLS ABOVE STATE AND NATIONAL BENCHMARKS. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY RELATED PROGRAMS. CPRMC WILL CONTINUE TO SUPPORT THE EFFORTS OF LOCAL YMCA PROGRAMS THAT ARE AIMED AT PROVIDING HEALTHY AND ACTIVE LIFESTYLE OPTIONS FOR CHILDREN AND THEIR FAMILIES. CPRMC HAS AND WILL CONTINUE TO SUPPORT THE YMCA TO ACHIEVE THESE OBJECTIVES. CPRMC HAS IDENTIFIED SUPPORT GROUPS AS A VITAL PART IN THE SUCCESS OF THEIR PATIENTS. CPRMC'S BARIATRIC SUPPORT GROUP PROVIDES SEMINARS ON GOAL SETTING, NUTRITION EDUCATION, BODY IMAGE, PHYSICAL FITNESS, GROCERY SHOPPING TOURS AND MANY OTHER OBESITY RELATED TOPICS FREE OF CHARGE FOR THOSE WHO ARE INTERESTED. IN ADDITION, THE BARIATRIC SUPPORT GROUP HOSTS GUEST SPEAKERS SUCH AS DIETICIANS, SURGEONS, AND PSYCHOLOGISTS TO HELP EDUCATE PARTICIPANTS ON HEALTHY LIFESTYLES AND OPTIONS FOR LOSING WEIGHT. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 WILLIAMSON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF WILLIAMSON COUNTY. FOR THE PAST 6 YEARS THE TOP THREE CAUSES OF DEATH IN WILLIAMSON COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE, SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER AS SOME OF THE GREATEST AREAS OF CONCERN. WITH THE LONG TERM DEVELOPMENTS OF CHRONIC DISEASE AND THE LIFESTYLE ATTRIBUTES THAT CONTRIBUTE TO THESE DISEASES, IT IS IMPERATIVE THAT A CONCERTED EFFORT BE MADE BY THE COMMUNITY TO PROMOTE HEALTHY CHOICES WHERE RESIDENTS LIVE, WORK, PLAY, AND WORSHIP. |
| Schedule H, Part V, Section B, Line 11 Facility A, 23 | Facility A, 23 - CEDAR PARK REGIONAL MEDICAL CENTER - part 2. CPRMC PROVIDES NUMEROUS EDUCATIONAL PROGRAMS AND OUTREACH ACTIVITIES TO BENEFIT THE COMMUNITY. THE HEALTHY WOMAN AND SENIOR CIRCLE PROGRAMS, WITH MORE THAN 6,000 MEMBERS, ARE IMPORTANT FOR THEIR SUPPORT, HEALTH, AND WELLNESS ACTIVITIES. THROUGH REGULAR E- NEWSLETTERS AND WELLNESS SEMINARS, MEMBERS LEARN STRATEGIES TO IMPROVE THEIR HEALTH STATUS AND PREVENT CHRONIC DISEASES. CPRMC ALSO HAS A FREE MEMBERSHIP PROGRAM FOR EXPECTANT MOTHERS CALLED TINY TOES WITH MORE THAN 2,000 MEMBERS, WHERE WOMEN RECEIVE INFORMATION ON PREGNANCY AND CHILDBEARING. EACH MEMBER RECEIVES THE CHILDBIRTH PREPARATION BOOK, WHAT TO EXPECT WHEN YOU'RE EXPECTING IN EITHER ENGLISH OR SPANISH. ALL PATIENTS AFTER DELIVERY ARE PROVIDED A FREE CAR SEAT AND INSTRUCTION TO PROMOTE INFANT SAFETY. SUPPORT GROUPS ON VARIOUS HEALTH TOPICS ARE PROVIDED FREE OF CHARGE TO SUPPORT THE NEEDS OF THE COMMUNITY. A MONTHLY BREAST CANCER SUPPORT GROUP IS OFFERED AT CPRMC IN COLLABORATION WITH THE BREAST CANCER RESOURCE CENTER OF TEXAS. A MONTHLY BREASTFEEDING SUPPORT GROUP IS ALSO OFFERED TO PROMOTE BREASTFEEDING FOR MOTHERS IN THE COMMUNITY. BLOOD PRESSURE AND GLUCOSE SCREENINGS ARE OFFERED REGULARLY AT COMMUNITY LOCATIONS SUCH AS ST. MARGARET MARY'S CATHOLIC CHURCH AND HILL COUNTRY BIBLE CHURCH TO IMPROVE HEALTH OUTCOMES. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS IDENTIFIED IN WILLIAMSON COUNTY. THE ASSESSMENT EXPOSED HIGH RATES OFF POOR MENTAL HEALTH AND SUBSTANCE ABUSE. 12% OF ADULTS REPORTED TO HAVING 5 OR MORE POOR MENTAL HEALTH DAYS PER MONTH WHICH PLACE WILLIAMSON BELOW THE NATIONAL AVERAGE, HOWEVER THE SUICIDE RATE WAS HIGHER THAN THE STATE AVERAGE. THESE TWO STATISTICS COUPLED WITH THE ABOVE AVERAGE RATE OF ADULTS WHO DRINK EXCESSIVELY, REVEALS WHY BEHAVIORAL HEALTH WAS IDENTIFIED AS THE SECOND HIGHEST PRIORITY FOR WILLIAMSON COUNTY. AS A HEALTHCARE PROVIDER THAT OFFERS ADVANCED MEDICAL CARE AND COMPREHENSIVE SERVICES, CPRMC PROVIDES MULTIDISCIPLINARY TEAMS TO HELP DEVELOP A COMPREHENSIVE TREATMENT PLAN FOR PATIENTS. FOR THOSE PATIENTS IDENTIFIED TO HAVE BEHAVIORAL HEALTH RELATED NEEDS, CPRMC WORKS WITH BLUEBONNET TRAILS SERVICES TO HELP TREAT THOSE PATIENTS AND TO IDENTIFY TRANSFER TO A MORE APPROPRIATE TREATMENT FACILITY I.E. AN INPATIENT FACILITY IF NEEDED. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN WILLIAMSON COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. THE DESIRE FOR A MORE COORDINATED APPROACH WAS IDENTIFIED AS AN AREA OF NEED IN ORDER TO MAXIMIZE THE LIMITED RESOURCES OF THE AREA. IN AN EFFORT TO CONTINUALLY FOSTER COMMUNITY COLLABORATION, CPRMC ALSO SUPPORTS THE PROGRAMS AND OBJECTIVES OF AREA HEALTHCARE NONPROFIT AGENCIES INCLUDING THE AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION, MARCH OF DIMES, YMCA AND AMERICAN CANCER SOCIETY. TEAMS FROM CPRMC PARTICIPATE IN THE ANNUAL WALKS OF THESE ORGANIZATIONS TO RAISE AWARENESS AND FUNDS. PROCEEDS FROM CEDAR PARK REGIONAL MEDICAL CENTER'S RACE AGAINST COLON CANCER ALSO BENEFIT THE AMERICAN CANCER SOCIETY'S PATIENT SERVICES. CPRMC IS A PROUD SUPPORTER OF THE LEANDER ISD EDUCATIONAL EXCELLENCE FOUNDATION (LEEF), HELPING TO PROVIDE INNOVATIVE TEACHING MINI-GRANTS TO IMPROVE ACADEMIC OUTCOMES FOR ALL STUDENTS IN LISD. CPRMC'S EXTENSIVE COMMUNITY PARTNERSHIPS INCLUDE GENEROUS DONATIONS FROM CPRMC ASSOCIATES TO HILL COUNTRY MINISTRIES' FOOD BANK. AN ANNUAL UNITED WAY CAMPAIGN IS ALSO PROVIDED AT CPRMC TO MEET THE CRITICAL COMMUNITY NEEDS IN WILLIAMSON COUNTY. THE ANNUAL LEADERSHIP CEDAR PARK AND LEADERSHIP LEANDER PROGRAMS ARE SUPPORTED BY CPRMC WITH DAY-LONG SEMINARS ON OUR CAMPUS TO SUPPORT EDUCATION TO COMMUNITY LEADERS ON HEALTHCARE ISSUES AND COMMUNITY PRIORITIES. ACCIDENTS A COMPREHENSIVE PLAN FOR TRAUMA DESIGNATION IS CURRENTLY UNDERWAY AND NUMEROUS PUBLIC SAFETY AND TRAUMA PREVENTION ACTIVITIES ARE OFFERED TO THE COMMUNITY. CPRMC PROVIDES A BIKE RODEO AND PARTICIPATES IN NUMEROUS HEALTH FAIRS HELP TO PROMOTE CHILDREN'S SAFETY SKILLS. CPRMC PARTNERS WITH THE CAPITAL AREA TRAUMA REGIONAL ADVISORY COUNCIL (CATRAC) TO PROVIDE BICYCLE HELMETS TO CHILDREN IN NEED. CPRMC ALSO PARTNERS WITH TWO CEDAR PARK HIGH SCHOOLS IN THE CREATION OF SHATTERED DREAMS, A FILM CREATED BY STUDENTS TO DRAMATICALLY DEMONSTRATE THE DANGERS OF DRUNK DRIVING AND PROMOTE HEALTHY DECISION MAKING. EDUCATIONAL PROGRAMS FOR EMS PROFESSIONALS ARE OFFERED ON A QUARTERLY BASIS TO PROMOTE THE QUALITY AND COORDINATION OF EMERGENCY CARE. FINANCIAL ASSISTANCE CPRMC IS COMMITTED TO DELIVERING SAFE, PERSON-CENTERED, QUALITY HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A JOINT VENTURE WITH A NONPROFIT HOSPITAL PARTNER, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. TO HELP ADDRESS THE FINANCIAL MEANS TO ACCESSING CARE, CPRMC'S FINANCIAL ASSISTANCE POLICY IS THE SAME POLICY THAT SETON INSTITUTED TO COVER PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILL. WITH SOME PUBLICLY SUBSIDIZED PROGRAMS AVAILABLE IN THE COUNTY, STAFF WILL WORK WITH PATIENTS AND THEIR FAMILIES TO HELP CONNECT THEM TO THESE RESOURCES THAT MAY HELP PAY FOR THE SERVICES THEY RECEIVED DURING THEIR VISIT. IF COVERAGE IS NOT AVAILABLE, THE PATIENT CAN REQUEST FINANCIAL ASSISTANCE. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE CURRENT YEAR'S FEDERAL POVERTY GUIDELINES AND CPRMC AND SETON PROVIDE FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375 PERCENT OF THE FEDERAL POVERTY LEVEL. |
| Schedule H, Part V, Section B, Line 11 Facility A, 24 | Facility A, 24 - CENTRAL TEXAS REHABILITATION HOSPITAL - part 1. CTRH IS AN INPATIENT REHABILITATION HOSPITAL THAT OFFERS INTENSE INPATIENT PROGRAMS THAT PROVIDE ONGOING CARE. OUR GOAL IS TO PREPARE OUR PATIENTS FOR A RETURN HOME INDEPENDENTLY OR WITH ASSISTANCE FROM FAMILY MEMBERS OR OTHER CARE PROVIDERS. INPATIENT REHABILITATION HOSPITALS ARE FOR INDIVIDUALS WHO HAVE BEEN IMPAIRED BY AN INJURY OR ILLNESS AND ARE CONSIDERED BY THEIR PHYSICIANS TO BE MEDICALLY STABLE AND PHYSICALLY ABLE TO BEGIN A COMPREHENSIVE REHABILITATION PROGRAM CONSISTING OF AT LEAST THREE HOURS OF THERAPY A DAY, FIVE DAYS A WEEK. PATIENTS ADMITTED TO CTRH BENEFIT FROM SPECIALIZED INTENSE REHABILITATION FOR MEDICAL NEEDS THAT PRECLUDE THEM FROM BEING ACCEPTED INTO A LOWER LEVEL OF CARE SUCH AS A SKILLED NURSING FACILITY. ALL THERAPY PROGRAMS ARE CUSTOMIZED BASED ON THE INDIVIDUAL'S EXISTING ABILITIES, TOLERANCE FOR THERAPY AND DESIRED OUTCOMES. PROSPECTIVE PATIENTS REQUIRE DAILY PHYSICIAN OVERSIGHT, A MINIMUM OF TWO TYPES OF THERAPY AND 24-HOUR NURSING CARE. EVERY PATIENT IN OUR HOSPITAL IS TREATED WITH DIGNITY, RESPECT AND COMPASSION. ALL OF OUR PROGRAMS CONSIST OF AN INTERDISCIPLINARY REHABILITATION TEAM COMMITTED TO HELPING EACH PATIENT AND FAMILY PROGRESS TO RECOVERY. THIS SPECIALIZED TEAM EVALUATES AND DEVELOPS A PERSONALIZED TREATMENT PLAN DESIGNED TO HELP EACH INDIVIDUAL RECOVER AND DEVELOP THE SKILLS NEEDED TO RETURN HOME OR TO LIVE AS INDEPENDENTLY AS POSSIBLE. GIVEN THE SPECIFIC FOCUS AND MISSION OF CTRH AS AN INPATIENT REHABILITATION HOSPITAL, CTRH RECOGNIZES THAT SOME COMMUNITY HEALTH NEEDS MAY FALL OUTSIDE OF OUR DIRECT LINE OF SERVICE. ADDITIONALLY, THESE NEEDS MAY BE BETTER SERVED BY OTHER COMMUNITY PARTNERS WHOSE MISSION IS TO ADDRESS CHRONIC DISEASE, OBESITY, AND BEHAVIORAL HEALTH DIRECTLY. HOWEVER, GIVEN THAT ALL OF THESE HEALTH NEEDS ARE INTERRELATED, CTRH WILL INCORPORATE IMPLEMENTATION STRATEGIES FOR ALL AREAS OF NEED. THE CTRH IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS TO VARYING DEGREES; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE TRAVIS COUNTY CHNA. ALSO ADDRESSED IN THE CTRH PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. OBESITY THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE MOST PRESSING HEALTH ISSUES. WHILE OBESITY IN TRAVIS COUNTY IS BELOW THE NATIONAL AVERAGE, CHILDHOOD OBESITY WAS LISTED AS A PARTICULAR AREA OF NEED AS THIS CONDITION IS DISPROPORTIONATELY EVIDENT AMONG MINORITY POPULATIONS. WITH A 24% OBESITY RATE IN ADULTS, TRAVIS COUNTY FALLS BELOW THE STATE AVERAGE OF 29.6%. HOWEVER, WHEN THAT RATE IS BROKEN DOWN BY ETHNICITY, THE NEED TO ADDRESS OBESITY AMONG MINORITY POPULATIONS BECOMES MORE OBVIOUS. 41.7% OF THE BLACK/AFRICAN AMERICAN ADULTS IN TRAVIS COUNTY AND 36.5% OF LATINO/HISPANIC ADULTS ARE CONSIDERED OBESE COMPARED TO 19.4% FOR WHITE RESIDENTS. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY-RELATED PROGRAMS. WITH AN UNEQUAL DISTRIBUTION AND EDUCATION REGARDING HEALTHY EATING THROUGHOUT THE COUNTY, CTRH RECOGNIZES THAT HEALTHY EATING EDUCATION IS OFTEN REQUIRED IN ORDER FOR PATIENTS TO SUCCEED WHEN THEY GO BACK INTO THEIR COMMUNITIES. FOR THIS REASON, CTRH PROVIDES A DIETICIAN ON-SITE TO CONDUCT HEALTHY EATING EDUCATION TO OBESE PATIENTS. THESE CONSULTATIONS ALLOW FOR PHYSICIANS TO WRITE SPECIFIC DIETARY ORDERS FOR PATIENTS AND FOR PATIENTS TO HAVE SPECIALIZED ONE ON ONE EDUCATION ON HOW TO ACHIEVE THE HEALTHY EATING GOALS SET BY THE PHYSICIAN. |
| Schedule H, Part V, Section B, Line 11 Facility A, 25 | Facility A, 25 - CENTRAL TEXAS REHABILITATION HOSPITAL - part 2. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF TRAVIS COUNTY. FOR THE PAST SIX YEARS THE TOP THREE CAUSES OF DEATH IN TRAVIS COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. CTRH WILL DEVELOP A STROKE PREVENTION AND EDUCATION CLASS DESIGNED TO PROVIDE EDUCATION AND RESOURCES TO THE ELDERLY MEMBERS OF THE COMMUNITY. THESE CLASSES WILL BE CONDUCTED AT LOCAL CHURCHES AND TEACH PARTICIPANTS THE SIGNS OF A STROKE AND THE STEPS TO TAKE TO PREVENT STROKES. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS RAISED BY TRAVIS COUNTY RESIDENTS. FOCUS GROUP PARTICIPANTS AND INTERVIEWEES ALIKE MENTIONED THE RISING RATES OF MENTAL HEALTH CONDITIONS AMONG TRAVIS COUNTY RESIDENTS. THIS INCLUDED AREAS SUCH AS SUBSTANCE ABUSE AND INADEQUATE MENTAL HEALTH SERVICES. THE CHNA IDENTIFIED THAT 20% OF TRAVIS COUNTY ADULTS EXPERIENCED FIVE OR MORE DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH, WHICH IS WELL ABOVE THE NATIONAL MEDIAN. MANY PATIENTS THAT COME TO CTRH HAVE A PSYCHIATRIC CO-MORBIDITY (I.E. DEPRESSION, BIPOLAR, SCHIZOPHRENIA, ETC.). IN ORDER TO MEET THIS NEED WITHOUT HAVING TO SEND PATIENTS TO A SEPARATE FACILITY, CTRH HAS PARTNERED WITH BEHAVIORAL HEALTH CONSULTANTS, A BEHAVIORAL HEALTH CARE GROUP, TO PROVIDE CONSULTATIONS TO PATIENTS WITH BEHAVIORAL HEALTH RELATED ILLNESSES. IN ORDER TO ASSIST IN THE REHABILITATION PROCESS AND ADDRESS ANY CO-MORBIDITIES, CTRH HAS A PSYCHOLOGIST TO HELP WORK WITH THEIR PATIENTS. ACCESS TO CARE ACCESS TO HEALTH CARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE FACILITIES AND RESOURCES. ALSO MENTIONED WERE THE DIFFICULTY OF NAVIGATING THE HEALTH CARE SYSTEM, THE HIGH COST OF CARE, AND THE INABILITY TO GAIN AND RETAIN HEALTH INSURANCE. COMMUNITY FORUM PARTICIPANTS RECOGNIZED A PRESENCE OF FACILITIES AND PROGRAMMING BUT THE MAJORITY NOTED THAT HEALTH CARE RESOURCES ARE GREATLY LACKING, ESPECIALLY FOR LOW-INCOME AND AGING POPULATIONS. MANY PATIENTS IN NEED DO NOT HAVE A FUNDING SOURCE AND TYPICALLY WILL NOT RECEIVE THE REHABILITATION NEEDED TO ALLOW THEM TO RECOVER TO THEIR FULLEST POTENTIAL. MOST OF THESE PATIENTS WILL BE DISCHARGED HOME OR TO A NURSING HOME WHERE THEIR RECOVERY PROCESS WILL BE HALTED. CTRH SUPPORTS THE SETON MISSION BY PROVIDING REHABILITATION TO PATIENTS WITHOUT FUNDING. ON ANY GIVEN DAY, CTRH WILL HAVE AT LEAST 1 UNFUNDED PATIENT IN-HOUSE. WITH INCREASINGLY STRETCHED HEALTH CARE RESOURCES, HELPING FAMILIES CONNECT TO A FUNDING SOURCE IS THE FIRST STEP IN MEETING THE ACCESS TO CARE NEEDS. CTRH ASSISTS FAMILIES IN OBTAINING DRS-CRS FUNDING WHICH FUNDS ACUTE REHABILITATION, OUTPATIENT REHABILITATION, AND POST-ACUTE REHABILITATION FOR PATIENTS WITH TRAUMATIC BRAIN INJURIES AND TRAUMATIC SPINAL CORD INJURIES. THIS FUNDING COMES FROM THE STATE OF TEXAS AND HELPS ALLEVIATE THE BURDEN OF FAMILIES WHO FACE BARRIERS DUE TO THE HIGH COST OF INTENSIVE CARE. CTRH WILL CONTINUE TO SUPPORT THE SETON COMMUNITY HEALTH CENTERS. THE SETON HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. CTRH HAS AND WILL CONTINUE TO SUPPORT THE WORK AND VISION OF THESE MINISTRIES THROUGH FUNDRAISING, EDUCATION, AND COMMUNITY ADVOCACY FOR THESE COMMUNITY HEALTH CENTERS. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN TRAVIS COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. MORE COORDINATED APPROACHES WOULD HELP MAXIMIZE LIMITED RESOURCES. CTRH ENGAGES REPRESENTATIVES OF THE COMMUNITY IN THE IDENTIFICATION OF COMMUNITY REHABILITATION NEEDS THROUGH ITS COMMUNITY ADVISORY COUNCIL. THE PURPOSE OF THIS COUNCIL IS TO CONTINUE TO IDENTIFY THE NEEDS OF THE COMMUNITY AND ENSURE CENTRAL TEXAS REHABILITATION HOSPITAL IS ENHANCING THE QUALITY AND SCOPE OF SERVICES PROVIDED. CTRH WILL CONTINUE ITS SUPPORT OF THE LONESTAR PARALYSIS FOUNDATION. THE MISSION OF THE LONE STAR PARALYSIS FOUNDATION IS TO CURE SPINAL CORD PARALYSIS THROUGH FUNDING RESEARCH, ADVANCED RECOVERY, AND COMMUNITY OUTREACH. CTRH FULLY SUPPORTS THE FOUNDATION BY SPONSORING AND PARTICIPATING IN MANY EVENTS THROUGHOUT THE YEAR. CTRH PARTICIPATES IN THE ANNUAL COLLABORATING FOR CURES EVENT. THIS EVENT PROVIDES THE COMMUNITY WITH EDUCATION ABOUT CURRENT RESEARCH, REHABILITATION AND TREATMENT ADVANCES AS WELL AS EMERGING APPROACHES FOR ALZHEIMER'S, STROKE AND TRAUMATIC BRAIN INJURY CARE. CTRH HAS BEEN A PARTICIPATING MEMBER IN YEARS PAST AND WILL CONTINUE TO BE A PART OF THIS IMPORTANT COMMUNITY EVENT IN THE YEARS TO COME. FINANCIAL ASSISTANCE CTRH IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A MEMBER OF THE HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. CTRH SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS CTRH'S PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; CTRH PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL. |
| Schedule H, Part V, Section B, Line 16 Facility A, 1 | Facility A, 1 - Facility 1 -- Seton Medical Center Austin. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility A, 2 | Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility A, 3 | Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility A, 4 | Facility A, 4 - Facility 6 -- Seton Northwest Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility A, 5 | Facility A, 5 - Facility 7 -- Seton Southwest Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility A, 6 | Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility A, 7 | Facility A, 7 - Facility 10 -- Seton Medical Center Hays. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility A, 8 | Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility A, 9 | Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 22 Facility A, 1 | Facility A, 1 - Facility 1 -- Seton Medical Center Austin. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility A, 2 | Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility A, 3 | Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility A, 4 | Facility A, 4 - Facility 6 -- Seton Northwest Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility A, 5 | Facility A, 5 - Facility 7 -- Seton Southwest Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility A, 6 | Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility A, 7 | Facility A, 7 - Facility 10 -- Seton Medical Center Hays. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility A, 8 | Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility A, 9 | Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 5 Facility B, 1 | Facility B, 1 - Facility 4 -- Seton Edgar B. Davis Hospital. Seton Healthcare Family, in collaboration with the Community Health Coalition of Caldwell County, hosted a Community Health Needs Summit for Caldwell and Gonzales counties. The Summit was designed as a way to update the community on progress that has been made since the last CHNA and to provide them with current data to engage in needs identification. The two goals for the summit were for the community to discuss current needs affecting Caldwell and Gonzales and then prioritize those needs in order of importance. The invitation to the Summit was sent out through local collaborations, partnership, and council list serves with targeted outreach to schools and other key community stakeholders. In attendance was representation from the public health department, hospitals, clinics, school districts, and other service providers that serve the community. A complete list of Summit participants can be found in Appendix 1 of the Community Health Needs Assessment. In order to identify the community's needs, Seton Healthcare Family presented current health and demographic data to the Summit participants. Participants then engaged in table discussions regarding what the data revealed to them as well as what other needs they see in the community that did not show up in the data. This collaborative process created a list of needs that were shared with the larger group and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants then used a dot voting method to express their opinion as to which category was the highest priority need and which sub group was most important within that need. After tallying the results, the participants reviewed the results and further added any remaining thoughts. The following information is a summation of the data analysis coupled with the feedback from the community. |
| Schedule H, Part V, Section B, Line 5 Facility B, 2 | Facility B, 2 - Facility 5 -- Seton Highland Lakes Hospital. Seton Healthcare Family, in collaboration with the Highland Lakes Health Partnership, conducted a virtual Community Health Needs Survey for Burnet County. The survey was designed as a way to gain insight into the progress that has been made since the last CHNA and to provide participants an avenue to identify current needs. The two goals for the survey were for the community to discuss current needs affecting Burnet County and then prioritize those needs in order of importance. The survey invitation was sent out through local collaborations, partnership, and council list serves with targeted outreach to schools and other key community stakeholders. In response, there was representation from the public health department, hospitals, clinics, school districts, and other service providers that serve the community. A complete list of survey participants' occupations can be found in Appendix 1 of the Community Health Needs Assessment. This collaborative process created a list of needs that were prioritized by survey respondents and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants used a Likert scale to express their opinion as to which category was the highest priority need and which sub group was most important within that need. The following information is a summation of the data analysis coupled with the feedback from the community. |
| Schedule H, Part V, Section B, Line 5 Facility B, 3 | Facility B, 3 - Facility 13 -- Seton Medical Center Harker Heights. Seton Healthcare Family, in collaboration with Seton Medical Center Harker Heights, conducted a virtual Community Health Needs Survey for Bell County. The survey was designed as a way to gain insight into the progress that has been made since the last CHNA and to provide participants an avenue to identify current needs. The two goals for the survey were for the community to discuss current needs affecting Bell County and then prioritize those needs in order of importance. The survey invitation was sent out through local collaborations, partnership, and council list serves with targeted outreach to community members, public health officials, and other key community stakeholders. In response, there was representation from the public health department, hospitals, clinics, school districts, and other service providers that serve the community. A complete list of survey participants' occupations can be found in Appendix 1 of the Community Health Needs Assessment in addition to the organizations those participants represent (only listed if participants choose to provide their organization). This collaborative process created a list of needs that were prioritized by survey respondents and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants used a Likert scale to express their opinion as to which category was the highest priority need and which sub group was most important within that need. The following information is a summation of the data analysis coupled with the feedback from the community. |
| Schedule H, Part V, Section B, Line 5 Facility B, 4 | Facility B, 4 - Facility 14 -- Seton Smithville Regional Hospital. Seton Healthcare Family, in collaboration with the Community Health Coalition of Caldwell County, hosted a Community Health Needs Summit for Bastrop County. The Summit was designed as a way to update the community on progress that has been made since the last CHNA and to provide them with current data to engage in needs identification. The two goals for the summit were for the community to discuss current needs affecting Bastrop County and then prioritize those needs in order of importance. The invitation to the Summit was sent out through local collaborations, partnership, and council list serves with targeted outreach to schools and other key community stakeholders. In attendance was representation from the public health department, hospitals, clinics, school districts, community residents and other service providers that serve the community. A complete list of Summit participants can be found in Appendix 1 of the Community Health Needs Assessment. In order to identify the community's needs, Seton Healthcare Family presented current health and demographic data to the Summit participants. Participants then engaged in table discussions regarding what the data revealed to them as well as what other needs they see in the community that did not show up in the data. This collaborative process created a list of needs that were shared with the larger group and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants then used a dot voting method to express their opinion as to which category was the highest priority need and which sub group was most important within that need. After tallying the results, the participants reviewed the results and further added any remaining thoughts. The following information is a summation of the data analysis coupled with the feedback from the community. |
| Schedule H, Part V, Section B, Line 7 Facility B, 1 | Facility B, 1 - Facility 4 -- Seton Edgar B. Davis Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Caldwell_Community_Needs_assessment.pdf |
| Schedule H, Part V, Section B, Line 7 Facility B, 2 | Facility B, 2 - Facility 5 -- Seton Highland Lakes Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Burnet_Community_Needs_assessment.pdf |
| Schedule H, Part V, Section B, Line 7 Facility B, 3 | Facility B, 3 - Facility 13 -- Seton Medical Center Harker Heights. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: http://setonharkerheights.net/wp-content/uploads/2013/12/Final-Bell-County-CHNA-Written-Report-06_24_13.pdf |
| Schedule H, Part V, Section B, Line 7 Facility B, 4 | Facility B, 4 - Facility 14 -- Seton Smithville Regional Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Bastrop_Community_Needs_assessment.pdf |
| Schedule H, Part V, Section B, Line 11 Facility B, 1 | Facility B, 1 - SETON EDGAR B. DAVIS HOSPITAL - PART 1. BEHAVIORAL HEALTH The CHNA identified mental health as the greatest health concern raised by Caldwell County residents. With few behavioral health providers in the both Caldwell and Gonzales, it was no surprised that behavioral health was noted as the top priority by Summit participants. According to a 2011 report created by the Department of State Health Services, no psychiatrists had their primary county of practice in Caldwell or Gonzales. While this does not take into account the number of psychologists and/or counselors in Caldwell and Gonzales or the number of psychiatrists who visit these counties on a part time bases, it further supports the community perspective on the lack of mental health providers in these counties. In addition to the lack of providers, Summit participants expressed the need for long term behavioral health services as well as the need to integrate primary care with behavioral health in order to meet the comprehensive needs of county residents. It was suggested that this could be conducted through the co-location of services such as school health clinics in order to facilitate better access and earlier detection. One program currently in place through SEBD is the Heritage Program. The Heritage Program provides an intensive outpatient psychiatric program for seniors in Caldwell and surrounding counties. The seniors served have a mental health need, primarily anxiety or depression, and a comorbidity including congestive heart failure, diabetes, or COPD. The program provides group, individual, and family therapy, as well as family and community education. The Heritage staff includes a nurse, master level therapist, and a program psychiatrist that comes in weekly. Transportation is provided to participants and home assessments are done to ensure the best referral is made. The Heritage program also offers specialty groups to the community such as geriatric attention deficit disorder and trauma groups. SEBD will expanded access to Psychiatric Telemedicine in the Emergency Department beginning in September 2013 and will continue to expand these behavioral health services to remainder of the hospital floors by the end of 2014. By providing 24/7 psychiatric consultations patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. SEBD will collaborate with Bluebonnet Trails Community Services and the Community Health Centers of Central Texas in an attempt identify ways to expand behavioral health services in Caldwell County. Access to Care Access to care was identified as the second highest priority need by summit participants. This included many aspects that fall under the umbrella of access to care but the greatest concern for residents was afterhours care and primary care for the un- and underinsured. In addition, community members expressed concern about the growing number of uninsured residents, and transportation issues that inevitably arise when examining the needs of rural counties. SEBD supports the Lockhart Rural Health Clinic and will open the Luling Rural Health Clinic to provide additional options for low income residents to access to primary care. The CHNA identified a decreasing number of providers that accept new Medicare and Medicaid patients and it was speculated that these rural health clinics, along with the Community Health Centers of Central Texas FQHC's, are the only clinics accepting these patients. As a response to the growing need for extended hours care, the Lockhart RHC has extended hours Monday - Saturday, until 7pm, which gives patients appointment flexibility and access to walk in care without having to take time off work. In addition, the Lockhart RHC provides a Specialty Clinic with outpatient lab services, an Internal Medicine Clinic, Family Practice, as well as Cardiology and Pulmonology for those patients with specialty needs. SEBD has, and will continue to engage in its partnership with Community Health Centers of Central Texas (CHCCT) as a means of increasing primary care access for the un- and underinsured residents of Gonzales and Caldwell County. CHCCT has a Federally Qualified Health Center in southern Caldwell County and Seton will continue to look for ways to support these services for low income residents. Given the need to increase primary care access, especially for the un- and underinsured, SEBD is committed to the continuation of the Seton Children's Care-A-Van. Offering primary care services, the mobile clinic is often available for same day acute visits, eliminating some of the barriers residents face trying to access care. The Care-A-Van currently visits schools and churches that have been identified as areas of need and can serve as a primary care home for children ages birth- 18, who cannot access care anywhere else. With the CHNA identifying a gap in services for the uninsured and underinsured, SEBD has committed to taking on the management of the Caldwell County Indigent Program (CCI). This program provides services for those residents at or below 21% of the federal poverty limit and SEBD will act as an Accountable Care Organization to manage the entirety of a CCI members care. By doing this, SEBD will be able to provide case management services to the individual and provide them with a medical home to ensure proper and timely care is being delivered. To help underserved residents navigate the complicated and fragmented health care system, SEBD will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified large disparities in the ability of different ethnic groups to access care. The reasons are complex but, in an effort to administer care in a patient centered, culturally competent manner, SEBD provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, SEBD provides in-person sign language services to those that need it. Obesity The 2013 Caldwell County Community Health Needs Assessment identified obesity as another one of the community's health needs. While overall, obesity in Central Texas is close to the national average, Caldwell County has continually seen its rates stay above the national median. Residents identified a lack of access to healthy food and resources in addition to the need for age appropriate education for children as the two obesity related gaps. While we certainly need to address the impact of obesity in our community, it is crucial that we also take steps to address the issue prior to individuals becoming obese. As identified in the CHNA, healthy food access and nutrition education are two elements of a healthy lifestyle that were identified gaps in Caldwell County. In order to fill this need, SEBD will partner with the Community Health Coalition of Caldwell County and work to develop an environment that increases access to healthy foods. This will involve the creation of Farmer's Market's, community gardens, and working to connect local foods to local businesses. This program will attempt to develop environmental changes that can help support a healthy lifestyle and combat obesity in Caldwell County. Chronic Disease and Disease Management The 2012 Caldwell County Community Health Needs Assessment identified chronic disease and disease management as a health related priority facing residents of Caldwell County. Chronic disease has remained the top cause of death for the past 6 years and, with cancer and heart disease topping the list again, chronic disease is expected to remain as the top cause of death for the foreseeable future. Many community members cited chronic disease education, specifically self-disease management as one of the greatest needs for their community. |
| Schedule H, Part V, Section B, Line 11 Facility B, 2 | Facility B, 2 - SETON EDGAR B. DAVIS HOSPITAL - PART 2. Seton Network Oncology Services currently works with several Seton hospitals, including SEBD, providing access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. According to the National Cancer Institute, Caldwell County has an age adjusted annual incident rate of 1,302 per 100,000 for all races 50 and over. Compounding the problem is a 14.5% poverty rate. The need for the SEBD Outpatient Chemotherapy Service is apparent and until now it has not been accessible for a large demographic population primarily due to funding and transportation. Prior to the implementation of chemotherapy services at SEBD, patients had to drive as far as Kyle, New Braunfels, or Austin to seek treatment. Many patients did not have the resources to make this commitment and some chose to forgo treatment. The Leadership Team of SEBD and Seton Physicians recognized this need in our community and immediately took action. SEBD is now offering chemotherapy services to all of the surrounding communities. The impact these services will have for the community is immeasurable in time and convenience. As an Accountable Care Organization, SEBD is committed to expanding our scope service to provide chemotherapy to this demographic population. SEBD will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, SEBD will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Looking to improve the health of patients with chronic disease, SEBD will continue to support Seton's Asthma Education program for Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Central Texas residents. SEBD will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. With the CHNA emphasizing self-disease management, SEBD proposes to work with the Community Health Coalition of Caldwell County to establish and implement a Diabetes Education Program. This proposed program will identify Caldwell County residents diagnosed with diabetes and will provide disease education and nutrition guidance to help patients manage their own care. As chronic disease continues to be the top causes of death for Caldwell County, SEBD is committed to help find additional ways to decrease chronic disease. As a first step, SEBD will work with the Community Health Coalition in Caldwell County as they work to identify and encourage healthy lifestyle policies for Caldwell County. This will include such policies as smoke and tobacco free workplaces and restaurant serving local and healthy foods. Community Collaboration Despite non-profit and social service organizations within Caldwell County, and many in the surrounding counties, many summit participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of education on how to connect to these programs has been a challenge. The desire for a more connected approach to service delivery will help maximize the limited resources of the area. SEBD and the Seton Healthcare Family provided strong support for the creation of the Community Health Coalition of Caldwell County. This local collaboration is comprised of various community stakeholders that work as a subgroup of the Integrated Care Collaboration (ICC). In 1997, Seton led the formation of the ICC, an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. Accidents With motor vehicle accidents representing a need identified in the CHNA, summit participants felt the biggest area for improvement was with resident driving under the influence. This sentiment was echoed by community residents and given this need, SEBD believes that this particular need falls outside of the hospitals direct mission to provide high quality healthcare with special concern for the poor and vulnerable. However, as a stakeholder concerned with community safety, SEBD will join in community discussions around highway safety and the prevention of resident driving under the influence. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SEBD screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SEBD patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. As the cost of care rises, summit participants suggested that there was a need to identify ways to connect patients to resources that may be able to help lower the cost of care. SEBD has established a partnership, and provides support to, the Community Health Coalition of Caldwell County (CHCCC) to provide a Prescription Assistance Program to residents of Caldwell County. SEBD will continue to support this partnership and work to identify ways to increase the ability to connect residents to this valuable resource. |
| Schedule H, Part V, Section B, Line 11 Facility B, 3 | Facility B, 3 - SETON HIGHLAND LAKES HOSPITAL - PART 1. The SHL Implementation Plan addresses the four health needs; access to care, behavioral health, chronic disease, and obesity in the order of priority identified through the Burnet County CHNA. Also addressed in the SHL plan is an overview of the hospital's policy of providing financial assistance to low income patients and a strategy for addressing community collaboration. Behavioral Health The CHNA identified mental health as the greatest health concern raised by Burnet County residents. With few behavioral health providers in the Burnet County, it was no surprise that behavioral health was noted as the top priority by survey respondents. According to a 2011 report created by the Department of State Health Services, 3 psychiatrists had their primary county of practice in Burnet County. While this does not take into account the number of psychologists and/or counselors in Burnet County or the number of psychiatrists who visit this area on a part time bases, it further supports the community perspective on the lack of mental health providers in these counties. In addition to the lack of providers, survey respondents expressed the need for substance abuse treatment and prevention measures in Burnet County. SHL proposes to collaborate with Lone Star Circle of Care to examine opportunities to bring psychiatric services to Burnet County. SHL will collaborate with Bluebonnet Trails Community Services and the Burnet County Sheriff's Department to develop a Crisis Assessment for Persons in Behavioral Health Crisis program. This program will provide crisis assessment, referral and short term stabilization in Burnet County. To establish this service, a space near the Emergency Department (ED) of SHL in Burnet, Texas will be renovated so that it is suitable for walk-in patients and for law enforcement. Frequently, law enforcement will use it for persons who are being held under Emergency Detention and require evaluation to determine the best options for treatment and stabilization. SHL will expanded access to Psychiatric Telemedicine in the Emergency Department beginning in August 2013 and will continue to expand these behavioral health services to remainder of the hospital floors by the end of 2014. By providing 24/7 psychiatric consultations patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. Access to Care Access to care was identified as the second highest priority need by survey respondents. While this included a broad spectrum of needs that fall under the access to care umbrella, the greatest concern for residents was care for the older members of the county and services for the un- and underinsured. With the 65+ population in Burnet County expected to double over the next 18 years, services for the aging will continue to be in need. Given the need to increase primary care access, especially for the un- and underinsured, SHL is committed to the continuation of the SHL Care-A-Van to help eliminate some of the barriers residents face while trying to access care. This mobile clinic will target care toward low income residents and eliminate the transportation barriers associated with accessing care in rural communities. The Care-A-Van currently visits schools and churches that have been identified as areas of need and can serve as a primary care home for those residents who cannot access care elsewhere. SHL is committed to providing support for the Highland Lakes Rural Health Clinics which provides additional options for low income residents to access to primary care. SHL has clinics located in Burnet, Bertram, Lampasas, and Marble Falls in an attempt to provide services in the communities with the greatest need. The CHNA identified a decreasing number of providers that accept new Medicare and Medicaid patients, both of which are accepted by these clinics. To help underserved residents navigate the complicated and fragmented health care system, SHL will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, Seton provides in person sign language contracted services at all of its facilities. As part of an integrated approach to administer care in a person centered, culturally competent manner, the Seton Healthcare Family will develop a Language Services Resource Center and a Culturally Competent Care Curriculum at four Seton hospitals and will implement the learnings and best practices at SHL.The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. It is projected that the population over the age of 65 will more than double over the next 18 years and because of this projected need for aging services, SHL will continue to support the Highland Lakes Hospice and Home Health that provide a portion of the aging services for Burnet County. By supporting these programs, SHL will help ensure that appropriate services are available for residents as they age. SHL proposes to develop a Patient Care Navigation program to effectively navigate services for indigent and uninsured patients in Burnet County. This project will implement a patient navigation system to connect indigent and uninsured patients with primary care or medical homes in order to reduce inappropriate utilization and provide cost-effective, timely, and site-appropriate health care services. Patients will be routed to a medical home by care navigators responsible for managing long-term relationships with the patients to reduce the patient's need for advanced medical care, including the (ED). Chronic Disease and Disease Management The 2012 Burnet County Community Health Needs Assessment identified chronic disease and disease management as a health related priority facing residents of Burnet County. Chronic disease has remained the top cause of death for the past 6 years and, with cancer and heart disease topping the list again, chronic disease is expected to remain as the top cause of death for the foreseeable future. Many survey respondents cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. With the long-term developments of chronic disease and the lifestyle attributes that contribute to these diseases, it is imperative that a concerted effort be made by the community to promote healthy choices where residents live, work, play, and worship. |
| Schedule H, Part V, Section B, Line 11 Facility B, 4 | Facility B, 4 - SETON HIGHLAND LAKES HOSPITAL - PART 2. Seton Network Oncology Services currently works with several Seton hospitals, including SHL, to provide access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. SHL refers patients to the Seton Shivers Cancer Center. The Shivers Cancer Center provides a variety of outpatient services for adult cancer patients in Central Texas regardless of ability to pay. In addition to clinical services, the Shivers health care professionals work closely with the Seton Cancer Care Team to provide vital case management services plus a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. SHL will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, SHL will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Looking to improve the health of patients with chronic disease, SHL will continue to support Seton's Asthma Education program for Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Central Texas residents. SHL will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. As chronic disease continues to be the top causes of death for Burnet County, SHL is committed to help find additional ways to decrease chronic disease. As a next step, SHL will work with the Highland Lakes Partnership as they work to identify and encourage healthy lifestyle policies for Burnet County. This will include such policies as smoke and tobacco free workplaces and restaurants serving local and healthy foods. Obesity The 2013 Burnet County Community Health Needs Assessment identified obesity as one of the most pressing health issues. While overall, obesity in Central Texas is close to the national average, Burnet County has continually seen its rates stay above the national median. Residents identified a lack of access to healthy food and resources in addition to the need for improve recreation areas as the two obesity related gaps. While we certainly need to address the impact of obesity in our community, it is crucial that we also take steps to address the issue prior to individuals becoming obese. As identified in the CHNA, healthy food access and nutrition education are two elements of a healthy lifestyle that were identified gaps in Burnet County. In order to fill this need, SHL will work with the Williamson County Collaborative and the Highland Lakes Partnership to develop policies and programs that increase access to healthy foods. This may involve the creation of Farmer's Market's, community gardens, and working to connect local foods to local businesses. This program will attempt to develop environmental changes that can help support a healthy lifestyle and combat obesity in Burnet County. SHL is dedicated to improving the nutritional value of the food offered at the facility. SHL will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Community Collaboration Despite many non-profit and social service organizations within Burnet County, survey participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesion and focused vision lead participants to feel that there is more dialogue than there is action. The desire for a more coordinated approach was identified as an area of need in order to maximize the limited resources of the area. SHL and the Seton Healthcare Family provided strong support for the creation of the Highland Lakes Partnership. This local collaboration is comprised of various community stakeholders that work as a subgroup of the Integrated Care Collaboration (ICC). In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. Accidents With motor vehicle accidents representing a need identified in the CHNA, survey respondents felt the biggest area for improvement was around road safety. This sentiment was echoed by community residents. Given the nature of this need, SHL believes that it currently falls outside of the hospitals direct mission to provide high quality healthcare with special concern for the poor and vulnerable. However, as a stakeholder concerned with community health and safety, SHL will join in community discussions around road safety. Financial Assistance eton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SHL screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SHL patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. |
| Schedule H, Part V, Section B, Line 11 Facility B, 5 | Facility B, 5 - SETON MEDICAL CENTER HARKER HEIGHTS - PART 1. Access to Care Bell County participants listed access to care as the highest ranking health priority. Care for the un- and underinsured and improved access to primary care were the two areas identified as needing improvement by the survey participants. With twice the amount of population per primary care provider than the national average, it was no surprise that these two subgroups emerged. The fewer the primary care providers, the longer individuals have to wait to receive care and the fewer options available for un- and underinsured patients. As the population continues to grow in Bell County, opportunities exist to streamline avoidable hospital use and cost, especially among more vulnerable populations. In June 2012 SMCHH opened its doors and by doing so gave the community in Bell County increased options to access care. While this was a major step forward in increasing access to care, SMCHH is committed to continue to look for ways to increase access. Currently SMCHH is actively recruiting physicians to the area to help bring specialty services to Bell County rather than forcing residents travel to neighboring counties to receive care. Since SMCHH has opened it has brought 21 new physicians/specialists to Bell County and is projected to bring an additional 15 over the next three years. Currently there are over 250 physicians on the medical staff. SMCHH has an on campus Physician Group that offers same day appointments for those residents needing non-emergent care. This physician group offers services such as primary care, obstetrics, gastroenterology, pulmonary, ENT, orthopedics and general surgery. The physician group currently accepts both Medicare and Medicaid and will continue to look for ways to expand access to their services in the coming years. SMCHH has worked with multiple community partners to improve patients' access to care. SMCHH will work with primary care clinic partners who have opened and/or are planning to open facilities in the hospital's primary and secondary service areas. Currently, SMCHH is engaged in collaboration with the Killeen Free Clinic to help provide access to care for the most vulnerable residents of Bell County. Behavioral Health With limited behavioral health providers in Bell County, the need for behavioral health services was noted as a high priority by community residents. According to a 2011 report created by the Department of State Health Services, 20 psychiatrists had their primary county of practice in Bell County. This equates to one psychiatrist per 14,833 residents. While this does not take into account the number of psychologists and/or counselors in Bell County, or the number of psychiatrists who visit the county on a part-time basis, it supports the community's perceived lack of mental health services. SMCHH works closely with the Central Counties MHMR to help coordinate services for those individuals that enter through the Emergency Department. When a patient enters SMCHH and is experiencing a mental health crisis that can better be treated by mental health professionals, SMCHH coordinates with Central Counties MHMR to help provide a more appropriate treatment option than can be provided at the hospital. This partnership increases the timeliness of the patient receiving the most appropriate care. SMCHH is currently evaluating options to connect with local behavioral health providers to provide a better continuum of care for community residents needing to access behavioral health services. The SMCHH Emergency Department is currently exploring a Psychiatric Telemedicine model that would allow for patients to be seen by mental health professional in a timelier manner. Typically, patients in psychiatric crisis presenting after-hours to the SMCHH ED wait until the next day for appropriate psychiatric assessment. Through implementation of telemedicine, patients will receive a timely assessment, leading to earlier disposition at a less intense (and costly) level of care. SMCHH currently works with Army Marathon and will continue to pursue this partnership to benefit the behavioral health needs of the community. With Fort Hood being located in Bell County and the increasing awareness of the impact combat has on the mental health of our veterans, the Army Marathon helps raise support for behavioral health services and research in the military. Chronic Disease and Disease Management As has been the case for many years, cancer and heart disease are the leading causes of death across the Central Texas region. While not prioritized as the highest need category, the need for more chronic disease education and treatment of long-term health problems was clear given survey responses. In addition, survey participants also prioritized the prevention of chronic disease in older adults as an area of improvement related to chronic disease. Participants understood that chronic disease and other health needs are often intertwined. Because of this, many community members expressed the need for a multidisciplinary approach to care because; success would require addressing chronic disease with attendant behavioral health, lifestyle and cultural barriers. SMCHH currently funds a Diabetes Academy that helps educate persons with diabetes and those that care for them. Three family medicine physicians spearhead the education series with support from a diabetes educator and hospital clinical dietitian. The group is fed healthy snacks and the physicians offer ideas and support for those in attendance. After the session, a one-on-one visit with a physician and educator occurs. As a method of treating and providing resources for those community members suffering from chronic conditions, SMCHH has added two new internal medicine physicians to its staff. While this is a giant step in helping manage and treat those residents with chronic diseases, SMCHH will explore opportunities to bring more physicians to the community who focus on the treatment of chronic disease. By bringing more physicians to the area community members will not have to wait as long to be seen and the un- and underinsured will have more options. SMCHH will explore adding additional classes as necessary to meet the health needs of the community. Currently, SMCHH offers CPR and first aid classes in addition to the Diabetes Academy and will look for opportunities to expand the scope of classes offered. Some classes currently being discussed are those revolving around healthy lifestyle, nutrition, and healthy heart. Obesity Within the region as a whole, obesity continues to increase and is consistently above the national average. The data points out that there is limited access to healthy foods and participants agreed that healthy eating education and access to healthy food were the areas of greatest need. It was noted by some stakeholders that while recreation outlets may be available in the community, the rural nature of the county may not allow residents to access them because they have to travel long distances to get to them. SMCHH is currently engaged in collaboration with the Armed Services YMCA to build a Community Fitness and Rehabilitation Facility that will help promote a healthy and active environment for the community. This new recreation facility will go beyond the simple workout equipment found in most YMCAs and will offer soldier rehabilitation programs, military family counseling, family meet-ups, holistic wellness programs and nutrition classes. Groundbreaking for this center is expected within the next year and being completed within 2015. |
| Schedule H, Part V, Section B, Line 11 Facility B, 6 | Facility B, 6 - SETON MEDICAL CENTER HARKER HEIGHTS - PART 2. With limited access to healthy food being a need identified by the CHNA, SMCHH will explore ways to offer community education on healthy eating. With a Clinical Dietician/Nutritionist on staff, SMCHH will identify opportunities to host classes that teach residents about what makes a healthy meal, how to shop for healthy foods, and provide healthy recipe ideas to participants. These classes are in the early stages of implementation at SMCHH and will look to expand these classes in the next three years. Community Collaboration In an effort to increase and foster community collaboration, SMCHH has collaborative partnerships with many local agencies and other non-profit organization including but not limited to: the Armed Service YMCA, the Killeen Free Clinic, the Heart Association, the Regional Health Policy Group, Hope Pregnancy Center, Harker Heights Food Bank, and the United Way. Through these partnerships, SMCHH is able to better connect residents to service organizations and support community health needs that fall outside the scope of the hospital. SMCHH expects to continue these collaborative partnerships and will explore opportunities to engage other community based organizations. Financial Assistance SMCHH is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a member of the health system in Bell County, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SMCHH screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SMCHH's patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. |
| Schedule H, Part V, Section B, Line 11 Facility B, 7 | Facility B, 7 - SETON SMITHVILLE REGIONAL HOSPITAL - PART 1. Access to Care Access to care was identified as the highest priority need by summit participants. This included many aspects that fall under the umbrella of access to care but the greatest need was to identify ways to connect residents to available resources, especially for the un- and underinsured. In addition, community members felt that the lack of certain types of providers was the cause for long wait times and difficulties accessing care. Dental care and specialty care were identified as the top two needed services. The ability to recruit and retain specialist has been a challenge for Bastrop County and according to community stakeholders still remains a top need when addressing access related issues. Seton Smithville has, and will continue to engage in its partnership with Lone Star Circle of Care as a means of increasing primary care access for the un- and underinsured residents of Bastrop County. LSCC and Seton are committed to bringing a Federally Qualified Health Center to Bastrop County and Seton will provide financial support for this project. Given the need to increase primary care access, especially for the un- and underinsured, Seton Smithville will implement a mobile Care-A-Van in Bastrop County to help eliminate some of the barriers residents face trying to access care. This mobile clinic will target care for low income residents and eliminate the transportation barriers associated with accessing care in rural communities. To help underserved residents navigate the complicated and fragmented health care system, Smithville will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, Seton provides in person sign language contracted services at all of its facilities. As part of an integrated approach to administer care in a person centered, culturally competent manner, the Seton Healthcare Family will develop a Language Services Resource Center and a Culturally Competent Care Curriculum at four Seton hospitals and will implement the learnings and best practices at Smithville. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. Obesity The 2013 Bastrop County Community Health Needs Assessment identified obesity as a pressing health issue. While overall, obesity in Central Texas is close to the national average, Bastrop County has continually seen its rates remain consistently above the national median. Residents identified nutrition education and the lack of recreation outlets as two prominent gaps related to obesity. While we certainly need to address the impact of obesity in our community, it is crucial that we also take steps to address the issue prior to individuals becoming obese. As identified in the CHNA, healthy food access and nutrition education are two elements of a healthy lifestyle that were identified gaps in Bastrop County. In order to fill this need, Smithville will partner with the Community Health Coalition of Caldwell County and work to develop an environment that increases access to healthy foods. This will involve the creation of Farmer's Market's, community gardens, and working to connect local foods to local businesses. This program will attempt to develop environmental changes that can help support a healthy lifestyle and combat obesity in Bastrop County. Smithville is dedicated to improving the nutritional value of the food offered at the facility. Smithville will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Community Collaboration Despite non-profit and social service organizations within Bastrop County, and many in the surrounding counties, many summit participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of joint use agreements for use of facilities has provided challenges to leveraging resources. The desire for a more connected approach and the ability to access resources in nearby counties was identified as an area of need in order to maximize the limited resources of the area. Smithville and the Seton Healthcare Family provided strong support for the creation of the Opportunity Bastrop Collaborative. This local collaboration is comprised of various community stakeholders that work as a subgroup of the Integrated Care Collaboration (ICC). In 1997, Seton led the formation of the ICC, an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. |
| Schedule H, Part V, Section B, Line 11 Facility B, 8 | Facility B, 8 - SETON SMITHVILLE REGIONAL HOSPITAL - PART 2. Behavioral Health The CHNA identified mental health as one of the three greatest health concerns raised by Bastrop County residents. Summit participants mentioned the rising rates of mental health conditions among residents in the County. These included areas such as substance abuse, suicide interventions, and an inadequate number of mental health providers who could prescribe medication. The CHNA identified that Bastrop County adults experienced on average 2.8 poor mental health days in the past month and slightly higher than average suicide rates. Currently psychiatric care is provided by Bluebonnet Community Services on-site, but as the need grows Smithville will explore the option of incorporating access to Psychiatric Telemedicine throughout the facility if it is determined that this is needed. Through Psychiatric Telemedicine, Smithville could provide 24/7 psychiatric consultations patients in psychiatric crisis who will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. Smithville will collaborate with Bluebonnet Community Services and Lone Star Circle of Care in an attempt identify ways to expand behavioral health services in Bastrop County. Chronic Disease and Disease Management The 2012 Bastrop County Community Health Needs Assessment identified chronic disease and disease management as a health related priority facing residents of Bastrop County. Chronic disease has remained the top cause of death for the past 6 years and, with cancer and heart disease topping the list again, chronic disease is expected to remain as the top cause of death for the foreseeable future. Many community members cited chronic disease education, specifically self-disease management as one of the greatest needs for their community. Seton Network Oncology Services currently works with several Seton hospitals, including Smithville, providing access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. Smithville refers patients to the Seton Shivers Cancer Center. The Shivers Cancer Center provides a variety of outpatient services for adult cancer patients in Central Texas regardless of ability to pay. In addition to clinical services, the Shivers health care professionals work closely with the Seton Cancer Care Team to provide vital case management services plus a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. Smithville will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, Smithville will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Looking to improve the health of patients with chronic disease, Smithville will continue to support Seton's Asthma Education program for Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. |
| Schedule H, Part V, Section B, Line 11 Facility B, 9 | Facility B, 9 - SETON SMITHVILLE REGIONAL HOSPITAL - PART 3. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Central Texas residents. Smithville will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. With the CHNA emphasizing self-disease management, Smithville proposes to work with the Community Health Coalition of Caldwell County, and Lone Star Circle of care to establish and implement a Diabetes Education Program. This proposed program will identify Bastrop County residents diagnosed with diabetes and will provide disease education and nutrition guidance to help patients manage their own care. In addition, Smithville will support the development of a Care Coordination Partnership between these same organizations to help navigate patients with chronic illnesses and connect them to available resources. Seton Smithville will work in partnership with The Seton Brain and Spine Institute to bring community education events regarding stroke symptoms and prevention to Bastrop County. Seton Smithville is committed to continuing this partnership and will look for additional opportunities for community education. As chronic disease continues to be the top causes of death for Bastrop County, Seton Smithville is committed to help find additional ways to decrease chronic disease. As a first step, Seton Smithville will work with the Community Health Coalition in Caldwell County to identify and encourage healthy lifestyle policies for Bastrop County. This will include such policies as smoke and tobacco free workplaces and restaurant serving local and healthy foods. Accidents With motor vehicle accidents representing a significant amount of the years of potential life lost in Bastrop County, the CHNA identified it was one of Bastrop County's needs. This sentiment was echoed by community residents but with the focus being on improved highway safety, Seton Smithville believes that this falls outside of its direct mission to provide high quality healthcare with special concern for the poor and vulnerable. However, as a stakeholder concerned with community safety, Smithville will join in community discussions around highway safety and the prevention of resident driving under the influence. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. Smithville screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers Smithville patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. As the cost of care rises, summit participants suggested that there was a need to identify ways to connect patients to resources that may be able to help lower the cost of care. Smithville has established a partnership, and provides support to, the Community Health Coalition of Caldwell County (CHCCC) to provide a Prescription Assistance Program to residents of Bastrop County. Smithville will continue to support this partnership and work to identify ways to increase the ability to connect residents to this valuable resource. |
| Schedule H, Part V, Section B, Line 16 Facility B, 1 | Facility B, 1 - Facility 4 -- Seton Edgar B. Davis Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility B, 2 | Facility B, 2 - Facility 5 -- Seton Highland Lakes Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility B, 3 | Facility B, 3 - Facility 13 -- Seton Medical Center Harker Heights. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 16 Facility B, 4 | Facility B, 4 - Facility 14 -- Seton Smithville Regional Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 22 Facility B, 1 | Facility B, 1 - Facility 4 -- Seton Edgar B. Davis Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility B, 2 | Facility B, 2 - Facility 5 -- Seton Highland Lakes Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility B, 3 | Facility B, 3 - Facility 13 -- Seton Medical Center Harker Heights. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 22 Facility B, 4 | Facility B, 4 - Facility 14 -- Seton Smithville Regional Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - Seton Shoal Creek Hospital. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive. |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - Seton Shoal Creek Hospital. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - Seton Shoal Creek Hospital. The other organizations with which the reporting hospital conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation |
| Schedule H, Part V, Section B, Line 7 Facility , 1 | Facility , 1 - Seton Shoal Creek Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - SETON SHOAL CREEK HOSPITAL - PART 1. Seton Shoal Creek Hospital (SSC) has been serving Austin-area patients for more than 30 years and offers a wide spectrum of mental health and substance abuse services. SSC treats, on an inpatient or outpatient basis, children, adolescents, adults and senior adults who may be experiencing emotional and/or substance abuse difficulties. Inpatient services include intensive psychiatric stabilization for patients dealing with emotional crises, depression and drug/alcohol dependence. For those individuals requiring less intensive, longer term treatment, outpatient services are offered. SSC has a complete continuum for patient care which includes in-patient hospitalization, ECT services, Partial Hospitalization, Intensive Outpatient Programs including geri-psych and telepsychiatric consults. The Seton Mind Institute is the faculty practice of board certified psychiatrists that supervise the UT Southwestern psychiatric residency program. Given the behavioral health and substance abuse scope and mission of SSC, obesity and chronic disease treatment fall outside the realm of the hospitals direct service capabilities. While SSC does not have programs directly focused on these areas of need, SSC does participate in many collaborative efforts to provide behavioral health services as part of a multidisciplinary approach to obesity and chronic disease treatment including oncology. Behavioral Health The CHNA identified mental health as one of the foremost health concerns raised by Travis County residents. Focus group participants and interviewees alike both mentioned the rising rates of mental health conditions among residents in the County. This included areas such as substance abuse and inadequate mental health services. It was reported that 20% of Travis County adults experienced five or more days of poor mental health in the past month which is well above the national median. In an attempt to expand access to provide 24/7 psychiatric consultations and through SCC's close relationship with the Seton Mind Institute, SCC will provide the expansion of Psychiatric Telemedicine services to all Seton Hospitals. Typically, patients in psychiatric crisis presenting after-hours to hospital ED's wait until the next day for appropriate psychiatric assessment. Through implementation of telemedicine, patients across the Seton network will be able to connect to SSC physicians via telemedicine and receive a timely assessment, leading to earlier disposition at a less intense (and costly) level of care. SSC is committed to the support of the Seton Cove Spirituality Center. This center offers people of all faiths the opportunity to nourish and foster this journey towards wholeness. Through a variety of seminars, classes and events led by a multidisciplinary faculty, Seton Cove is a place of hospitality and solace for people seeking to integrate spirituality more fully into their daily lives. These programs are open to the community and hope to increase awareness within society of the healing role of spirituality for individuals and communities. SSC has been a founding financial member of the Ending Community Homelessness Collaboration (ECHO) and is committed to remaining involved to help meet the needs of some of Austin's most vulnerable residents. In collaboration with other community stakeholders, SSC provided initial funding for the ECHO to apply for 501(c)3 status and hirer full time staff. SSC lead the creation of the Crisis Implementation Committee (CIC) which is a collaboration of all behavioral health providers, EMS, Austin Policy Department and other governmental entities involved in care of patients with behavioral health. For the past seven years the CIC has collaborated in building programs and brining in public and private dollars to fund expanded safety net that improve access to care in less expensive settings and improving the system of care for crisis services. Over the years CIC has created more bed capacity for hospitalization, funded access for partial hospitalization and IOP services. In addition, the CIC has built a dashboard to monitor services with metrics guiding the committee on process improvement initiatives. Outcomes include expanded 24/7 Psychiatric Emergency Services, Communitywide Peer Review program, Expanded Mobile Crisis Services and Telepsychiatric consults. The CIC reports to a behavioral health stakeholder group under the hospital District which advocates for improved services for behavioral health patients. Shoal Creek Hospital and The Seton Mind Institute are active members in both the CIC and the Stakeholder group and have led many initiatives for improvement of care in behavioral health services. To augment the public school health education curriculum, Seton Healthcare Family has purchased HealthTeacher, a comprehensive K-12 online health education curriculum for teachers in school districts within Travis, Williamson, and Hays County. The curriculum provides over 300 age-appropriate lessons across 10 content areas aligned with the National Health Education Standards (NHES). Lessons are designed for integration into core curriculum areas such as language arts, science and social studies, and have been aligned with the Texas TEKS. They provide skills-based instruction linked to assessments. Health educators in school districts in Travis County were trained by national HealthTeacher staff on how to integrate and implement the HealthTeacher curriculum in the classroom. SSC will continue to support the Generations Program. The Generations Program provides an intensive outpatient psychiatric program for seniors in Travis and surrounding counties. The seniors served have a mental health need, primarily anxiety or depression, and a comorbidity including congestive heart failure, diabetes, or COPD. The program provides group, individual, and family therapy, as well as family and community education. The Generations staff includes a nurse, master level therapist, and a program psychiatrist that comes in weekly. Transportation is provided to participants and home assessments are done to ensure the best referral is made. The Generations program also offers specialty groups to the community such as geriatric attention deficit disorder and trauma groups. Obesity The 2012 Travis County Community Health Needs Assessment identified obesity as one of the most pressing health issues. While obesity in Travis County is below the national average, childhood obesity was listed as a particular area of need as this condition is disproportionately evident among minority populations. With a 24% obesity rate in adults, Travis County falls below the state average of 29.6%. However, when that rate is broken down by ethnicity, the need to address obesity among minority populations becomes more obvious. 41.7% of the Black/African American adults in Travis County and 36.5% of Latino/Hispanic adults are considered obese compared to 19.4% for White residents. According to CHNA data and focus group respondents, this disparity may be attributed to the unequal distribution and affordability of fresh fruit and vegetable outlets throughout the County as well as an unequal distribution of obesity-related programs. SSC partners with the Texas Center for the Prevention and Treatment of Childhood Obesity (TCPTCO) to provide behavioral health resources to children suffering from obesity. With many social and individual pressures associated with childhood obesity, behavioral health services help children maintain a healthy perspective and deal with many of the mental challenges obesity brings. SSC will continue to support these services for TCPTCO and look for addition ways to engage in obesity treatment. |
| Schedule H, Part V, Section B, Line 11 Facility , 2 | Facility , 2 - SETON SHOAL CREEK HOSPITAL - PART 2. Seton currently serves in a leadership role with the Mayor's Health and Fitness Council (MHFC). MHFC is a local non-profit organization in Travis County whose vision is to support and inspire people to improve their health by encouraging physical activity, improved nutrition and tobacco-free living. A Seton hospital Chief Operating Officer currently serves on the board as the Vice Chair for the Council and Seton will continue to participate in this collaborative effort to make Austin the healthiest city in America. Access to Care Access to health care was a predominant theme among residents, specifically the availability and accessibility of health care facilities and resources. Also mentioned were the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Community forum participants recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. The Seton Health Centers were established to provide accessible, comprehensive health services to medically underserved families in Austin. Primary care physicians, nurse practitioners and physician assistants provide quality primary care to community residents on a sliding scale based on family size and income. Medicare, Medicaid and CHIP are also accepted. Each of the three clinics offers primary care, laboratory, case management, and health education services. Comprehensive social services are part of the Centers' medical mission as well. SSC has and will continue to refer unfunded patients without a medical home to the Seton Community Health Centers for primary care. The Travis County Medical Society, the Seton Healthcare Family and other members of the Integrated Care Collaboration have initiated a coordinated system of volunteer doctors called Project Access. They work with other local providers to provide medical, hospital, diagnostic and pharmacy assistance for the uninsured in Travis County. The mission of Project Access is to provide ready access to appropriate health care services for uninsured people in Travis County whose incomes are at or below 200% of the Federal poverty level and to improve the overall health of our community. Seton helped secure a grant to create the program. More than 1,000 volunteer physicians participate in Project Access and Seton will continue to support the work of this collaboration to improve access to care. To help underserved residents navigate the complicated and fragmented health care system, SSC will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, Seton provides in person sign language contracted services at all of our facilities. As part of an integrated approach to administer care in a person centered, culturally competent manner, the Seton Healthcare Family will develop a Language Services Resource Center and a Culturally Competent Care Curriculum at four Seton hospitals and will implement the learnings and best practices at SSC. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. SSC will continue to increase access to services by supporting the Seton League House, a 38-room bed-and-bath facility designed to provide families and caregivers with a place to stay while their loved ones are hospitalized in an Austin-area hospital. The subsidized rooms reduce the barrier of travel costs associated with treatment. SSC will continue to expand IOP and partial hospitalization services to other counties and to unique segments of the population with specific behavioral health disorders. IOP is already located in Travis, Williamson and Hays counties. Chronic Disease The 2012 Travis County Community Health Needs Assessment identified chronic disease and disease management as the second highest health issue facing residents of Travis County. For the past six years the top three causes of death in Travis County have been related to chronic disease. Many focus group participants and interviewees cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. Seton Healthcare Family has many different programs aimed at addressing chronic disease management, education, and navigation. SSC has, and will continue, to connect with these programs in an effort to help provide behavioral health services to those suffering from chronic diseases. These programs include Seton Total Health Partners, Seton Total Health Transitions, Cancer Care Team and Navigation, and Diabetes Management. Through this collaborative approach, SSC plans to have staff embedded in these programs allowing these programs to fully meet the needs of the community's most vulnerable residents and will continue to explore the ways to connect to other programs around the community by integrated behavioral health with medical care. Community Collaboration Despite many non-profit and social service organizations within Travis County, many focus group participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesiveness and focused vision leads residents to feel that there is more dialogue than there is action. More coordinated approaches would help maximize limited resources. In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers for the un/underinsured, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal is to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure and plays a leadership role in the collaborations organized and supported by ICC in six counties (Bastrop, Caldwell, Williamson, Hays, Burnet and Travis. |
| Schedule H, Part V, Section B, Line 11 Facility , 3 | Facility , 3 - SETON SHOAL CREEK HOSPITAL - PART 3. In 2012, Seton and the Travis County Healthcare District began development of a non-profit Community Care Collaborative (CCC) with the purpose of advancing the care coordination and access to the most vulnerable populations in Travis County through high-quality, cost effective, person centered care. The essential elements of the CCC are: patient centered medical homes, developing a health information exchange for its patients, case management of a selected high risk population, pharmacy management, integrated outpatient/inpatient protocols, and transitional care. The CCC will be outcome driven and rely heavily on analytics to drive process improvement and best practice clinical care through system innovation and care coordination. Seton Healthcare Family is a partner of the Community Action Network (CAN) and will continue to support this local collaboration. CAN is a partnership of government, non-profit, private, and faith-based organizations who work together to enhance the social, health, educational, and economic well-being of Central Texas. As a partner of CAN, Seton has representatives on the Board of Directors and is committed to working with other CAN Partners to attain the mission of CAN. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SSC screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SSC patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. |
| Schedule H, Part V, Section B, Line 16 Facility , 1 | Facility , 1 - Seton Shoal Creek Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. |
| Schedule H, Part V, Section B, Line 22 Facility , 1 | Facility , 1 - Seton Shoal Creek Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Northwest Surgery Center LLP | ||||
| 11111 Research Blvd Suite LL3 | AUSTIN | TX | 78759 | Outpatient Surgery Center |
| Medical Park Tower Surgery Center LLC | ||||
| 1301 West 38th St | AUSTIN | TX | 78705 | Outpatient Surgery Center |
| The Surgery Center at Williamson LLC | ||||
| 301 Seton Parkway | ROUND ROCK | TX | 78665 | Outpatient Surgery Center |
| Seton McCarthy Community Health Center | ||||
| 2811 East Second Street | AUSTIN | TX | 78702 | Outpatient Clinic |
| Seton Kozmetsky Community Health Center | ||||
| 3706 S First Street | AUSTIN | TX | 78704 | Outpatient Clinic |
| Seton Topfer Community Health Center | ||||
| 8913 Collinfield Road | AUSTIN | TX | 78758 | Outpatient Clinic |
| Towers Nursing Home | ||||
| 907 Garwood Street | SMITHVILLE | TX | 78957 | Skilled Nursing Center |
Supplemental Information Detail SupplementalInformationDetail (31 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP - PART 2 | Clinical Enterprise - Seton Medical Group - Seton Community Care - The Topfer Building Condominium Association - AISD School Nurse Program SUPPORT SERVICES Insurance Services - Seton Health Plan - Seton Physician Hospital Network - Managed Care - Mission Care - Seton Health Alliance - Seton Accountable Care Organization, Inc. - Dell Children's Health Alliance Education and Research - Austin Medical Education Programs - Clinical Education Center - Academic Medical Education - Research Innovation Technology Network Services - The Seton Cove, Inc. - Professional Office Buildings Fund Development - Seton Fund of the Daughters of Charity of St. Vincent de Paul, Inc. - Fund Development - CMC Foundation of Central Texas - Seton Hays Foundation - Blue Ladies Minerals, Inc. - Twenty-Six Doors, Inc. - Fickett Health Legacy, Inc. Entities Accounted for Under the Equity Method of Accounting - Covenant Management Systems, LP - Central Texas Laundry, LLC - Strictly Pediatrics Surgery Center of Central Texas, LLP - Cedar Park Health System, LP - Cedar Park Surgery Center, LLP - Northwest Surgery Center, LLP - Central Texas Rehabilitation Hospital, LLC - The Surgery Center at Williamson, LLC - Medical Park Tower Surgery Center, LLC - HH/Killeen Health System, LLC - Austin Cyberknife, LLC - RediClinic Austin, LLC Through some of the affiliated entities, Seton provides health care and other related services to the communities we serve. The purpose, activities and accomplishments of some of the affiliated entities is listed below. Adult Inpatient Medical Services (AIMS) Purposes and Activities: Adult Inpatient Medical Services (AIMS) is organized as a Texas non-profit health organization pursuant to Texas laws and the Texas Medical Board's rules and regulations governing non-profit health corporations. AIMS activities include partnering with Austin Regional Clinic to assist in providing hospitalist services to Seton Family of Hospitals. AIMS and Seton are dedicated to developing a single, unified, integrated delivery system for the purpose of providing high-quality, cost-effective tertiary health care services to adults within the AIMS service area. Additionally, AIMS assists in providing and arranging for the medical care of all socioeconomic segments of the community. AIMS will negotiate managed care contracts with third-party payers. The program will pursue clinical and translational research as it matures. Austin Children's Chest Associates II (ACCA) Purposes and Activities: Austin Children's Chest Associates II (ACCA) is organized as a Texas non-profit health organization pursuant to Texas laws and the Texas Medical Board's rules and regulations governing non-profit health corporations. Accomplishments: - Provided 13,384 patient visits in FY15; - Provided pediatric pulmonary and sleep medical care services to Central Texas children; - Supported medical education and developed the capabilities of individuals and institutions to teach and practice medicine, especially in the field of pediatric medicine; - Engaged in the instruction of the general public in the area of pediatric medical care, public health, hygiene and related instruction useful to the individual and beneficial to the community; - Developed a single, unified, integrated delivery system to provide high quality, cost effective, tertiary health care services to infants, children and adolescents within ACCA's service area; - Provided and arranged for the medical care of all socioeconomic segments of the community served, negotiated managed care contracts with third party payers, and performed clinical and translational research. Children's Bone Joint and Spine Center (CBJSC) Purposes and Activities: Children's Bone Joint and Spine Center (CBJSC) is organized as a Texas non-profit health organization pursuant to Texas laws and the Texas Medical Board's rules and regulations governing non-profit health corporations. |
| Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP - PART 3 | Accomplishments: - Provided pediatric orthopedic care to Central Texas children; - Supported medical education and developed the capabilities of individuals and institutions to teach and practice medicine, especially in the field of pediatric medicine; - Engaged in the instruction of the general public in the area of pediatric medical care, public health, hygiene and related instruction useful to the individual and beneficial to the community; - Developed a single, unified, integrated delivery system to provide high quality, cost effective, tertiary health care services to infants, children and adolescents within CBJSC's service area; - Provided and arranged for the medical care of all socioeconomic segments of the community served, negotiated managed care contracts with third party payers, and performed clinical and translational research. Healthcare Collaborative Purposes and Activities: Healthcare Collaborative (HC) is organized as a Texas non-profit health organization pursuant to Texas laws and the Texas Medical Board's rules and regulations governing non-profit health corporations. Accomplishments: - Provided specialized medical services to individuals of the Central Texas region; - Collaborated with other service providers in the Central Texas region to streamline the delivery of healthcare services to patients in the region; - Supported medical education and developed the capabilities of individuals and institutions to teach and practice medicine; - Engaged in the instruction of the general public in the area of pediatric medical care, public health, hygiene and related instruction useful to the individual and beneficial to the community; - Developed a single, unified, integrated delivery system to provide high-quality, cost effective, tertiary health care services to patients within the HC service area; - Provided and arranged for the medical care of all socioeconomic segments of the community served, negotiated managed care contracts with third-party payers, and performed clinical and translational research. Institute of Reconstructive Plastic Surgery of Central Texas (SIRPS) Purposes and Activities: Institute of Reconstructive Plastic Surgery of Central Texas, d/b/a Seton Institute of Reconstructive Plastic Surgery (SIRPS), is a sub-specialty 501(c)(3) charitable organization that provides patient care and educational programs and organizes and directs clinical and basic science research programs. SIRPS serves the patient populations of University Medical Center Brackenridge (UMC Brackenridge), Seton Medical Center Williamson and other regional hospitals. UMC Brackenridge and Seton Medical Center Williamson are operated by a related tax-exempt organization, Seton Family of Hospitals (d/b/a Seton Healthcare and Daughters of Charity Health Services of Austin). SIRPS faculty represents a variety of subspecialties, including Wound Care, Hand, Breast, Craniofacial and Reconstructive Plastic Surgery. Involvements: Many SIRPS patients are covered by government insurance programs, including Medicare, Medicaid and managed Medicaid or were self-pay or charity. Faculty members hold leadership positions in a variety of local, regional and national professional organizations. In addition, SIRPS physicians were/are: - Actively involved in resident, medical student and allied health education. - An integral part of UMC Brackenridge acquiring and maintaining Level I Trauma Center status. - An integral part of Seton Medical Center Williamson acquiring and maintaining Level II Trauma Center status. Accomplishments: - Provided 12,918 patient visits in FY15 SIRPS faculty: - Provided leadership and direction for development of the following multi-disciplinary programs at UMC Brackenridge: Hand Center, Breast Center, Craniofacial Center, Wound Care and Plastic Surgery; - Created an outpatient Hand Therapy center to provide continuity of care to our patients; - Instituted outpatient imaging services for quick, same-day imaging with outpatient pricing; - Developed a clinic at the Travis County jail to reduce transport costs, decrease ER visits and improve safety; - Saw all patients, regardless of ability to pay. SIRPS Community Outreach Activities: Physicians with SIRPS participate in a variety of community outreach activities including: - Giving lectures to community physicians and allied health personnel to continue education and improve quality of care. - Participating in community health fairs educating the general population (e.g., Mock Surgery Fair). - Mentoring undergraduate students and working with student observers interested in pursuing careers in healthcare. - Providing leadership and direction for the specialty of plastic surgery as it develops in Austin and the surrounding counties. - Updating the public via numerous media outlets (radio, television, internet) on plastic surgery related health concerns, such as skin cancer and breast cancer awareness, hand injuries and cosmetic treatments of the breast, body and face. Pediatric Critical Care Associates (PCCA) Purpose and Activities: Pediatric Critical Care Associates (PCCA) is a tax-exempt pediatric sub-specialty 501(a) nonprofit corporation dedicated to providing quality patient care to the critically ill children of Central Texas that present to the pediatric intensive care unit at Dell Children's Medical Center of Central Texas (Dell Children's), which serves a 46-county area in Central Texas. Dell Children's is the only dedicated pediatric facility in the region and is operated by a related tax-exempt organization Seton Family of Hospitals (d/b/a Seton Healthcare and Daughters of Charity Health Services of Austin). The physicians at PCCA are all board certified Pediatric Intensivists. PCCA physicians are an integral component of the pediatric trauma team and participate in multiple hospital-wide quality improvement projects. Involvements: - Continue to participate in the National Association of Children's Hospitals and Related Institutions (NACHRI) and NACHRI's National CA-BSI Collaborative. This collaborative was initially made up of 30 Pediatric Intensive Care Units (PICU) nationwide working together to eradicate Catheter-Associated Blood Stream Infections in the Intensive Care Unit (ICU). The program is designed to establish "best practice" and now PCCA along with the other original group members, are serving as facilitators to help "spread" to more than 300 PICU's nationwide. - Serve as leaders in NACHRI's PICU focus group which conducts multi-center research programs and establishes PICU best practices based on consensus. - Participate in the Pediatric Acute Lung Injury and Sepsis Investigation (PALISI). We are conducting National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and corporately-sponsored multi-center clinical research. We are studying new therapies for acute hypoxemic respiratory failure and courses of critical pertussis and influenza infections. - Serve as a teaching faculty for pediatric residency program, emergency room residents and fellows, medical students, nursing students, respiratory therapists and pre-hospital emergency personnel. |
| Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP - PART 4 | Accomplishments: - Provided 6,771 patient visits in FY15 - Ongoing research studies through the Pediatric Palliative Care Program, established in 2006. Two peer reviewed articles have been published as a result of this research. - Expanded and continued to provide medical directorship for the pediatric transport team. Dell Children's Medical Center of Central Texas performs more than 1,000 patient transports per year. This benefits both local children and those outside the Austin Metro area. - Continued to provide medical directorship for the Pediatric Intermediate Care Unit (IMC), the PICU, the Pediatric Transport Team and ECMO. - Recognized for teaching excellence in support of pediatric resident education. - Development and delivery of an annual seminar for pediatric residents on communicating bad news to families. - Development of hospital wide protocol to standardize care of patients with complicated bacterial pneumonia. PCCA Community Outreach Activities: Physicians with Pediatric Critical Care Associates participate in a variety of community outreach activities including: - Milagros: Family support group for patients with congenital heart disease. - Heartgift Program: PCCA physicians provide medical services for pediatric cardiac patients from foreign countries who travel to Austin for care. - Spine Hope: A non-profit organization that transforms the lives of children with spinal deformities worldwide through surgery, education and research. - Sammy's House: Daycare for medically fragile infants and children. - CMC Foundation of Central Texas: Volunteer DJ for Radiothon; Physician liaison to Children's Miracle Hospital Medical Network Committee and guest speaker at many civic organizations on behalf of CMC Foundation of Central Texas. - Pediatric Advance Life Support (PALS): Medical Director of Dell Children's Medical Center of Central Texas and Austin Community College program. Train hundreds of nurses, physicians and EMS first responders in PALS annually. - Courageous Kids: Annual reunion for PICU survivors and their families. Pediatric Surgical Subspecialists (PSS) Purposes and Activities: Pediatric Surgical Subspecialists (PSS) d/b/a Pediatric Specialty Services is organized as a Texas non-profit health organization pursuant to Texas laws and the Texas Medical Board's rules and regulations governing non-profit health corporations. Accomplishments: - Provided 59,789 patient visits in FY15; - Provided pediatric subspecialty medical care to Central Texas children; - Supported medical education and developed capabilities of individuals and institutions to teach and practice medicine, especially in the field of pediatric medicine; - Engaged in the instruction of the general public in the area of pediatric medical care, public health, hygiene and related instruction useful to the individual and beneficial to the community; - Developed a single, unified, integrated delivery system to provide high-quality, cost effective, tertiary health care services to infants, children and adolescents within the PSS service area; - Provided and arranged for the medical care of all socioeconomic segments of the community served, negotiated managed care contracts with third-party payers, and performed clinical and translational research. Seton Ear Nose and Throat (SENT) Purposes and Activities: Seton Ear Nose and Throat (SENT) is organized as a Texas non-profit health organization pursuant to Texas laws and the Texas Medical Board's rules and regulations governing non-profit health corporations. Accomplishments: - Provided 12,227 patient visits in FY15; - Focused on providing specialized care for babies, children and adolescents with ear, nose and throat conditions; - Supported medical education and developed the capabilities of individuals and institutions to teach and practice medicine, especially in the field of pediatric medicine; - Engaged in the instruction of the general public in the area of pediatric medical care, public health, hygiene and related instruction useful to the individual and beneficial to the community; - Developed a single, unified, integrated delivery system to provide high-quality, cost effective, tertiary health care services to infants, children and adolescents within the SENT service area; - Provided and arranged for the medical care of all socioeconomic segments of the community served, negotiated managed care contracts with third-party payers, and performed clinical and translational research Seton Family of Pediatric Surgeons (SFPS) Purposes and Activities: Seton Family of Pediatric Surgeons (SFPS) is organized as a Texas non-profit health organization pursuant to Texas laws and the Texas Medical Board's rules and regulations governing non-profit health corporations. Accomplishments: - Provided pediatric general and trauma surgery; - Supported medical education and developed the capabilities of individuals and institutions to teach and practice medicine, especially in the field of pediatric medicine; - Engaged in the instruction of the general public in the area of pediatric medical care, public health, hygiene and related instruction useful to the individual and beneficial to the community; - Developed a single, unified, integrated delivery system to provide high-quality, cost effective, tertiary health care services to infants, children and adolescents within the SFPS service area; - Provided and arranged for the medical care of all socioeconomic segments of the community served, negotiated managed care contracts with third-party payers, and performed clinical and translational research. |
| Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP - PART 5 | Seton Family of Physicians (d/b/a Seton Brain & Spine Institute) (SBSI) Purposes and Activities: Seton Family of Physicians, d/b/a Seton Brain & Spine Institute (SBSI), is a non-profit corporation that has assembled an expert, multidisciplinary team of physicians and other medical professionals to cover the entire spectrum of brain and spine care. SBSI research and clinical trials are at the forefront of a program dedicated to improving neurosciences care for all Central Texans. SBSI employs more than 30 board-certified physicians specializing in neurosurgery, orthopedic surgery, neurology, physical medicine and rehabilitation. SBSI is operated by a related tax-exempt organization, Seton Family of Hospitals. Inpatient and outpatient treatment is provided to the community for the following: - Brain and spine tumors - Epilepsy - Scoliosis - Degenerative Disc Disease - Painful spine conditions - Stroke - Spinal cord injury - Memory disorders - Movement disorders - Traumatic brain injury - Concussions Medical services include: - Neurology - Neurosurgery - Orthopedic spine - Physical medicine and rehabilitation Some of the services listed above operate at a loss in order to ensure that all services are available to meet community health care needs. SBSI furthers its charitable purposes by providing a broad array of services to the community. Its investment in research also provides access to state-of-the-art technology, medications and treatment protocols. This allows SBSI healthcare practitioners to experience and share new and upcoming treatment options on the leading edge of science. This relationship between research and practice, combined with SBSI's collaborative and interdisciplinary care model, leads to more advances and exceptional outcomes for Central Texas patients. Accomplishments: - Provided 73,512 patient visits in FY15. Seton Medical Group (SMG) Purposes and Activities: Seton Medical Group (SMG) is a physician practice organization that provides medical staffing for a related tax exempt organization, Seton Healthcare Family (Seton). Physicians with SMG work with patients at Seton's urban and rural community health centers and clinics to address a variety of healthcare needs. Sliding-fee scales make the centers' services affordable in an effort to provide access for families who would otherwise not be able to afford medical care. Facilities include: - Seton Burnet Healthcare Center - Seton Marble Falls Healthcare Center - Seton Bertram Healthcare Center - Seton Pedi Care-A-Van - Seton Lockhart Center for Healthcare - Seton Community Health Centers (McCarthy, Kozmetsky, Topfer) - Seton Luling Family Medical Clinic - Seton Children's Care-a-Van - Seton Total Health Partners Accomplishments: - Provided 29,812 patient visits in FY15 SMG provides the following inpatient and outpatient medical services to the community: - Asthma education/Spirometry - Diabetes specialty clinic and foot clinic - Clinic for children at risk for diabetes and cardiovascular disease - Family practice - Family therapy - General surgery - Internal medicine - Laboratory services - Nephrology - Neurology - Orthopedics - Pain Management - Patient education - Pediatrics - Obesity education for at-risk children - Pulmonology - Social worker at each site - Pharmacy Assistance Program - Urogynecology Many of the services listed above charge patients a co-pay on a sliding scale or without consideration of a patient's ability to pay in order to ensure that all services are available to meet community health care needs. |
| Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP - PART 6 | In addition to providing health care services to all individuals who require medical attention, SMG sponsors several programs to help provide patient education. SMG also provides continuing medical education for its members in order to provide the best health care to the community. Participating physicians have access to Seton-sponsored Continuing Medical Education activities, which included: - Adult Cancer Management - Brain & Spine Clinical Rounds - Breast Pre-Treatment Planning - Chest Conference - Communication of Electronic Fetal Monitoring - GYN Cancer Conference - Heart Transplant Board Meetings - Internal Medicine Grand Rounds - Invasive Cardiology Morbidity & Mortality - Neonatal Grand Rounds - OB/GYN Grand Rounds - Pediatric Cancer Management Conference - Pediatric Cardiology/Cardiovascular Surgery Conference - Pediatric Grand Rounds - Perinatal Outreach - Searching for Evidence: Using PubMed & Other Online Resources - Seton Medical Center Grand Rounds - Stroke Case Conference - Trauma Rounds Seton/UT Dell Medical School University Physicians Group (f/k/a Seton/UT Southwestern University Physicians Group) (SUUPG) Purposes and Activities: Seton/UT (University of Texas) Dell Medical School University Physicians Group (f/k/a Seton/UT Southwestern University Physicians Group) (SUUPG) was organized to provide graduate and undergraduate training programs in Austin under the leadership of the practicing medical community and full-time faculty from the University of Texas Southwestern Medical Center. Combining real world clinical experience with quality, personalized instruction, medical residents are gaining the skills they need to build successful careers in medicine. In turn, those residents along with medical students and faculty members provide coverage at multiple local hospitals and clinics throughout the Central Texas region. Accomplishments: Some of the facilities benefiting from SUUPG include those operated by health care organizations, the Health Care District, Veterans Administration, and city, county and state mental health organizations. SUUPG continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families and society as a whole. SUUPG is home to Austin's graduate medical education program. Seton has entered into a long-term affiliation with the University of Texas Southwestern Medical Center to provide graduate and undergraduate training programs in Austin. SUUPG furthers this goal through delivery of direct patient care services, including care to the elderly and indigent, as well as patient education and health awareness programs for the community. Available services are provided to people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. The following inpatient and outpatient medical services are provided to the community: - Family Medicine - Internal Medicine - Gastroenterology - Endocrinology - Infectious Disease - Dermatology - Pediatrics - Adult/Child/Geriatric Psychiatry - Obstetrics/Gynecology - Women's Health (UroGyn/GynOncology) - Surgery - Rheumatology (inpatient) Some of the services listed above charge patients on a sliding scale or without regard to the patient's ability to pay in order to ensure that all services are available to meet community health care needs. As a physician practice, SUUPG provides a substantial portion of its services to the elderly and poor. SUUPG seeks to improve the health status of its surrounding community by providing inpatient and outpatient medical and psychiatric services in multiple locations throughout the region. Services are extended not only to its tax exempt corporate member, Seton, but to other tax exempt entities throughout the community, some of which include: - Austin Independent School District - Austin State Hospital - Austin/Travis County Mental Health Mental Retardation (MHMR) - Austin/Travis County MHMR Child & Adolescent Clinic - Blackstock Family Health Clinic - Brackenridge Hospital - Children's Hospital of Austin (a department of Brackenridge Hospital) - Children's Shelter - The Travis County clinics - City of Austin Federally Qualified Health Clinics - Forensic/Federal Correctional Institution - Bastrop (outpatient) - People's Clinic - Post-Traumatic Stress Disorder Clinic at Veterans Administration - St. David's Medical Center (The Partnership is not an exempt organization.) - Seton Medical Center - Seton Shoal Creek (psychiatric hospital) - Seton Southwest Health Center - Texas Child Study Center (in collaboration with Dell Children's Medical Center) - University Physician Group - Trinity and 38th Street locations - Dermatologic Surgery Center (Mohs) - University of Texas Counseling Center - Veterans Administration Clinics - Veterans Administration Post Traumatic Stress Disorder Clinic |
| Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP - PART 7 | SUUPG together with The University of Texas Southwestern Medical Center (UTSW) provide an extensive list of classes, seminars and materials to medical residents and staff related to each specialty. All core and elective requirements for graduate medical education and undergraduate medical students are offered as specified by the Accreditation Council for Graduate Medical Education, which is responsible for the Accreditation of post-MD medical training programs within the United States. In addition, SUUPG trains and recruits healthcare professionals who are likely to remain in the region to meet unmet needs for physician services in both the urban and rural setting, and in doing so, provides direct physician services to the public, including a significant number of persons who are elderly or poor. Development of new physicians is an integral part of improving community health status in the future. 'Specially for Children Children's Hospital Subspecialists of Central Texas (SFC) Purposes and Activities: 'Specially For Children Children's Hospital Subspecialists of Central Texas (SFC) is a non-profit pediatric sub-specialty physician organization that provides specialized care for hospitalized patients and outpatients of Dell Children's Medical Center of Central Texas (DCMC), which serves a 46-county area in Central Texas. DCMC is the only dedicated pediatric facility in the region and is operated by a related tax-exempt organization, Seton Family of Hospitals. The mission of SFC is to provide comprehensive pediatric subspecialty healthcare services that meet the needs of all children within the communities served. Accomplishments: SFC provided 74,132 patient visits in FY15 and is widely recognized in Central Texas as a leader in the evaluation and treatment of children and adolescents with special needs and complex medical conditions. It is the only group of its kind in the region, playing an integral role in the development of a comprehensive, pediatric multi-disciplinary team approach to caring for children. Further, each of the group's pediatric specialists has advanced training in a medical subspecialty and has specifically chosen to work with children. The physicians of SFC provide state-of-the-art diagnosis, treatment and clinical management of children and adolescents to meet the healthcare needs of patients and organizations in the community. The availability of these essential medical services helps to improve the overall health status of the region and offers young patients personalized care in a child friendly environment. The physician specialists employed by SFC are experts in many different areas of pediatric medicine and provide comprehensive, high quality clinical care for children and adolescents from birth through eighteen years of age. The group, originally formed in 1996 with six pediatric subspecialists, has expanded to better serve the needs of Central Texas and today, consists of more than 39 pediatric subspecialists in the area including: - Pediatric Allergy, Asthma & Immunology - Pediatric Dermatology - Pediatric Endocrinology and Diabetes Care - Pediatric Gastroenterology and Nutrition - Pediatric Hematology and Oncology - Pediatric Infectious Diseases/Adoption and Travel Clinic - Pediatric Nephrology and Dialysis Services - Palliative Care - Pediatric Rheumatology - Clinical Genetics - Comprehensive Complex Care Clinic - A medical home for children with complex chronic medical conditions SFC participates in a variety of community outreach activities including: - Project Access: Travis County Medical Society program to provide free care to uninsured individuals in the community in collaboration with hospital and primary care service providers. - Camp Bluebonnet: Pediatric Hematology/Oncology Program participates in this camp for cancer and blood disorder patients and their families. - Heartgift Program: Physicians provide medical services for pediatric cardiac patients from foreign countries who travel to Austin for care. - Camp Okawehna: Nephrology participates in this camp for kids on dialysis or kids that have had kidney transplants. - Camp Bluebonnet: Endocrinology Program participates in this camp for kids with diabetes. In addition, dedicated social workers counsel patients who need assistance connecting with other community resources, including Any Baby Can, Texas Neuro Rehab, LifeWorks, Capital Area ARC and Halo. Assistance also is provided to assist patients who qualify for Medicaid, the Austin/Travis County Medical Assistance Program and the Children's Health Insurance Program (CHIP). Tri-County Clinical (TCC), d/b/a Seton Family of Doctors, Seton Heart Institute and Riverbend Medical Group Purposes and Activities: Tri-County Clinical (TCC), d/b/a Seton Family of Doctors, Seton Heart Institute and Riverbend Medical Group, is a tax-exempt 501(c)(3) non-profit corporation dedicated to providing quality primary and specialist care to patients and extending the continuum of care from Seton Family of Hospitals to outpatient clinics. As the leading provider of comprehensive health care services in Central Texas for more than a century, Seton continues to drive the level of care available in our community. TCC is a premier group of practices with more than 45 doctors and researchers offering services in specialties from primary care to cardiology. TCC also has worked to improve access to healthcare in the region through its facilities in underserved and rural communities in Central Texas. Accomplishments: - Provided 168,087 patient visits in FY15. CMC Foundation of Central Texas Purpose and Activities: CMC Foundation of Central Texas raises philanthropic funds to support Dell Children's Medical Center of Central Texas (Dell Children's), a member of Seton Family of Hospitals. Dell Children's serves a 46-county region in Central Texas. Through its fundraising initiatives, CMC Foundation of Central Texas contributes to health care excellence and Seton Healthcare Family in Central Texas to serve the poor and vulnerable. Through its partnerships with generous donors, community volunteers and support groups, CMC Foundation of Central Texas helps build and strengthen sustainable collaborative efforts that benefit the health and well-being of the local community. The CMC Foundation of Central Texas Board of Trustees includes community, corporate and civic leaders, and physicians. Sources of philanthropic support include donations from individuals, foundations, corporations and civic organizations, the Children's Miracle Network, special events and volunteer support groups including the Circle of Friends chapters, Children's Council, Children's Trust, Women's Trust and Grandparent's Club. Special events such as the Annual Children's Council Gala, Circle of Friends fundraisers and radiothon raise funds and also awareness of Dell Children's mission to serve the health care needs of Central Texas children, including the poor and vulnerable. Accomplishments: In FY15, CMC Foundation of Central Texas raised more than $10.2 million (pledges and cash) from generous donors to support Seton programs, equipment and building needs and the endowment for the benefit of Dell Children's Medical Center of Central Texas. Contributions supported a variety of needs including: - Medical equipment, renovation, expansion and new construction. - Programs, operating support and the endowment for Texas Child Study Center serving children's mental health needs. - Programmatic support for pediatric obesity, trauma, neurosciences, blood and cancer disorders, and child life. - Operating support for Children's Health Express serving the health care needs of low-income children in the Austin area via a mobile health van. |
| Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP - PART 8 | Seton Hays Foundation Purpose and Activities: Seton Hays Foundation raises philanthropic funds to support Seton Medical Center Hays, Seton Edgar B. Davis Hospital, and Seton Southwest Hospital, members of Seton Family of Hospitals. Through its fundraising initiatives, Seton Hays Foundation contributes to health care excellence and the Daughters of Charity Health Care Ministry in Central Texas to serve the poor and vulnerable. Through its partnerships with generous donors, community volunteers and support groups, Seton Hays Foundation helps build and strengthen sustainable collaborative efforts that benefit the health and well-being of the local community. The Seton Hays Foundation Board of Trustees includes community, corporate and civic leaders, and physicians. Sources of philanthropic support include donations from individuals, foundations, corporations and civic organizations. Special events raise funds and also awareness of Seton's mission to serve the health care needs of Central Texas, including the poor and vulnerable. Accomplishments: In FY15, Seton Hays Foundation raised more than $2.1 Million (pledges and cash) from generous donors to support Seton programs, equipment and building needs, and the endowment for the benefit of Seton Medical Center Hays, Seton Edgar B. Davis Hospital and Seton Southwest Hospital. Contributions supported a variety of needs including: - Building and equipment at Seton Medical Center Hays, Seton Edgar B. Davis Hospital and Seton Southwest Hospital. - Seton nurse scholarship fund supporting associates currently in or entering the nursing profession. - Operating support for the Seton Children's Care-a-Van serving the health care needs of low-income, rural school children in Caldwell and Hays counties via a mobile health van. Seton Williamson Foundation Purpose and Activities: Seton Williamson Foundation raises philanthropic funds to support Seton Medical Center Williamson, Seton Northwest Hospital, and Seton Highland Lakes Hospital, members of Seton Family of Hospitals. Through its fundraising initiatives, Seton Williamson Foundation contributes to health care excellence and the Daughters of Charity Health Care Ministry in Central Texas to serve the poor and vulnerable. Through its partnerships with generous donors, community volunteers and support groups, Seton Williamson Foundation helps build and strengthen sustainable collaborative efforts that benefit the health and well-being of the local community. The Seton Williamson Foundation Board of Trustees includes community, corporate and civic leaders, and physicians. Sources of philanthropic support include donations from individuals, foundations, corporations, and civic organizations. Special events raise funds and also awareness of Seton's mission to serve the health care needs of Central Texas, including the poor and vulnerable. Accomplishments: In FY15, Seton Williamson Foundation raised more than $2.6 Million (pledges and cash) from generous donors to support Seton programs, equipment and building needs, and the endowment for the benefit of Seton Medical Center Williamson, Seton Northwest Hospital and Seton Highland Lakes Hospital. Contributions supported a variety of needs including: - Building and equipment at Seton Northwest Hospital and Seton Medical Center Williamson. - Seton nurse scholarship fund supporting associates currently in or entering the nursing profession. - Program costs for Project Search at Seton Medical Center Williamson. Seton Fund of the Daughters of Charity of St. Vincent de Paul, Inc. Purpose and Activities: Seton Fund of the Daughters of Charity of St. Vincent de Paul, Inc. (Seton Fund) raises philanthropic funds to support Seton Healthcare Family, including Seton Medical Center Austin, University Medical Center Brackenridge, Seton Shoal Creek Hospital and the Seton Kozmetsky, Seton McCarthy and Seton Topfer Community Health Centers. Through its fundraising initiatives, Seton Fund contributes to Seton's commitment to health care excellence and Seton Healthcare Family in Central Texas to serve the poor and vulnerable. Through its partnerships with generous donors, community volunteers and support groups, Seton Fund helps build and strengthen sustainable collaborative efforts that benefit the health and well-being of the local community. The Seton Fund Board of Trustees includes community, corporate and civic leaders, and physicians. Sources of philanthropic support include donations from individuals, foundations, corporations, civic organizations, special events, and volunteer support groups, including the Seton Development Boards and its associate groups across Central Texas, Elizabeth Ann Seton Board, University Medical Center Brackenridge Development Council, Seton Forum, the Fifty and League House Board. Special events help raise funds and also awareness of Seton's mission to serve the healthcare needs of our community, including the poor and vulnerable. Accomplishments: In FY15, Seton Fund raised more than $20.3 million (pledges and cash) from generous donors to support Seton programs, equipment and building needs and the endowment. Contributions supported a variety of needs including: - Research efforts, new construction, renovation and expansion at University Medical Center Brackenridge. - Medical equipment, renovation and expansion at Seton Medical Center Austin, including the new Breast Cancer Center. - Operating support for the Seton Care-a-Vans serving the health care needs of low-income, rural school children in Burnet, Llano, Lampasas and Caldwell Counties via a mobile health van. - Breast cancer initiatives, including emergency assistance for low-income women. - Seton nurse scholarship endowment supporting Seton associates currently in or entering the nursing profession. - Programs, operating support and endowment for the Seton Kozmetsky, Seton McCarthy and Seton Topfer Community Health centers serving low-income families. Blue Ladies Minerals, Inc. Purpose and Activities: The purpose of the organization is to own and manage oil, gas, mineral rights and real or personal property and remit the income to its sole member, Seton Fund of the Daughters of Charity of St. Vincent De Paul, Inc. (Seton Fund). Seton Fund's primary mission is the promotion and support, financial and otherwise, of the ministry of holistic healing serving the population of central Texas with special emphasis on the underserved. Seton Fund accomplishes this mission by supporting its sole corporate member. Blue Ladies Minerals, Inc. provides important functional support to both Seton Fund and Seton Healthcare Family. Twenty-Six Doors, Inc. Purpose and Activities: The only purpose of the organization is to hold title to real property and remit the income generated to its shareholder. The property consists of certain real property known as the Twenty-Six Doors Shopping Center located in Travis County, Austin, Texas. The organization's sole shareholder is Seton Fund of the Daughters of Charity of St. Vincent De Paul, Inc. (Seton Fund). Seton Fund was organized on October 30, 1981, as a Texas not-for-profit corporation. |
| Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP - PART 9 | Fickett Health Legacy, Inc. The purpose of the organization is to hold and collect income from certain real property, and remit such income to its shareholder, Twenty-Six Doors, Inc., a Texas not-for-profit corporation, for the benefit of Seton Highland Lakes Hospital. Funds are restricted to capital needs for Seton Highland Lakes Hospital. Twenty-Six Doors' sole shareholder is Seton Fund of the Daughters of Charity of St. Vincent De Paul, Inc. Seton Fund of the Daughters of Charity of St. Vincent de Paul, Inc. was organized on October 30, 1981, as a Texas not-for-profit corporation. The Seton Cove, Inc. Purpose and Activities: The Seton Cove, Inc. (Seton Cove) is a non-profit interfaith center for spirituality with a mission of providing a welcoming place of solace and hospitality where people of any faith may nourish their spiritual growth and journey toward wholeness. The center offers a holistic approach to life that integrates spiritual and human development through programs designed to honor the dignity of every person and to reflect the connections between spirituality and the human experience. Activities include programs to promote mental health and spiritual growth through workshops and presentations. Seton Cove is operated by a related tax-exempt organization, Seton Family of Hospitals. More than three-fourths of Seton Cove's community services are provided to Seton Cove's tax-exempt corporate member, Seton Healthcare Family. Seton Cove provided 14,874 hours of ministry to approximately 10,700 participants in FY15 at a cost of $577,000. Seton Cove offers access to a variety of classes, presentations and programs designed to help educate the community. Classes are listed on the Seton Cove website: www.setoncove.org. In addition, the site includes information on spiritual direction, journaling, labyrinths, retreats and workshops. Examples of Seton Cove classes and activities include: - Holistic Touch by appointment - Spiritual Direction - Group Spiritual Direction - Table Massage offered at Seton Cove - Chair Massage offered monthly at Seton Northwest Hospital, Quarry Lake, Seton Shoal Creek Hospital, University Medical Center Brackenridge, and Seton Administrative Offices - Chair Massage provided for department-wide events by request, at the different locations of Seton Family of Hospitals - Seton Southwest New Mother Massage Program - Meditation - Stress reduction and wellness retreats - Chair yoga and chair ta-chi Accomplishments: Services offered at Seton Family of Hospitals include: - Tranquility Place monthly luncheons at University Medical Center Brackenridge, Seton Medical Center Austin, Seton Northwest Hospital, Seton Shoal Creek Hospital, Dell Children's Medical Center of Central Texas, Seton Medical Center Williamson, Seton Southwest Hospital, Seton Medical Center Hays, Seton Administrative Services, Quarry Lake, Seton Smithville, Seton Mind Institute, Seton Highland Lakes, Children's Comprehensive Care, and Chevy Chase. - In-network Fearless at Work workshops, Awake At Work workshops and wellness retreats for the Clinical Enterprise core team, AIS team, HR, Finance Department, and monthly Physician Spirituality Groups at SMCA. - Stress reduction day long workshop in 2015 for physicians: 25 participants at SMCA. - Wellness and self-care programs offered on a quarterly basis for Very Important Hearts (cardiac rehab patients) at various Seton sites. - Conducting monthly Wellness committee meetings. - Seton Ongoing Executive Formation as well as an Ascension Management Formation. - Launched Senior Leadership Team Formation plan which includes 3 Renewal Days for Seton senior leaders: 20 participants at each retreat, along with follow up activities including, Reflective Practice sessions throughout the year. - Co-led Seton Local Heritage Pilgrimages. - Facilitated quarterly labyrinth walks for associates. - Led meditation at Seton events and health fairs such as Ignite, breast care center, Psychiatric residents at Seton Shoal Creek Hospital, and chair yoga at Seton McCarthy Community Health Center. Outreach activities and programs offered to the general community include: - Wednesday evening meditation group - Friday morning Contemplative Prayer group - Two Wednesday morning meditation groups - Restoring Balance luncheons facilitated by presenters from the community - Spring Seminar workshop led by J. Pittman McGehee, who has been added to Seton Cove's adjunct faculty - Stress reduction workshops - Spiritual Intelligence Assessments and coaching Major Accomplishments: - Led 2015 Leadership Pilgrimage program, which concluded with 25 graduates. - Led 2015 Contemplative Leadership program with 23 participants. This is a year-long program of six one-day retreats offering continued practice for participants that have completed the Leadership Program. - Led 14 participants to the Contemplative Leadership Winter Intensive 5 day retreat in Taos, New Mexico. - Facilitated the Thirteenth Annual Sr. Mary Rose McPhee Lecture series on Leadership and Spirituality with Michael Carroll. - Facilitated Contemplative Art of Stillness 4 day retreat in December 2014 in Tucson, Arizona with 8 participants. - Offered and completed off-site Soul Collage retreat. - Offered and completed Day Camp for Teens at Dell Children's Medical Center of Central Texas with 22 participants. - Offered and completed day and a half-long Summer Intensive for Leaders at the Seminary of the Southwest with 22 participants. Community Care Collaborative (CCC) Purpose and Activities: The CCC 501(c)(3) was created in July 2013 through a public-private partnership between Seton Healthcare Family and Central Health, the Travis County Health District, to provide a coordinated continuum of services to a defined patient population through a new integrated delivery system. This population includes approximately 75,000 uninsured adults residing in Travis County. Through CCC, healthcare providers in Travis County join together to provide patient centered care through a "no wrong door" approach. Wherever eligible patients present for care, be it the emergency room, community clinic or elsewhere, the system will provide care and navigation services to ensure individuals receive appropriate levels of service and are connected to a medical home. Some care is provided through 15 additional DSRIP projects delivered by CCC partners and contracted organizations. The system is building a coordinated continuum of services that is easily navigated by and feels seamless to the patient. The overarching goal of CCC is to provide the principles of CMS' triple aim of high quality, cost effective, patient centered care to improve health outcomes through expanded care coordination, types of care and patient management. Accomplishments: In FY15, CCC: 1) Formalized a plan for coordination of the Integrated Delivery System. 2) Conducted substantial evaluation of the existing Medical Assistance Program (MAP), Indigent Care Program, sliding fee scale and charity care programs. 3) Initiated development of a New Benefits Plan for the poor and the vulnerable covered population (up to 375% FPL) in Travis County. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - part 2 | Highlights from Seton's Community Health Needs Assessment: Mortality Rates for Central Texas: While mortality rates for the community as a whole continue to decline (mortality rates for population as a whole), prevention opportunities are still present for deaths from accidents, suicide, cancer, cardiovascular and cerebrovascular diseases. Premature mortality rates are higher in the more rural east and west regions of Central Texas. In addition: - Cancer and cardiac disease account for nearly half of the deaths in Central Texas. - Accidents, stroke and chronic lower respiratory diseases together cause another 20 percent of deaths. - Downward trends are evident in mortality rates in cancer and diseases of the heart. - Accidents are the fourth highest cause of death in Central Texas, trading places with cerebrovascular diseases. Communicable Diseases: Several key indicators are worth noting: - Declining AIDS incidence rates tied with increasing HIV prevalence suggest that medication and education are making HIV/AIDS more of a chronic disease affecting fewer new people each year. - Syphilis incidence rates are increasing. - Tuberculosis incidence rates are increasing. Teen pregnancy: - Rates are relatively stable at less than 35 per 1,000 teenaged females, and below national averages. Lifestyle Heath Indicators: These include: - The percentage of Central Texans reporting that they are overweight or obese is increasing. - Slightly fewer Central Texans report that they smoke. - Diabetes is increasing throughout the region. Access to Physicians: - The region faced a shortage of almost 200 physicians in 2012. This shortage was projected to grow to almost 900 physicians by 2016. This shortage considers the service provided by mid-level providers such as advanced practice nurses and physician assistants. The shortage is driven by several factors: increasing demand due to aging of the population; population growth; and the aging and expected retirement of the current physician supply. - A provider shortage is felt not only in the population at large, but among the older residents of the area as well. Providers accepting Medicare continue to decline. - Seton is closely monitoring the physician shortage and the need for physicians as determined by each hospital's projected volumes. Seton is focusing on strategies to increase the supply through medical education; increasing the number of employed physicians; and active recruiting of private physicians. Identified Health Needs: All seven CHNAs identified three top health-related needs: chronic disease, behavioral health issues, and obesity. These three needs are often interrelated and community stakeholders often spoke about residents who have behavioral health issues that, when unresolved, affect obesity and chronic disease management. Chronic disease and obesity are both closely correlated to many of the top causes of death across the communities served by Seton. Another gap consistently identified across all the CHNAs was access to care. This overarching need includes a multitude of factors including lack of providers for the uninsured and underinsured; the high cost of care; education on service navigation; limited specialty care or services; lack of insurance coverage, and transportation-related issues. Increasing and improving community collaboration to improve the health and well-being of individuals was also identified as a need across all communities. There were a few unique needs that surfaced in the individual CHNAs and they are addressed in each individual hospital Implementation Plan. Implementation Plan: Seton has developed fourteen Implementation Plans, one for each of its hospitals and joint venture hospitals. Each plan identifies the programs and activities the hospital, through the support of Seton Healthcare Family and local partnerships, commits to provide in order to help address the needs identified in the CHNA of its service area. While similar needs were identified across all of the communities Seton serves, Seton recognizes that each community has its own unique set of needs, assets, and community partners. Therefore, the strategies listed below may apply to all facilities or may only be relevant to one facility. For some facilities (i.e., Seton Shoal Creek and Central Texas Rehabilitation Hospital), certain community health needs fell outside of the scope of the direct services that the hospital provides. In these instances, the hospital still listed implementation strategies in those areas but they played more of a supporting role in those strategies. These strategies represent a three-year plan for addressing community health needs. However, given the dynamic nature of community health needs and the potential changes in Seton's strategy, these implementations may change over the three-year period. If any changes are made, funding will be reallocated from the original pot of community benefit dollars. Currently, Seton Healthcare Family is waiting on guidance from the IRS regarding its reporting expectations for the Implementation Plans. Seton has developed internal metrics to measure each program identified in the Implementation Plan and hopes to share with the community the progress made in meeting those metrics. SUMMARY of all 14 Seton Healthcare Family Hospital Implementation Strategies: Acronyms referenced: CPRMC - Cedar Park Regional Medical Center, CTRH - Central Texas Rehabilitation Hospital, DCMC - Dell Children's Medical Center of Central Texas, SEBD - Seton Edgar B. Davis, SHL - Seton Highland Lakes Hospital, SMCA - Seton Medical Center Austin, SMCH - Seton Medical Center Hays, SMCHH - Seton Medical Center Harker Heights, SMCW - Seton Medical Center Williamson, SNW - Seton Northwest Hospital, SSRH - Seton Smithville Regional Hospital, SSC - Seton Shoal Creek Hospital, SSW - Seton Southwest Hospital and UMCB - University Medical Center Brackenridge. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - part 3 | DSRIP Seton provides 20 DSRIP projects through the Texas 1115 Medicaid Waiver, administered through the Texas Health and Human Services Commission (HHSC) and the Centers for Medicare and Medicaid Services (CMS). Many of the projects challenge patients and providers to approach care differently. All projects address one or more priorities identified on the 2012 Community Health Needs Assessments. All DSRIP projects are on track to successfully provide required outcomes and Seton receives payments based on achievement of metrics. In the first two years (Oct. 2012 - Sept. 2014) of DSRIP implementation, there were 265,478 patient encounters and 41,288 patients served. DSRIPs are designed to: - Care primarily for Medicaid recipients or low income individuals without insurance, - Improve the health of the population, - Lower costs through efficiencies and improvements. Areas of focus include: - Low income individuals, - Patients with chronic disease, - Special populations that are particularly vulnerable including children, pregnant women, homeless individuals, and those with behavioral health conditions. The start of the fifth and final year of the DSRIP projects timeline began in FY15. Seton is actively collecting outcome data on these projects. Seton has also taken a strong leadership role across the state to extend DSRIP beyond September 30, 2016 to continue support and innovation to the Central Texas safety net. The 20 Seton DSRIP Projects: 1. Behavioral Health Assessment & Resource Navigation: Provide free behavioral health assessments and navigate individuals to community behavioral health providers. - Patient Impact: 5,720 Individuals - Target Population: University Medical Center Brackenridge inpatients (UMCB) and ED patients 2. Behavioral Health School Campus Counseling I: Increase access to behavioral health services on school campuses. - Patient Impact: 5,875 Individuals - Target Population: AISD school children 3. Behavioral Health School Campus Counseling II: Increase access to behavioral health services on school campuses. - Patient Impact: 590 Individuals - Target Population: AISD school children 4. Care Transitions: Coordinate and monitor care for patients with chronic diseases from hospital to home. - Patient Impact: 5,876 Individuals - Target Population: Adults discharged from a Seton hospital in Travis County 5. Chronic Care Management - Adults: Provide treatment and care coordination for adults with chronic condition(s) or serious injury. - Patient Impact: 2,600 Individuals - Target Population: Adults discharged from a Seton hospital in Travis County 6. Chronic Care Management - Community Clinics: Provide treatment and care coordination for adults with chronic condition(s) or serious injury. - Patient Impact: 2,350 Individuals - Target Population: Adults seen at Seton Community Clinics 7. Chronic Care Management - Pediatrics: Provide specialty treatment and care coordination for children with high disease complexity. - Patient Impact: 1,050 Individuals - Target Population: Children and adolescents 8. Culturally Competent Care Training: Provide staff training to increase awareness of the diverse populations and cultures served. - Patient Impact: 6,420,000 Encounters - Target Population: UMCB and later to include Seton Medical Center Austin (SMCA) & Seton Northwest Hospital (SNW) 9. Diabetes Chronic Care: Standardize testing routines for individuals at-risk or with diabetes and communicate the discharge plan directly to provide follow up. - Patient Impact: 9,500 Individuals - Target Population: Adult inpatients at UMCB, SNW, & SMCA 10. ED Patient Navigation: Navigate emergency department to a medical home. - Patient Impact: 400 Individuals - Target Population: Individuals who qualify for Burnet County or Seton Highland Lakes (SHL) Indigent Care 11. Family & Child Obesity: Deliver a multi-delivery approach to prevent and treat childhood obesity. - Patient Impact: 1,025 Individuals - Target Population: Travis County children, adolescents, and their families 12. Language Services Resource Center: Centralize language services and add qualified healthcare interpreters. - Patient Impact: 76,670 encounters - Target Population: Spanish-speaking UMCB patients; later other Seton hospitals in Travis County 13. Obstetrics Care Navigation: Provide pre- and post-natal navigation for Hispanic women. - Patient Impact: 600 individuals - Target Population: Hispanic women 14. Palliative Care Program: Create palliative care program for individuals with chronic or terminal illness. - Patient Impact: 6,239 encounters - Target Population: UMCB inpatients and/or community clinics patients 15. Post-Graduate Training for Psychiatric Specialties: Provide new psychiatric residencies and fellowships. - Patient Impact: 21,000 encounters - Target Population: Inpatients and outpatients throughout Travis County 16. Psychiatric Emergency Department: Create a new psychiatric emergency department. - Patient Impact: 5,475 individuals - Target Population: UMCB emergency department patients in psychiatric crisis 17. Psychiatric Telemedicine: Expand inpatient and ED telepsychiatry services. - Patient Impact: 1,859 encounters - Target Population: Patients at Seton hospitals in Travis County 18. Substance Use Disorder Navigation: Navigate individuals at risk of a substance use disorder to intervention and treatment. - Patient Impact: 3,917 encounters - Target Population: UMCB inpatients and emergency department patients 19. Women's Oncology Care Navigation: Provide navigation services from cancer diagnosis to treatment, as well as cancer survivorship support services for women. - Patient Impact: 450 individuals - Target Population: Travis County women receiving treatment at Shivers or cancer survivors 20. Women's Oncology Care Screening: Expand mobile mammography and cervical screenings. - Patient Impact: 8,762 individuals - Target Population: Women age 40-64 for breast cancer screenings and/or age 21-64 for cervical screening Chronic Disease and Disease Management: All of the Community Health Needs Assessments identified chronic disease and disease management as a priority health issue facing residents of their County. For the past six years, the top three causes of death in Central Texas have been related to chronic disease. With many communities landing above national benchmarks for chronic disease - specifically diabetes, heart disease, and cancer - several opportunities exist for meeting this community health need. Seton Network Oncology Services currently works with several Seton hospitals to provide access to the Seton Cancer Prevention and Early Detection program; the Oncology Nurse Registry; the Survivorship Program; the Multidisciplinary Cancer Conference and clinics; and Navigation services. Seton's oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. These services are available in communities served by UMCB, SMCA, SNW, SMCW, SHL, SSW, SMCH, SEBD, and SSRH. In addition, SSC serves as the behavioral health partner for this program. Seton Women's Oncology Care Screening program works with all Seton hospitals to expand timely access to breast and cervical cancer screenings. A mobile unit travels to six counties to screen uninsured and underinsured women in Central Texas who otherwise would not receive these life-saving services. The screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, Seton will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. These services are available in communities served by UMCB, SMCA, SNW, SMCW, SHL, SSW, SMCH, SEBD, and SSRH. In addition, SSC serves as the behavioral health partner for this program. Seton Shivers Cancer Center, located within UMCB provides oncology care to all uninsured and underinsured women referred by Seton hospital, including the medical oncology clinic; the oncology specialty clinic; and diagnostic and therapeutic services including infusion services for adult cancer patients. Shivers staff also work closely with the Seton Cancer Care Team to provide case management services and a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. The Shivers Cancer Center and the Seton Cancer Care Team provide services to communities served by UMCB, SMCA, SNW, SMCW, SHL, SSW, SEBD, SMCH, and SSRH. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - part 4 | Seton Diabetes Chronic Management program provides referral support to all Seton hospitals for diabetes education programs. Diabetes education programs are available for all Central Texas residents regardless of ability to pay. In addition, UMCB, SMCA, and SNW are now utilizing continuous quality improvement methodology to improve outcomes for adult inpatients diagnosed with Diabetes Mellitus. Diabetes Chronic Care Management will implement small, straightforward evidence-based practices to implement a Diabetes Care Bundle that, when performed collectively and reliably, has been proven to improve patient outcomes. In addition, this project will establish an interdisciplinary diabetes team, led by an endocrinologists and a diabetes clinical nurse specialist, to address the clinical, safety, and psychosocial needs of inpatients with diabetes while preparing for a successful discharge. The project will also implement evidence-based practice (EBP) protocols to ensure improved clinical outcomes during and post-hospitalization. This program has been shared throughout other Central Texas communities in other primary care safety net clinics. The Diabetes Chronic Care Management program now includes SMCW and SMCH. To improve the health of patients with chronic disease, Seton has established Seton Total Health as a prototype of integrated care management and continuing support as patients leave the hospital setting. Over the past five years, Seton has enhanced and expanded this model to better coordinate care through collaboration with community partners. This approach includes a multi-disciplinary team that monitors and coordinates the care of patients with chronic diseases immediately following discharge from the hospital, and coordinates integration into primary and specialty care. This project optimizes the patient's recovery, improves quality of life, and reduces readmissions to the hospital. Services provided through this program include home visits to provide short-term direct care, social services, behavioral health support, transportation, telehealth and patient training regarding self-care management of chronic disease(s). In addition to the services noted above, Seton Mind Institute serves as the behavioral health partner for this program at all participating hospitals. SEBD provides the Diabetes Education Program to uninsured and underinsured residents. This proposed program will identify Caldwell County residents diagnosed with diabetes and will provide disease education and nutrition guidance to help patients manage their own care. SEBD, SSRH, UMCB and SMCA support residents of Bastrop and Caldwell Counties in accessing free medications through the outpatient Patient Prescription Assistance Program (PPAP). PPAP improves access to medications for patients at Seton hospitals and outpatient settings including the Seton Community Health Centers. Seton provides assistance to uninsured patients with the often tedious and complex paperwork required by the pharmaceutical companies to receive these free medications. Patients benefit from reduced costs and ultimately better health. SMCA will continue its support of various clinics that help provide care for patients suffering from heart related chronic diseases. Heart disease was identified in the CHNA as a top cause of death for the community and SMCA will continue to provide support through the Heart Specialty Care and Transplant Center and the Cardiac Rehab Clinic as a means of addressing the increasing need for cardiology services. SEBD will continue its Outpatient Chemotherapy Service in order to make treatment accessible for those challenged by transportation and funding limitations. Prior to the implementation of chemotherapy services at SEBD, patients had to drive as far as Kyle, New Braunfels, or Austin to seek treatment. Many patients did not have the resources to make this commitment and some chose to forgo treatment. SEBD is now offering chemotherapy services to all of the surrounding communities. The impact these services will have for the community is immeasurable in time and convenience. As an Accountable Care Organization, SEBD is committed to expanding our scope of service to provide chemotherapy to this demographic population. SSRH will work in partnership with The Seton Brain and Spine Institute to bring community education events regarding stroke symptoms and prevention to Bastrop County. SSRH is committed to continuing this partnership and will look for additional opportunities for community education. CTRH will develop a Stroke Prevention and Education class designed to provide education and resources to the elderly members of the community. These classes will be conducted at local churches and teach participants the signs of a stroke and the steps to take to prevent strokes. CPRMC provides numerous educational programs and outreach activities to benefit the community. The Healthy Woman and Senior Circle programs, with more than 6,000 members, are important for their support, health, and wellness activities. Through regular e-newsletters and wellness seminars, members learn strategies to improve their health status and prevent chronic diseases. CPRMC also has a free membership program for expectant mothers called Tiny Toes with more than 2,000 members, where women receive information on pregnancy and childbearing. Each member receives the childbirth preparation book, What to Expect When You're Expecting, in either English or Spanish. All patients after delivery are provided a free car seat and instructions to promote infant safety. CPRMC provides support groups on various health topics which are provided free of charge to support the needs of the community. A monthly Breast Cancer Support Group is offered at CPRMC in collaboration with the Breast Cancer Resource Center of Texas. A monthly Breastfeeding Support Group is also offered to promote breastfeeding for mothers in the community. Blood pressure and glucose screenings are offered regularly at community locations such as St. Margaret Mary's Catholic Church and Hill Country Bible Church to improve health outcomes. SMCHH currently funds a Diabetes Academy that helps educate persons with diabetes and those that care for them. Three family medicine physicians spearhead the education series with support from a diabetes educator and hospital clinical dietitian. The group is fed healthy snacks and the physicians offer ideas and support for those in attendance. After the session, a one-on-one visit with a physician and educator occurs. SMCHH has added two new internal medicine physicians to its staff as a method of treating and providing resources for those community members suffering from chronic conditions. While this is a giant step in helping manage and treat those residents with chronic diseases, SMCHH will explore opportunities to bring more physicians to the community who focus on the treatment of chronic disease. By bringing more physicians to the area, community members will not have to wait as long to be seen and the un- and underinsured will have more options. SMCHH will explore adding additional classes, as necessary, to meet the health needs of the community. Currently, SMCHH offers CPR and first aid classes, in addition to the Diabetes Academy, and will look for opportunities to expand the scope of classes offered. Some classes currently being discussed are those revolving around healthy lifestyle, nutrition, and healthy heart. |
| Schedule H, Part VI, Line 2 needs assessment - part 5 | DCMC will expand a pilot to manage the comprehensive care of children with complex, chronic disease in the outpatient setting with its Care Management for the Chronically Ill Children and Adolescents project. The purpose of this project is to identify and manage a population of children with a very high disease complexity and multiple co-morbid conditions to deliver comprehensive integrated care that can improve outcomes. The proposed model creates an outpatient clinic to deliver comprehensive integrated primary and specialty care to these children. Multidisciplinary services such as palliative care, behavioral medicine and psychiatric care are embedded in the care structure in a manner that affirms the family as a unit of concern and designs processes that maximize well days for the entire family unit. DCMC has helped AISD meet the state milestone of having 100% of the schools with 95% of students fully vaccinated. DCMC will continue to support AISD in meeting this standard of immunization but, in recognizing that immunization challenges still exist, DCMC will conduct Immunization Clinics at schools with the greatest need. These immunizations will be given free of charge and will provide students access to the necessary immunizations earlier in the school year cycle. Obesity: Obesity was identified as a community health need across the seven community health needs assessments that Seton participated in. While each community was unique in how they felt obesity could be addressed, Seton has identified various implementation strategies to help combat the increasing obesity trend. In an attempt to not duplicate efforts, we recognize that many city municipalities, local school districts, and local non-profits are working to reduce the obesity rate in our community and Seton's programs may vary depending upon current community efforts. The CHNA identified access to healthy foods as a high priority. With the number of visitors and community members who visit the Seton cafeterias on a daily basis, Seton is dedicated to improving the nutritional value of the food offered at the facility. Seton will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. The Healthy Dining Program will be implemented at UMCB, SMCA, SNW, SMCW, SHL, SMCH, DCMC and SSRH. Seton currently serves in a leadership role with the Mayor's Health and Fitness Council (MHFC). MHFC is a local non-profit organization in Travis County whose vision is to support and inspire people to improve their health by encouraging physical activity, improved nutrition and tobacco-free living. A Seton hospital Chief Operating Officer currently serves on the board as the Vice Chair for the Council and Seton will continue to participate in this collaborative effort to make Austin the healthiest city in America. The MHFC provides a benefit to the community served by UMCB, SMCA, SSC, SNW, and SSW. One way that Seton is exploring to reduce obesity is through the Seton Healthcare Family Pre-Diabetes Program. This program is a pilot program associated with the Seton Health Centers located in Travis County. The program helps to transform the lives of vulnerable working poor patients - patients who have been identified as being at increased risk for developing diabetes - by providing an array of empowering and essential interventions including psychosocial assessment, health literacy assessment, spiritual counseling, weight loss counseling, diabetes prevention education, nutrition counseling, grocery store tours, social services referrals, and community resource referrals. The program provides poor, at-risk adults with the information, tools and support they need to achieve obesity risk-reduction to help prevent diabetes, and to move patients from having pre-diabetes glucose levels to having normal glucose levels. This program provides services to the community served by SMCA, UMCB, SNW, and SSW. DCMC has implemented various community outreach programs and educational opportunities to help educate children and their families about living a healthy lifestyle throughout Central Texas. In response to the growing trend of obese children, DCMC established the Texas Center for the Prevention and Treatment of Childhood Obesity (TCPTCO) in 2010. The aim of TCPTCO was to provide children and their families an opportunity to learn from a multidisciplinary team through classes, nutrition education, and counseling to achieve a healthy lifestyle. In addition, DCMC collaborates with dozens of community organizations and advocacy groups whose goal is to turn the curve on the obesity trend in Central Texas. SSC serves as a behavioral health partner for this program. SMCW and SNW are committed to their support of the IGNITE Women's Health Program which is dedicated to providing women with a continuum of support regarding their health and wellness, and opportunities to light up their lives. IGNITE offers an array of programs from preventative wellness to restorative health care, to educate and encourage women in a healthy lifestyle and in turn - a healthy community. Programs include free fitness, Zumba, yoga, and self-defense classes, in addition to free cardiac screenings, BMI, blood pressure, and many more tests that help women measure their overall health. IGNITE also offers nutrition and cooking classes to help promote healthy eating habits. SMCHH and CPRMC are both currently engaged in partnerships with their local community's YMCA. SMCHH is currently engaged in collaboration with the Armed Services YMCA to build a Community Fitness and Rehabilitation Facility that will help promote a healthy and active environment for the community. This new recreation facility will go beyond the simple workout equipment found in most YMCAs and will offer soldier rehabilitation programs, military family counseling, family meet-ups, holistic wellness programs and nutrition classes. Groundbreaking for this center is expected within the next year and should be completed in 2015. CRRMC will continue to support the efforts of local YMCA programs that are aimed at providing healthy and active lifestyle options for children and their families. CPRMC has and will continue to support the YMCA to achieve these objectives. With an unequal distribution and education regarding healthy eating throughout Central Texas, CTRH and SMCHH recognize that healthy eating education is often required in order for patients to succeed when they go back into their communities. For this reason, both facilities provide a Clinical Dietician/Nutritionist on-site to conduct healthy eating education to obese patients. These consultations allow for physicians to write specific dietary orders for patients and for patients to have specialized one on one education on how to achieve the healthy eating goals set by the physician. SMCHH will identify opportunities to host classes that teach residents about what makes a healthy meal, how to shop for healthy foods, and provide healthy recipe ideas to participants. These classes are in the early stages of implementation at SMCHH and they will look to expand these classes in the next three years. During 2013 - 2015, DCMC will incorporate a Multi-level Family and Child Obesity Initiative into the currently established programs available at TCPTCO. This program will be a comprehensive childhood obesity intervention with a tiered approach, increasing the intensity of the intervention depending upon the unique needs of the child. This initiative will address the lack of: 1) Accessible information on local programming and resources that help support healthy active living, 2) Primary care provider's ability to effectively address childhood obesity in their offices, and 3) Access to services for the dramatic number of morbidly obese children in Travis County. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - PART 6 | In order to increase the physical fitness activities in the community, SSW serves as the sponsor for various community events aimed at providing active lifestyle opportunities for community members. SSW will continue the Run/Walk Program aimed at helping residents train to run a local 5K or 10K. In addition, SSW will continue to be one of the leading sponsors in many local races such as the Doggie Dash, Donkey Dash, and Run for the Water (10 mile race with kids 1K). SSW will continue its partnership with the Austin Independent School District (AISD) after school programs and their Micro-Society Program. SSW currently provides education related to the support of community health and nutrition to students who have created a micro-community that they are responsible for maintaining. SSW will continue to work with the southwest Austin AISD programs and other additional opportunities related to improving the health of children in the southwest Austin community. CPRMC has identified support groups as a vital part in the success of their patients. CPRMC's Bariatric Support Group provides seminars on goal setting, nutrition education, body image, physical fitness, grocery shopping tours and many other obesity related topics free of charge for those who are interested. In addition, the Bariatric Support Group hosts guest speakers such as dietitians, surgeons, and psychologists to help educate participants on healthy lifestyles and options for losing weight. Behavioral Health: Mental and behavioral health was one of the foremost health concerns raised by all of the communities represented in all of the Community Health Needs Assessments. This included substance abuse, an inadequate number of mental health providers, and a lack of behavioral health resources. In an attempt to meet some of these needs, Seton proposes to implement the strategies listed below. Seton has expanded access or plans to expand access to Psychiatric Telemedicine to the entire network of Seton hospitals and will continue to support this behavioral health service by providing 24/7 psychiatric consultations, including after hours. Patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessments, earlier dispositions and less costly levels of care. Currently this program is free of charge. The Psychiatric Telemedicine program is currently implemented at DCMC, SMCA, UMCB, SSC, SSW, SMCH and SMCW while future expansion to SHL, SNW, SEBD and SSRH is planned. SMCHH will also be exploring the possibility of implementing a psychiatric telemedicine model. The Seton Cove Spirituality Center provides spiritually healing discussion groups, classes and events led by a multidisciplinary faculty both on hospital campuses and at the Spirituality Center. All Seton Cove programs are open to the community. The Seton Cove Spirituality Center provides a service to the community's served by UMCB, SMCA, SSC, SNW, SMCW and SSW. In some of Seton's rural counties, Seton will collaborate with local Mental Health and Mental Retardation agencies (MHMRs) and Federally Qualified Health Center's (FQHCs) to expand services to meet the behavioral health needs of these communities. These collaborations will benefit the community's served by SMCH, SEBD, SSRH, CPRMC and SMCHH. SMCA and UMCB have implemented the No One Dies Alone (NODA) campaign to improve the health and well-being of patients. NODA provides trained volunteer bedside companionship for patients who might otherwise be alone at the time of death. SMCW will serve as a potential location for NODA expansion. By expanding the behavioral health workforce, greater care can be provided to individuals with behavioral health needs in Travis County, especially those who are under- or uninsured. Seton plans to expand Post Graduate Training for Psychiatric Specialties/Psychiatric Residency Programs. This project will expand the residency training programs in psychiatric specialties to expand the workforce of providers in our community treating psychiatric patients and increase access to behavior health services for the indigent and uninsured. Post Graduate Training for Psychiatric Specialties will be implemented at UMCB and SSC. SEBD will continue to support the Heritage Program. The Heritage Program provides an intensive outpatient psychiatric program for seniors in Caldwell and surrounding counties. The seniors served have a mental health need, primarily anxiety or depression, and a comorbidity including congestive heart failure, diabetes, or COPD. The program provides group, individual, and family therapy, as well as family and community education. The Heritage staff includes a nurse, master level therapist, and a program psychiatrist that comes in weekly. Transportation is provided to participants and home assessments are done to ensure the best referral is made. The Heritage program also offers specialty groups to the community such as geriatric attention deficit disorder and trauma groups. Substance abuse and Substance Use Disorder (SUD) were concerns for community members. UMCB will develop a Substance Abuse Navigation transition service for patients who are at risk for SUD. The program will direct individuals to early intervention and provide access to treatment opportunities and education for the indigent and uninsured. With a need for timely mental health assessments, UMCB will explore the development of a Behavioral Health Assessment and Resource Navigation project. This will be a free comprehensive assessment of behavioral health needs that can then be used to connect patients to community resources. DCMC is home to the Texas Child Study Center, a collaboration between Dell Children's Medical Center of Central Texas and the College of Educational Psychology of The University of Texas. The Texas Child Study Center provides evidence based treatment for children and adolescents with emotional, behavioral, and developmental disabilities. In addition, Texas Child Study Center provides assessment and treatment for those children with acute or chronic medical illnesses, epilepsy, cystic fibrosis, diabetes, obesity, and traumatic injuries to address co-occurring mental health issues that these youth often face. DCMC proposes to increase access to behavioral health services through the delivery of psychotherapy, psychiatric assessments and medication management on school campuses to children and adolescents through a Campus Based Counseling Referral Center. This project will provide psychotherapy and medication management on campuses of select AISD schools, especially targeting students who have difficulty accessing services due to funding, transportation, or access to providers. Each school year, this project will establish and operate one or more school-based behavioral health clinic(s); thereafter, the established clinic(s) will be operated by Lone Star Circle of Care in collaboration with AISD under the direction of DCMC. Early identification of mental health needs and access to services is crucial to preventing the unnecessary use of crisis services, utilization of the DCMC Emergency Department and use of inpatient resources. By providing services on the school campus, less classroom time is lost and transportation burdens are alleviated as students will not need to leave the school campus. DCMC, through the Children's/AISD Student Health Services collaboration, has been able to build a collaborative approach for responding to student behavioral and mental health needs. The school nurses, which are employees of DCMC, provide identified students with individualized care plans for significant ongoing behavioral and mental health needs. DCMC will increase professional development for these school based nurses to aid in identifying and addressing behavioral health issues in addition to improving its electronic system for capturing and reporting care plans, with the hope of improved identification and documentation of student behavioral health needs. As a result of the SHS data analysis and the CHNA, DCMC and SHS will work to improve information sharing on campus safety and student behavioral health issues between SHS, Child Study Teams, and community partners. Additionally, through this collaborative, DCMC will support the implementation of Social Emotional Learning (SEL) by AISD. SEL is a curriculum-based, evidence-based approach to teaching skills that support student behavioral health. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - PART 7 | SMCW has developed a Clinical Psychiatry program through partnership with Lone Star Circle of Care (LSCC). This is aimed at increasing behavioral health services in Williamson County and Seton is committed to its continued support. SHL will collaborate with Bluebonnet Trails Community Services and the Burnet County Sheriff's Department to develop a Crisis Assessment for Persons in the Behavioral Health Crisis program. This program will provide crisis assessment, referral and short term stabilization in Burnet County. To establish this service, a space near the Emergency Department (ED) of SHL in Burnet, Texas will be renovated so that it is suitable for walk-in patients and for law enforcement. Frequently, law enforcement will use it for persons who are being held under Emergency Detention and require evaluation to determine the best options for treatment and stabilization. SSC has been a founding financial member of the Ending Community Homelessness Collaboration (ECHO) and is committed to remaining involved to help meet the needs of some of Austin's most vulnerable residents. In collaboration with other community stakeholders, SSC provided initial funding for ECHO to apply for 501(c)(3) status and hire full time staff. SSC lead the creation of the Crisis Implementation Committee (CIC) which is a collaboration of all behavioral health providers, EMS, Austin Police Department and other governmental entities involved in care of patients with behavioral health. For the past seven years, CIC has collaborated in building programs and bringing in public and private dollars to fund expanded safety nets that improve access to care in less expensive settings and improving the system of care for crisis services. Over the years, CIC has created more bed capacity for hospitalization, and funded access for partial hospitalization and IOP services. In addition, CIC has built a dashboard to monitor services with metrics guiding the committee on process improvement initiatives. Outcomes include expanded 24/7 Psychiatric Emergency Services, a Communitywide Peer Review program, Expanded Mobile Crisis Services and Telepsychiatry consults. CIC reports to a behavioral health stakeholder group under the hospital District which advocates for improved services for behavioral health patients. Seton Shoal Creek Hospital and Seton Mind Institute are active members in both CIC and the Stakeholder group and have led many initiatives for improvement of care in behavioral health services. SSC will continue to support the Generations Program. The Generations Program provides an intensive outpatient psychiatric program for seniors in Travis and surrounding counties. The seniors served have a mental health need, primarily anxiety or depression, and a comorbidity including congestive heart failure, diabetes, or COPD. The program provides group, individual, and family therapy, as well as family and community education. The Generations staff includes a nurse, master level therapist, and a program psychiatrist that comes in weekly. Transportation is provided to participants and home assessments are done to ensure the best referral is made. The Generations program also offers specialty groups to the community such as geriatric attention deficit disorder and trauma groups. At CTRH many patients have a psychiatric co-morbidity (i.e. depression, bipolar, schizophrenia, etc.). In order to meet this need without having to send patients to a separate facility, CTRH has partnered with Behavioral Health Consultants, a behavioral health care group, to provide consultations to patients with behavioral health related illnesses. In order to assist in the rehabilitation process and address any co-morbidities, CTRH has a psychologist to help work with their patients. CPRMC, as a healthcare provider that offers advanced medical care and comprehensive services, provides multidisciplinary teams to help develop a comprehensive treatment plan for patients. For those patients identified to have behavioral health related needs, CPRMC works with Bluebonnet Trails Services to help treat those patients and to identify those that can be transferred to a more appropriate treatment facility, i.e. an inpatient facility if needed. SMCHH currently works with Army Marathon and will continue to pursue this partnership to benefit the behavioral health needs of the community. With Fort Hood being located in Bell County and the increasing awareness of the impact combat has on the mental health of our veterans, Army Marathon helps raise support for behavioral health services and research in the military. Access to Care: Access to health care was a predominant theme among residents throughout all seven Community Health Needs Assessments, specifically the availability and accessibility of health care facilities and resources. In addition, many communities expressed frustration with the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Most communities recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. Given this overarching need across Central Texas, Seton proposes to support the following implementation strategies. The reasons the CHNA identified health disparities and inequities in the ability of different ethnic groups to access care are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team, including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently, Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, we provide in person sign language contracted services at all of our facilities as well as Spanish in person interpreters at certain hospitals. As part of an integrated approach to administer care in a person centered, culturally competent manner, Seton Healthcare Family, will develop a Language Services Resource Center and a Culturally Competent Care Curriculum. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department, through the Culturally Competent Care Curriculum, will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. The Language Service Resource Center and the Culturally Competent Curriculum will be implemented at UMCB, SMCA, SSW, and SNW with the identified best practices then to be expanded to SSC, SMCW, SHL, SEBD, SMCH and SSRH. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - PART 8 | TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SETON WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY SETON HEALTHCARE NETWORK, SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE NURSE TRIAGE CALL CENTER PROVIDES SERVICES TO THE COMMUNITIES SERVED BY UMCB, SMCA, DCMC, SSC, SEBD, SSW, SMCH, SSRH, SNW, SMCW, AND SHL. THE SETON COMMUNITY HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. UMCB HAS AND WILL CONTINUE TO REFER UNFUNDED PATIENTS WITHOUT A MEDICAL HOME TO THE SETON COMMUNITY HEALTH CENTERS FOR PRIMARY CARE. THE SETON COMMUNITY HEALTH CENTERS PROVIDE SERVICES TO THE COMMUNITIES SERVED BY UMCB, SMCA, SSW, SMCH, SNW AND SSC. IN ADDITION, CTRH HAS AND WILL CONTINUE TO SUPPORT THE WORK AND VISION OF THE SETON HEALTH CENTERS THROUGH FUNDRAISING, EDUCATION, AND COMMUNITY ADVOCACY FOR THESE MINISTRIES. THE TRAVIS COUNTY MEDICAL SOCIETY, SETON HEALTHCARE FAMILY AND OTHER MEMBERS OF THE INTEGRATED CARE COLLABORATION HAVE INITIATED A COORDINATED SYSTEM OF VOLUNTEER DOCTORS CALLED PROJECT ACCESS. THEY WORK WITH OTHER LOCAL PROVIDERS TO PROVIDE MEDICAL, HOSPITAL, DIAGNOSTIC AND PHARMACY ASSISTANCE FOR THE UNINSURED IN TRAVIS COUNTY. THE MISSION OF PROJECT ACCESS IS TO PROVIDE READY ACCESS TO APPROPRIATE HEALTH CARE SERVICES FOR UNINSURED PEOPLE IN TRAVIS COUNTY WHOSE INCOMES ARE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL AND TO IMPROVE THE OVERALL HEALTH OF OUR COMMUNITY. SETON HELPED SECURE A GRANT TO CREATE THE PROGRAM. MORE THAN 1,000 VOLUNTEER PHYSICIANS PARTICIPATE IN PROJECT ACCESS AND SETON WILL CONTINUE TO SUPPORT THE WORK OF THIS COLLABORATION TO IMPROVE ACCESS TO CARE. PROJECT ACCESS PROVIDES A BENEFIT TO THE COMMUNITIES SERVED BY UMCB, SMCA, SSW, SNW, AND SSC. SETON WILL CONTINUE TO INCREASE ACCESS TO SERVICES BY SUPPORTING SETON LEAGUE HOUSE, A 38-ROOM BED-AND-BATH FACILITY DESIGNED TO PROVIDE FAMILIES AND CAREGIVERS WITH A PLACE TO STAY WHILE THEIR LOVED ONES ARE HOSPITALIZED IN AN AUSTIN-AREA HOSPITAL. THE SUBSIDIZED ROOMS REDUCE THE BARRIER OF TRAVEL COSTS ASSOCIATED WITH TREATMENT. SETON LEAGUE HOUSE PROVIDES A SERVICE TO THE COMMUNITIES SERVED BY UMCB, SMCA, SSC, SSW, AND SNW. ACCESS TO PRENATAL CARE IN THE FIRST TRIMESTER WAS IDENTIFIED AS A NEED ESPECIALLY AMONG THE LATINO/HISPANIC POPULATION. TO ADDRESS THIS, SETON WILL EXPAND ITS OBSTETRICS NAVIGATION (OB NAVIGATION) PROJECT TO IMPROVE ACCESS TO PRE AND POSTNATAL CARE FOR UNINSURED HISPANIC WOMEN WITH LIMITED ENGLISH PROFICIENCY THROUGH COMPREHENSIVE, EFFECTIVE PATIENT NAVIGATION SERVICES. CURRENTLY THE OB NAVIGATORS WORK WITH WOMEN AFTER THEY HAVE ESTABLISHED PRENATAL CARE. THE NEW NAVIGATION INITIATIVE WILL PLACE NAVIGATORS OUT IN THE COMMUNITY TO HELP ASSIST NEWLY PREGNANT WOMEN WITH ACCESSING CARE IN THEIR FIRST TRIMESTER, FOLLOWING THEM THROUGHOUT THEIR PREGNANCY ENSURING THEY RECEIVE A POST-PARTUM CHECK-UP AND ARE CONNECTED TO A MEDICAL HOME FOR ON-GOING PRIMARY CARE. THE OB NAVIGATION PROGRAM WILL USE CULTURALLY AND LINGUISTICALLY COMPETENT COMMUNITY HEALTH WORKERS TO SERVE AS PATIENT NAVIGATORS. THE OBSTETRICS NAVIGATION WILL BE IMPLEMENTED AT UMCB, SMCA, SNW, AND SMCW. SETON HAS, AND WILL CONTINUE TO, ENGAGE IN ITS PARTNERSHIP WITH LOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) IN THE COMMUNITIES WITH WHICH THEY SERVE. THROUGH THESE PARTNERSHIPS, SETON AIMS TO INCREASE PRIMARY CARE ACCESS FOR THE UN- AND UNDERINSURED RESIDENTS OF THESE COUNTIES. MANY OF THESE FQHC RELATIONSHIPS ARE IN PLACE AND SETON WILL CONTINUE TO SUPPORT THESE LOCAL PARTNERS. SHL, SMCH, SEBD, SSRH, SMCW AND SNW WILL ALL CONTINUE TO COLLABORATE WITH LOCAL FQHCS TO PROVIDE SERVICES TO THEIR LOCAL COMMUNITIES. UMCB WILL ALSO CONTINUE TO MAINTAIN ITS CLOSE RELATIONSHIP TO THE PAUL BASS CLINIC LOCATED AT THE HOSPITAL. THE PAUL BASS CLINIC SERVES AS THE MEDICAL HOME FOR MORE THAN 1,500 INDIVIDUALS. IT PROVIDES ADDITIONAL CAPACITY FOR RESIDENTS WITH MULTIPLE DIAGNOSES AND NO ESTABLISHED MEDICAL HOME. IN ADDITION TO PRIMARY CARE SERVICES, THE CLINIC WILL OFFER QUALITY SPECIALTY CARE IN AREAS SUCH AS CARDIOLOGY, PULMONOLOGY, GASTROENTEROLOGY, ORTHOPEDICS, OTOLARYNGOLOGY, ENDOCRINOLOGY, AND RHEUMATOLOGY. UMCB WILL CONTINUE TO SUPPORT THE CLINIC AT BRACKENRIDGE, AN OUTPATIENT DEPARTMENT OF UMCB THAT PROVIDES SPECIALTY EVALUATION, TREATMENT, AND FOLLOW-UP CARE TO ADULTS ON AN OUTPATIENT BASIS. REFERRALS COME FROM THE AUSTIN/TRAVIS COUNTY COMMUNITY HEALTH CLINICS AND SOME OTHER COMMUNITY AGENCIES, LABOR AND DELIVERY, AND THE EMERGENCY DEPARTMENT ACCORDING TO REFERRAL GUIDELINES. THE CLINICS ARE TRANSITIONAL IN NATURE AND AFTER CONSULTATION THE PATIENT IS SENT BACK TO THE REFERRING ENTITY FOR PRIMARY CARE. THIS CLINIC PROVIDES SPECIALTY CARE TO UNINSURED AND UNDERINSURED PATIENTS AND SEES OVER 25,000 INDIVIDUALS A YEAR. SEBD IS COMMITTED TO THE CONTINUATION OF SETON CHILDREN'S CARE-A- VAN WHICH WILL ADDRESS THE NEED TO INCREASE PRIMARY CARE ACCESS, ESPECIALLY FOR THE UN- AND UNDERINSURED. OFFERING PRIMARY CARE SERVICES, THE MOBILE CLINIC IS OFTEN AVAILABLE FOR SAME DAY ACUTE VISITS, ELIMINATING SOME OF THE BARRIERS RESIDENTS FACE TRYING TO ACCESS CARE. THE CARE-A-VAN CURRENTLY VISITS SCHOOLS AND CHURCHES THAT HAVE BEEN IDENTIFIED AS AREAS OF NEED AND CAN SERVE AS A PRIMARY CARE HOME FOR CHILDREN AGES BIRTH-18, WHO CANNOT ACCESS CARE ANYWHERE ELSE. SHL IS COMMITTED TO THE CONTINUATION OF SHL CARE-A-VAN TO HELP ELIMINATE SOME OF THE BARRIERS RESIDENTS FACE WHILE TRYING TO ACCESS CARE. THIS MOBILE CLINIC WILL TARGET CARE TOWARD LOW INCOME RESIDENTS AND ELIMINATE THE TRANSPORTATION BARRIERS ASSOCIATED WITH ACCESSING CARE IN RURAL COMMUNITIES. THE CARE-A-VAN CURRENTLY VISITS SCHOOLS AND CHURCHES THAT HAVE BEEN IDENTIFIED AS AREAS OF NEED AND CAN SERVE AS A PRIMARY CARE HOME FOR THOSE RESIDENTS WHO CANNOT ACCESS CARE ELSEWHERE. SEBD OPERATES THE LOCKHART RURAL HEALTH CLINIC AND OPENED THE LULING RURAL HEALTH CLINIC IN FALL 2013 TO PROVIDE ADDITIONAL OPTIONS FOR LOW INCOME RESIDENTS TO ACCESS PRIMARY CARE. THE CHNA IDENTIFIED A DECREASING NUMBER OF PROVIDERS THAT ACCEPT NEW MEDICARE AND MEDICAID PATIENTS AND IT WAS SPECULATED THAT THESE RURAL HEALTH CLINICS, ALONG WITH THE COMMUNITY HEALTH CENTERS OF CENTRAL TEXAS FQHC'S, ARE THE ONLY CLINICS ACCEPTING THESE PATIENTS. AS A RESPONSE TO THE GROWING NEED FOR EXTENDED HOURS CARE, THE LOCKHART RHC HAS EXTENDED HOURS MONDAY - SATURDAY, UNTIL 7PM, WHICH GIVES PATIENTS APPOINTMENT FLEXIBILITY AND ACCESS TO WALK-IN CARE WITHOUT HAVING TO TAKE TIME OFF WORK. IN ADDITION, THE LOCKHART RHC PROVIDES A SPECIALTY CLINIC WITH OUTPATIENT LAB SERVICES, AN INTERNAL MEDICINE CLINIC, FAMILY PRACTICE, AS WELL AS CARDIOLOGY AND PULMONOLOGY FOR THOSE PATIENTS WITH SPECIALTY NEEDS. SHL IS COMMITTED TO PROVIDING SUPPORT FOR THE HIGHLAND LAKES RURAL HEALTH CLINICS WHICH PROVIDES ADDITIONAL OPTIONS FOR LOW INCOME RESIDENTS TO ACCESS PRIMARY CARE. SHL HAS CLINICS LOCATED IN BURNET, BERTRAM, LAMPASAS, AND MARBLE FALLS IN AN ATTEMPT TO PROVIDE SERVICES IN THE COMMUNITIES WITH THE GREATEST NEED. THE CHNA IDENTIFIED A DECREASING NUMBER OF PROVIDERS THAT ACCEPT NEW MEDICARE AND MEDICAID PATIENTS, BOTH OF WHICH ARE ACCEPTED BY THESE CLINICS. DCMC WILL CONTINUE TO HELP CONNECT RESIDENTS WITH PUBLICLY AVAILABLE ASSISTANCE PROGRAMS THROUGH THEIR SUPPORT OF INSURE-A- KID, A SETON HEALTHCARE FAMILY DEPARTMENT. GIVEN THAT BEING UNINSURED IS A SIGNIFICANT BARRIER TO ACCESSING CARE, INSURE-A-KID STAFF ARE LOCATED WITHIN THE COMMUNITY AND WITHIN DCMC TO HELP FAMILIES WITH UNINSURED CHILDREN APPLY FOR AND ENROLL IN MEDICAID AND CHIP. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - PART 9 | As the population of Central Texas grows and to increase the availability of pediatric specialty services, DCMC has committed to hire additional physicians in the following specialties: pediatric gastroenterology, pediatric endocrinology, pediatric neurology, adolescent medicine, pediatric pain management and medical pediatrics/transitional medicine. With the addition of these specialists, DCMC will not only be able to better serve children in Central Texas, we will be able to serve those in rural communities, such as Williamson County, Waco and Bryan/College Station. DCMC, in continuing with the charge that all children deserve quality health care, will continue to provide primary care services for uninsured children and their teen parents through its mobile health unit, Children's Health Express. The mission of Children's Health Express is to address the health needs of children who do not have a medical home. This mobile health team delivers primary care and preventative pediatric health care at several school sites and community based organizations around the County. Children's Health Express will work with community partners to identify additional potential stops for the mobile clinic as the access needs change over time. DCMC, in addition to providing access to primary care, is committed to providing access to specialty care through its Specialty Care Center. The specialty care center is made up of a neurosurgery center, a craniofacial plastic surgery center, pediatric orthopedics, and a cystic fibrosis center in an effort to increase the availability and access of specialty services in Central Texas. DCMC will support exploring opportunities to expand and increase specialty services to medically underserved areas of their community. SHL will continue to support the Highland Lakes Hospice and Home Health that provide a portion of the aging services for Burnet County. In Burnet County, it is projected that the population over the age of 65 will more than double over the next 18 years and aging services will be spread thin. By supporting these programs, SHL will help ensure that appropriate services are available for residents as they age. SHL proposes to develop a Patient Care Navigation program to effectively navigate services for indigent and uninsured patients in Burnet County. This project will implement a patient navigation system to connect indigent and uninsured patients with primary care or medical homes in order to reduce inappropriate utilization and provide cost-effective, timely, and site-appropriate health care services. Patients will be routed to a medical home by care navigators responsible for managing long-term relationships with the patients to reduce the patient's need for advanced medical care, including the Emergency Department (ED). SSC will continue to expand IOP and partial hospitalization services to other counties and to unique segments of the population with specific behavioral health disorders. SSC's IOP services are currently available in Travis, Williamson and Hays counties. SSW has developed a relationship with Bethany Lutheran Church (BLC) in southwest Austin to help sponsor a community health fair. SSW has provided a host of services such as heart and stroke education, skin cancer screenings, diet and exercise awareness, and vaccinations. These health fairs help reach members of the community who may not traditionally access care due to transportation, schedule, or other perceived conflicts. SSW will continue to foster this relationship with BLC and provide resources for this annual health fair. SEBD provides enrollment, navigation and services to the Caldwell County Indigent Program (CCI) in order to address the gap in services for the uninsured and underinsured. This program provides services for those residents at or below 21% of the federal poverty limit and SEBD provides a continuum of services to support CCI members' care. By doing this, SEBD will be able to provide case management services to the individual and provide them with a medical home to ensure proper and timely care is being delivered. SSRH provided land in the city of Bastrop to Lone Star Circle of Care, a Federally Qualified Health Center, to open a clinic in the county. After receiving a $5M federal grant, the facility opened in spring 2015 and provides family medicine, pediatric care, dental services and behavioral health to uninsured and underinsured residents. CTRH helps families connect to a funding source which is often the first step in meeting the access to care needs. CTRH assists families in obtaining DRS-CRS funding which funds acute rehabilitation, outpatient rehabilitation, and post-acute rehabilitation for patients with traumatic brain injuries and traumatic spinal cord injuries. This funding comes from the State of Texas and helps alleviate the burden of families who face barriers due to the high cost of intensive care. At CTRH, many patients in need do not have a funding source and typically will not receive the rehabilitation needed to allow them to recover to their fullest potential. Most of these patients will be discharged home or to a nursing home where their recovery process will be halted. CTRH supports the Seton mission by providing rehabilitation to patients without funding. On any given day, CTRH will have at least 1 unfunded patient in-house. CPRMC works closely with the Leander Independent School District to increase access to health screenings and health education while at the same time promoting the health objectives of students, associates and parents of the district. An annual LISD Health Expo is provided for approximately 4,500 district employees. Health screenings, one-on-one information and wellness seminars are provided at the event. Topics include the prevention and treatment of chronic diseases, healthy nutrition and the prevention of obesity. CPRMC also provides speakers on health-related topics for an annual conference for the parents of LISD, called Connecting U. CPRMC and SMCHH will work with primary care clinic partners who have opened and are planning to open facilities in the hospital's primary and secondary service areas. Though many area providers no longer accept Medicaid and Medicare, patients on these plans can receive care at these clinic partners. Currently, SMCHH is engaged in collaboration with the Killeen Free Clinic to help provide access to care for the most vulnerable residents of Bell County. SMCHH has an on campus Physician Group that offers same day appointments for those residents needing non-emergent care. This physician group offers services such as primary care, obstetrics, gastroenterology, pulmonary, ENT, orthopedics and general surgery. The physician group currently accepts both Medicare and Medicaid and will continue to look for ways to expand access to their services in the coming years. In June 2012, SMCHH opened its doors and by doing so gave the community in Bell County increased options to access care. While this was a major step forward in increasing access to care, SMCHH is committed to continue to look for ways to increase access. Currently SMCHH is actively recruiting physicians to the area to help bring specialty services to Bell County rather than forcing residents to travel to neighboring counties to receive care. Since SMCHH has opened, it has brought 21 new physicians/specialists to Bell County and is projected to bring an additional 15 over the next three years. Currently there are over 250 physicians on the medical staff. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - PART 9.1 | Community Collaboration: Despite several non-profit and social service organizations within Central Texas, many community health needs assessment participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesiveness and focused vision lead residents to feel that there is more dialogue than there is action. More coordinated approaches would help maximize limited resources. This need for community collaboration was a sentiment that was found across all seven Community Health Needs Assessments. Community Care Collaborative (CCC), a 501(c)(3) non-profit was created in July 2013 through a public-private partnership between Seton Healthcare Family and Central Health, the Travis County Health District, to provide a coordinated continuum of services to a defined patient population through a new integrated delivery system. Through CCC, healthcare providers in Travis County join together to provide patient centered care through a "no wrong door" approach. Wherever eligible patients presents for care, be it the emergency room, community clinic or elsewhere, the system will provide care and navigation services to ensure individuals receive appropriate levels of services and are connected to a medical home. The system is building a coordinated continuum of services that is easily navigated by and feels seamless to the patient. The overarching goal of CCC is to provide the principles of CMS' triple aim of high quality, cost effective, patient centered care to improve health outcomes through expanded care coordination, types of care and patient management. CCC serves residents of Travis County which includes communities served by DCMC, CTRH, SMCA, SSC, SSW, SNW, and UMCB In 1997, Seton led the formation of Integrated Care Collaboration (ICC), an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Seton Healthcare Family continues to fund the ICC infrastructure. Integrated Care Collaboration and its multiple geographic specific collaborations provide benefits to the communities served by UMCB, SMCA, SSC, SSW, DCMC, SNW, SEBD, SMCH, SSRH, SMCW, and SHL. Seton Healthcare Family is a partner of the Community Action Network (CAN) and will continue to support this local collaboration. CAN is a partnership of government, non-profit, private, and faith-based organizations who work together to enhance the social, health, educational, and economic well-being of Central Texas. As a partner of CAN, Seton has representatives on the Board of Directors and is committed to working with other CAN Partners to attain the mission of CAN. The Community Action Network provides a benefit to the communities served by UMCB, SMCA, SSC, SSW, DCMC and SNW. DCMC will continue to support Children's Optimal Health as a community collaboration that aims to pull community based organizations together in an effort to identify and address the community needs of childhood obesity, access to prenatal care, motor vehicle collisions, and access to primary care. Through this collaboration, DCMC will assist in the review of geo mapping data regarding where there are volumes of families with uninsured children and no nearby public health clinics. Through this collaborative, DCMC's Injury Prevention Program has identified "hot spots" or areas of Travis County where child passenger seats are underutilized. The Program has moved child passenger seat fitting stations to the "hot spot" areas to improve access and education to those communities. CPRMC, in an effort to continually foster community collaboration, supports the programs and objectives of area healthcare nonprofit agencies including the American Heart Association, American Diabetes Association, March of Dimes, YMCA and American Cancer Society. Teams from CPRMC participate in the annual walks of these organizations to raise awareness and funds. Proceeds from Cedar Park Regional Medical Center's Race Against Colon Cancer also benefit the American Cancer Society's patient services. CPRMC is a proud supporter of the Leander ISD Educational Excellence Foundation (LEEF), helping to provide innovative teaching mini-grants to improve academic outcomes for all students in LISD. CPRMC's extensive community partnerships include generous donations from CPRMC associates to Hill Country Ministries' Food Bank. An annual United Way Campaign is also provided at CPRMC to meet critical community needs in Williamson County. CPRMC supports the annual Leadership Cedar Park and Leadership Leander programs with day-long seminars on our campus to support education to community leaders on healthcare issues and community priorities. CTRH engages representatives of the community in the identification of community rehabilitation needs through its Community Advisory Council. The purpose of this council is to continue to identify the needs of the community and ensure Central Texas Rehabilitation Hospital is enhancing the quality and scope of services provided. CTRH will continue its support of the Lonestar Paralysis Foundation. The Mission of the Lone Star Paralysis Foundation is to cure spinal cord paralysis through funding research, advanced recovery, and community outreach. CTRH fully supports the Foundation by sponsoring and participating in many events throughout the year. CTRH participates in the annual Collaborating for Cures event. This event provides the community with education about current research, rehabilitation and treatment advances as well as emerging approaches for Alzheimer's, stroke and traumatic brain injury care. CTRH has been a participating member in years past and will continue to be a part of this important community event in the years to come. SMCHH, in an effort to increase and foster community collaboration, has collaborative partnerships with many local agencies and other non-profit organization including but not limited to: the Armed Services YMCA, the Killeen Free Clinic, the Heart Association, the Regional Health Policy Group, Hope Pregnancy Center, Harker Heights Food Bank, and the United Way. Through these partnerships, SMCHH is able to better connect residents to service organizations and support community health needs that fall outside the scope of the hospital. SMCHH expects to continue these collaborative partnerships and will explore opportunities to engage other community based organizations. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - PART 9.2 | Accidents: Accidents were a category of need that was identified in the rural communities during the community health needs assessment process. Accidents come in many forms but motor vehicle accidents served as the biggest cause of potential life lost and presented as a significant area of need in the rural communities that Seton serves. Given that motor vehicle safety is impacted by many variables, some of which fall outside Seton's direct line of service, Seton will participate in community discussions around motor vehicle safety but may defer to local experts to lead the collaboration. As a stakeholder concerned with community safety, SEBD, SHL, and SSRH will participate in community discussions around motor vehicle safety within their communities. DCMC has created an Injury Prevention Program whose mission is to lessen the burden of pediatric injury by identifying and addressing injury risks that affect the lives of patients and families at DCMC and throughout our Central Texas communities. The DCMC injury prevention program will accomplish this by strengthening individual knowledge and skills, providing community education and access to resources, educating providers, fostering coalitions and networks, influencing organizational practices, and advocating at all levels of policy and legislation that protect children from injury. DCMC will also continue to support the Austin Area Safe Kids Coalition. Safe Kids Austin, led by Dell Children's Medical Center of Central Texas, is a member of Safe Kids Worldwide, the nation's first non-profit organization dedicated solely to the prevention of accidental childhood injury. Safe Kids Worldwide is made up of more than 600 state and local Safe Kids coalitions in all 50 states, the District of Columbia and Puerto Rico. Safe Kids Austin consists of 49 community, civic, and state organizations. The Coalitions' initiatives include classroom-based programs and educational events for families. The Coalition focuses on promoting safety in vehicles, around water and while walking and biking. Safe Kids Austin promotes changes in attitudes, behaviors, laws and the environment to prevent accidental injury to children. In the United States, Safe Kids partnerships have contributed to a 45 percent reduction in the child fatality rate from accidental injury - saving an estimated 38,000 children's lives. Locally, this is done through community partnerships, advocacy, public awareness and distribution of, and education on the proper uses of, safety equipment. DCMC is committed to continued participation in the Childhood Transportation Safety Committee. This committee is comprised of a group of stakeholders committed to reducing the incidence of unintentional injuries in the City of Austin by raising awareness of injury risks and encouraging behavioral, environmental and policy changes that prevent injury related to child motor vehicle occupants, child pedestrians, and child cyclists in targeted geographic areas. There are multiple workgroups under the committee attempting to develop a Childhood Transportation Safety Strategy (i.e. plan) for specific geographic areas in the Austin City limits. At CPRMC, a comprehensive plan for trauma designation is currently underway and numerous public safety and trauma prevention activities are offered to the community. CPRMC provides a Bike Rodeo and participates in numerous health fairs to promote children's safety skills. CPRMC partners with the Capital Area Trauma Regional Advisory Council (CATRAC) to provide bicycle helmets to children in need. CPRMC also partners with two Cedar Park high schools in the creation of Shattered Dreams, a film created by students to dramatically demonstrate the dangers of drunk driving and to promote healthy decision making. Educational programs for EMS professionals are offered on a quarterly basis to promote the quality and coordination of emergency care. Financial Assistance: Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. All of the community health needs assessments revealed that Central Texas has a high rate of uninsured individuals, and a lack of insurance can be one of many factors that prevent individuals from accessing care. At all Seton hospitals and Seton joint venture hospitals, staff screen uninsured patients and if found potentially eligible for a government funding source, provide assistance and/or resources to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines. Seton provides financial assistance for those who earn up to 375% of the federal poverty level. |
| Schedule H, Part I, Line 6a Community benefit report prepared by related organization | The organization prepares and files the annual statement of community benefit standards report with the Texas Department of State Health Services. The Texas Department of State Health Services Report utilizes different reporting rules, which may result in differing amounts of community benefit compared to this report. In addition, the organization provides a community benefit report on a monthly and annual basis to Ascension Health, a related organization. |
| Schedule H, Part I, Line 7g Subsidized Health Services | The organization contracts with physicians who provide services at the community and rural clinics. The associated costs and charges relating to physician services are included in all relevant categories in Part I. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The Organization uses a cost accounting system that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self-pay). The best available data was used to calculate the amounts reported in the table. For certain categories in the table, this was a cost accounting system; in other categories, a specific cost-to-charge ratio was applied. See further response in Schedule H, Part VI, Line 2. |
| Schedule H, Part II Community Building Activities | COMMUNITY BENEFIT/OBJECTIVE Improve the quality of life for the most vulnerable among us, help break the cycle of poverty that exists in disadvantaged families, and positively impact community health needs identified by the Community Health Needs Assessment. VULNERABLE POPULATION: The number of vulnerable members of Central Texas' population - children, the aged, and households that cannot afford quality health care or are uninsured - is increasing. For example, the percentage of households in the region who are living below the US Poverty level is 10%. In addition, 16% of those aged under 65 in Central Texas are uninsured in 2015, creating significant barriers to access health care. In 2015, 19% of Central Texas children age 6-17 were uninsured. More than half of uninsured children are eligible for public programs, but are not enrolled. This statistic is important because Hispanics are currently 32.1% of the population and are expected to be more 33.1% of the population by 2021. In addition, the Community Health Needs Assessments for Seton's 11 county areas identified four distinct health needs impacting Central Texas: access to care, chronic disease, behavioral health, and obesity. Community Building Activities: Seton has provided funding for the following initiatives related to the community benefit objective described above. Seton did not award these funds for marketing purposes, to increase the referral of patients with third-party insurance coverage, in fulfillment of regulatory requirements or current standard of care, or to benefit persons associated with the organization. In FY15, Seton provided a total of $3,212,646 in charitable contributions towards various community needs. Physical Improvements and Housing: In FY15, Seton contributed $25,950 toward initiatives including, but not limited to, the provision or rehabilitation of housing for vulnerable populations, such as removing building materials that harm the health of the residents, neighborhood improvement or revitalization projects, provision of housing for vulnerable patients upon discharge from an inpatient facility, housing for low-income seniors, and the development or maintenance of parks and playgrounds to promote physical activity. The organizations listed below received the total amount indicated above. - Foundation Communities - Ronald McDonald Charities of Central Texas - Caritas of Austin - Front Steps - Helping Hand Home for Children - Housing Works Austin - The Arc of the Capital Area - Saint Louise House - Annunciation Maternity Home Economic Development: In FY15, Seton contributed $40,410 toward initiatives including, but not limited to, assisting small business development in neighborhoods with vulnerable populations and creating new employment opportunities in areas with high rates of joblessness. The organizations listed below received the total amount indicated above. - Austin Chamber of Commerce - Austin Asian American Chamber of Commerce. - Capital City African American Chamber - Greater Austin Hispanic Chamber of Commerce - Austin Young Chamber of Commerce Community Support: In FY15, Seton contributed $51,000 toward initiatives including, but not limited to, child care and mentoring programs for vulnerable populations, neighborhood support groups, violence prevention programs, disaster readiness and public health emergency activities. The organizations listed below received the total amount indicated above. - Anti-Defamation League - Allies Against Slavery - YMCA of Greater Austin - Austin Partners in Education - Austin Child Guidance Center - African American Youth Harvest Foundation - The Austin Project - Classroom for Kids - Communities in Schools - SafePlace - Austin/Travis County Health and Human Services Department - AGE of Central Texas - Council on At Risk Youth (CARY) - Candlelight Ranch - Asian Family Support Services of Austin - Big Brothers Big Sisters of Central Texas - Open Door Preschool Environmental Improvement: In FY15, Seton contributed $1,750 toward initiatives including, but not limited to, activities that prevent environmental hazards that affect community health and safe removal of waste products. The organization listed below received the total amount indicated above. - Clean Air Force of Central Texas Leadership Development and Training for Community Members: In FY15, Seton contributed $9,250 toward initiatives including, but not limited to, training in conflict resolution; civic, cultural, or language skills; and medical interpreter skills for community residents. The organizations listed below received the total amount indicated above. - Leadership Austin - Austin Under 40 - The Texas Lyceum Coalition Building: In FY15, Seton contributed over $27,500 toward initiatives including, but not limited to, participation in community coalitions and other collaborative efforts with the community to address health and safety issues. The organizations listed below received the total amount indicated above. - Interfaith Action of Central Texas - Austin Area Urban League, Inc. - Austin Area Heritage Council - Texas Diversity Council Community Health Improvement Advocacy: In FY15, Seton contributed $84,000 toward initiatives including, but not limited to, efforts to support policies and programs to safeguard or improve public health, access to health care services, housing, the environment, and transportation. The organizations listed below received the total amount indicated above. - American Heart Association - American Cancer Society - Congressional Hispanic Caucus Institute - Center for Public Policy Priorities - Community Key - Leukemia & Lymphoma Society - NAMI Austin - Texas Mamma Jamma - Texans Standing Tall - American Diabetes Association - Alzheimer's Association Capital of Texas Chapter - Cystic Fibrosis Foundation Workforce Development: In FY15, Seton contributed $22,000 toward initiatives including, but not limited to, recruitment of physicians and other health professionals to medical shortage areas or other areas designated as underserved, and collaboration with educational institutions to train and recruit health professionals needed in the community. The organizations listed below received the total amount indicated above. - San Juan Diego Catholic High School - The National Society of Hispanic MBAs - Latino Leaders of America - Capital IDEA - Austin Community College Center for Public Policy and Political Studies |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | The Organization is part of the Seton Healthcare Family consolidated audit. The footnote that references bad debt expense in the June 30, 2015 consolidated audit is as follows: The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, Seton follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with Seton's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | Seton Family of Hospitals follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Amounts reported on line 6 were determined based on the Medicare cost report, which uses a combination of per diem and cost to charge ratio to determine costs. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | The Organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. A patient's eligibility for charity care/financial assistance may be determined at any point in the collection cycle. Collection agency agreements include language that requires adherence to Seton's/Ascension's billing and collection policies, and support the process by advising patients about the availability of financial assistance/charity care, providing patients with the application, and/or assisting with the completion process. |
| Schedule H, Part VI, Line 2 Needs assessment | Needs Assessment Process Seton Family of Hospitals (Seton) conducts a Community Health Needs Assessment once every three years, with updates made annually for Seton's Integrated Strategic Operation Financial Plan. The organization's Community Benefit Steering Committee is the assessment's sponsoring entity. The assessment is conducted by Seton's in-house planning staff using a variety of resources, including Texas Department of State Health Services, U.S. Census Bureau and other reference material. A comprehensive overview of the assessment is made available to the Seton Board of Trustees, the key audience for the report. There were seven Community Health Needs Assessments (CHNA) created in FY13 for the communities served by Seton Healthcare Family. The basis of the CHNA was a review and analysis of all primary health care data available for a 12-county area. Seton's planning department distilled the information into a series of charts and graphs with an easy-to-read analysis of the primary data. In Williamson County, Seton participated in a community needs assessment process conducted by the Williamson County and Cities Healthcare District. As a result, the Williamson County Needs Assessment was conducted with other hospital facilities - Baylor Scott and White Healthcare and St. David's Healthcare. In Travis County, Seton participated in a community needs assessment process conducted by Austin/Travis County Health and Human Services. As a result, the Travis County Needs Assessment was conducted with other hospital facilities including St. David's Healthcare, and other health related organizations, social service agencies, community leaders and area residents. Once the primary data collection was completed, Seton leveraged the local knowledge and expertise of the existing community collaborations created during the past 10 years to collect secondary data on the community's health needs. Community summits and community surveys were used to engage residents, public health officials, and other non-profit, government, and business stakeholders to provide insight on health needs identified in the CHNA. For one of its hospitals, Seton Shoal Creek (SSC), Seton chose not to address all of the health needs identified in the CHNA. SSC is a behavioral health hospital that offers mental health and substance abuse services. Given the behavioral health and substance abuse scope and mission of SSC, obesity and chronic disease treatment fall outside the realm of the hospital's direct service capabilities. While SSC does not have programs directly focused on these areas of need, SSC does participate in many collaborative efforts to provide behavioral health services as part of a multidisciplinary approach to obesity and chronic disease treatment, including oncology. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | The following describes how the organization informs and educates the patients and persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under the Organization's charity care program: - Eligibility for charity care may be determined at any point in the revenue cycle. - Post a summary of the Charity Care Policy (in both English and Spanish) and financial assistance contact information in admissions areas, emergency departments and other areas of the Organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in patient financial services reception areas. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, crime victims, COBRA, county indigent, Veterans benefits, third party liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's Insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor. - A significant percentage of our patient access and patient financial service customer service representatives are fluent in both English and Spanish. - Patient access employees and patient financial service customer service representatives are trained (including at least annual updates) on eligibility criteria for financial assistance and various potential federal, state, and/or local government funding programs, including but not limited to Medicaid, CHIP, SSI, county indigent, crime victims, COBRA, Veterans benefits, third party liability, etc. - Seton utilizes the patient account rank order (PARO) score to identify patients who are eligible for financial assistance who did not apply through the avenues outlined above. (THE PARO score is a presumptive financial means score that utilizes and analyzes demographic and public financial databases to evaluate and quantify the patient's ability to pay a medical bill). - In addition to assistance with potential funding sources, governmental programs and charity care/financial assistance, efforts are made to enroll and link patients with primary care homes. - Include a summary of the Charity Care Policy, application form, and financial assistance contact information (in either English or Spanish) with other discharge materials provided to patients. - financial assistance contact information is included on patient statements. - all revenue cycle business partners (primary and secondary collection agencies, eligibility vendor, etc.) are contractually required to follow Seton's and Ascension's billing and collection policies, including notification of the availability of financial assistance. |
| Schedule H, Part VI, Line 4 Community information | Geographic Area Seton Family of Hospitals (Seton) serves an 11-county area, covering 9,645 square miles in central Texas and divided into regions: - West Region: Burnet, Llano and Blanco Counties - North Region: Williamson County - Central Region: Travis County (home to Texas' state capital, Austin) - South Region: Hays and Caldwell Counties - East Region: Lee, Bastrop, Fayette and Gonzales Counties In 2015, there were 1.9 million people living in the region; this number is expected to grow to 2.4 million by 2021. Seton's service area includes the rapidly growing urban Austin-Round Rock metropolitan area (Bastrop, Caldwell, Hays, Travis and Williamson Counties), as well as sparsely-populated rural areas with less convenient access to health care. More than 94% of the persons receiving inpatient care from Seton reside in this 11-county service area. Seton manages hospitals in six of the 11 counties; patients from the other five counties travel to access care in Seton facilities. SERVICE PROVIDED/OTHER HEALTH CARE PROVIDERS Seton is a not-for-profit health care system that serves the community via 11 hospitals: six general medical-surgical hospitals, a children's hospital, three hospitals in rural areas and a psychiatric hospital. Seton provides 40% of the inpatient care in the area. Seton provides a number of distinctive services in the region: the only Level I adult and pediatric trauma facilities, the only free-standing children's hospital, the only free-standing psychiatric hospital, and the only heart transplant center. Three of the system's hospitals are tertiary care facilities that serve the entire 11-county area with a broad array of services that can address the most complex health care needs: Seton Medical Center Austin, University Medical Center Brackenridge, and Dell Children's Medical Center of Central Texas. Seton Edgar B. Davis Hospital and Seton Highland Lakes Hospital are designated critical access hospitals and, as such, are the sole hospitals in their respective rural communities, Caldwell and Burnet counties. Seton also provides home health care and hospice care in rural Burnet County. The remaining general medical-surgical hospitals (Seton Northwest Hospital, Seton Southwest Hospital, Seton Medical Center Williamson, and Seton Medical Center Hays) serve residents from a smaller area surrounding each facility. However, Seton Medical Center Williamson and Seton Medical Center Hays have the technology and clinical capability to serve a wider area as the demands of the region increase due to population growth and aging of the population. Seton provides ambulatory care via three safety net community clinics in Austin and a network of Rural Health Clinics in both the south and west parts of the service area. Seton is developing a system of physician practices with both primary care physicians and sub-specialists. Seton has 517 employed providers (physicians, advance practice nurses, and physician assistants) in addition to about 264 medical residents. There are 2,330 physicians who are credentialed to practice in Seton hospitals with approximately 348 of that total being employed. The other major hospital provider in the area is HCA/St. David's Healthcare System, a for-profit system with five hospitals and 41.2% market share. Baylor Scott & White Healthcare system, a multi-hospital system regionally based in Temple, has several hospitals within Seton's service area and has 5.0% market share. There are other hospitals in the area; these are a mix of for-profit, public, and not-for-profit. POPULATION CHARACTERISTICS The Central Texas region is comparatively young, but growing older. In 2015, the largest percentage of the population - 44.7% - were aged 15 to 44 years; that percentage is expected to drop to 43.4% in 2020. In 2015, persons 65 years and older constituted 9.9% of the population; by 2020 that demographic will grow to 11.45%. Young people from infant to 14 years represent 21.0% of the region's population in 2015; their share of the population will remain steady at 20.68%in 2020. In 2015, persons aged 45 to 64 were 23.1% of the region's population; by 2021, they will represent 23.0% of the region's population. The rural areas of the region tend to have older populations than the urban/suburban core. In the years ahead, the growth of older populations in the region will present a multitude of challenges, including an expected increase in demand for health care services. The diversity of the region is increasing. Non-Hispanic Anglos are 52.6% of the population in 2015 and are expected to be 50.2% of the population in 5 years. Hispanics are 33.6% of the population, and expected to be 35.8% by 2020. The region is remarkably well educated. Central Texas residents possess higher levels of educational attainment than either Texas or the United States. Today, more than 88% of all adult residents are high school graduates; more than 39% possess a bachelor's degree; and close to 13% hold a professional degree. Although the region has not been entirely immune to the recent economic downturn, the regional economy continues to outperform most other US communities. At 3.4%, the Austin Metropolitan Area's December 2014 unemployment rate was 1.4% below the national average. Most detrimental economic effects are readily apparent in statistics concerning median household income. Adjusted for inflation, median household income in the Austin metropolitan region dropped from $63,000 in the mid-2000's to $53,946 in 2009-2013. While Texas and the US also experienced declines in median household income, neither was as severe as the Austin region. Yet median household income in the Austin metropolitan region remains more than 13 percent higher than the national figure and 11 percent higher than the Texas figure. The percentage of households in the region who are living below the US Poverty level is 10%. In addition, 16% of those aged under 65 in central Texas are uninsured in 2015, creating significant barriers to access health care. In 2015, 19% of central Texas children age 6-17 were uninsured. More than half of uninsured children are eligible for public programs, but are not enrolled. Data regarding inpatient discharges in the region illustrates the impact these insurance coverage rates have on Seton's operations. Seton serves a disproportionate market share of Medicaid and self-pay patients. While the hospital system serves 42.4% of the total inpatient needs of the Community, it also supports 52.3% of Medicaid patients and 54.6% of self-pay patients. Specifically: - Medicare reimburses for 38.1% of inpatient discharges in central Texas. With an aging population, the percentage of patients covered by Medicare will continue to increase. - Medicaid reimburses for 16.5% of inpatient discharges in the region, while commercial insurance covers 34.8% of discharges. Employer-sponsored Insurance had been declining over the last 10 years. - Self-pay and "other" accounts for 10.7% of central Texas resident discharges. While 18.9% of central Texas' under-65 population is uninsured, many more are under-insured in programs that do not cover the costs of care. |
| Schedule H, Part VI, Line 5 Promotion of community health | Composition of the Governing Body - A majority of the members of Seton Family of Hospitals' governing board reside in the organization's primary service area. Medical Staff Privileges - Staff privileges at Seton facilities are open to all qualified physicians in the community, subject to completing a Seton-specific credentialing process to ensure that the physician meets all required licensing and experience requirements for the position. Use of Surplus Funds - Any surplus funds generated from Seton's operations are reinvested in the organization's activities, including patient care, medical education and research. Detailed descriptions of these programs and activities can be found in the narratives addressing Schedule H, Part II, Community Building Activities, Form 990, Part III, Line 4a, and questions 2 through 4 of Schedule H, Part VI. Below are some of the organizations Seton has used surplus funds to help address prioritized community health needs. Community Health Need: Obesity Obesity was identified as a community health need across the seven community health needs assessments that Seton participated in. While each community was unique in how they felt obesity could be addressed, Seton has identified various implementation strategies to help combat the increasing obesity trend. In an attempt to not duplicate efforts, Seton recognizes many city municipalities, local school districts, and local non-profits are working to reduce the obesity rate in our community. Below is a list of some community partners Seton supported with donations to help address this community health need: - YMCA of Greater Austin - Children's Optimal Health - Sustainable Food Center Community Health Need: Chronic Disease and Disease Management All of the Community Health Needs Assessments identified chronic disease and disease management as a priority health issue facing residents of their County. For the past six years, the top three causes of death in Central Texas have been related to chronic disease. With many communities landing above national benchmarks for chronic disease - specifically diabetes, heart disease, and cancer - several opportunities exist for meeting this community health need. Below is a list of some community partners Seton supported with donations to help address this community health need: - American Heart Association - American Cancer Society - Leukemia & Lymphoma Society - Texas Mamma Jamma - Texans Standing Tall - American Diabetes Association - Alzheimer's Association Capital of Texas Chapter - Cystic Fibrosis Foundation Community Health Need: Behavioral Health Mental and behavioral health was one of the foremost health concerns raised by all of the communities represented in all of the Community Health Needs Assessments. This included substance abuse, an inadequate number of mental health providers and a lack of behavioral health resources. Below is a list of some community partners Seton supported with donations to help address this community health need: - NAMI Austin - Caritas of Austin - Austin Travis County Integral Care - Foundation Communities - Austin Child Guidance Center Community Health Need: Access to Care A gap consistently identified across all the CHNAs was access to care. This overarching need includes a multitude of factors including lack of providers for the uninsured and underinsured, the high cost of care, education on service navigation, limited specialty care or services, lack of insurance coverage, and transportation-related issues. Below is a list of some community partners Seton supported with donations to help address this community health need: - CommuniCare Health Centers (Barrio Comprehensive Family Health Center) - Lone Star Circle of Care - People's Community Clinic Community Health Need: Community Collaboration Increasing and improving community collaboration to improve the health and well-being of individuals was also identified as a need across all communities. Below is a list of some community partners Seton supported with donations to help address this community health need: - Integrated Care Collaborative (ICC) - Community Care Collaborative (CCC) - Children's Optimal Health (COH) - Interfaith Action of Central Texas - Austin Area Urban League, Inc. - Austin Area Heritage Council - Capital IDEA |
| Schedule H, Part VI, Line 6 Affiliated health care system | Seton Healthcare Family (Seton) is a member of Ascension Health. In December 2011, Ascension Health Alliance, doing business as Ascension, became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 states and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension serves as the member or shareholder of various other subsidiaries. Ascension, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System. Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. Seton, located in Austin, Texas, is a nonprofit system that organizes, develops, coordinates and delivers a complex, full continuum of healthcare services for residents of Austin and the surrounding area. Admitting physicians are primarily practitioners in the local area. Seton is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health are related to providing health care services. MISSION: The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: 1. Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. 2. Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for the persons living in poverty and other vulnerable persons. 3. Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. 4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated using internal cost data and is estimated by reducing charges forgone by a factor derived from the ratio total operating expenses to billed charges for patient care. Certain costs such as graduate medical education and certain other activities are excluded from total operating expense for purposes of this computation. The amount of traditional charity care provided, determined on the basis of cost, was approximately $160.0 million and $163.1 million for the years ended June 30, 2015 and 2014, respectively. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying supplementary information. AFFILIATES OF SETON HEALTHCARE FAMILY Seton Healthcare Family operates several affiliated entities. A full list of the individual entities within Seton are as follows: SETON FAMILY OF HOSPITALS - Dell Children's Medical Center - Seton Medical Center Austin - Seton Shoal Creek Hospital - Seton Northwest Hospital - Seton Highland Lakes Hospital - Seton Medical Center Williamson - Seton Southwest Hospital - Seton Edgar B. Davis Hospital - Seton Medical Center Hays - Seton Smithville Regional Hospital - Towers Nursing Home - University Medical Center Brackenbridge OTHER PATIENT CARE OPERATIONS Physician Enterprise - 'Specially for Children Children's Hospital Subspecialists of Central Texas - Pediatric Critical Care Associates - Pediatric Surgical Subspecialists - Austin Children's Chest Associates II - Institute of Reconstructive Plastic Surgery of Central Texas - Seton Management Services Organization - Seton Brain and Spine Institute - Dell Children's Health Alliance (f/k/a Seton Family of Pediatricians) - Seton Family of Pediatric Surgeons - Seton Family of Physicians - Seton ENT - Healthcare Collaborative - Adult Inpatient Medical Services |
| Schedule H, Part VI, Line 7 State filing of community benefit report | TX |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| Ascension Health Council on Philanthropy (AHCOP) | ||||||||
| 1444 Massachusetts Ave | troy | NY | 12180 | $5,625 | INTERNAL CONFERENCE | |||
| austin interfaith sponsoring committee incorporated | ||||||||
| 1301 S IH 35 STE 313 | Austin | TX | 78726 | $10,000 | SUPPORT LOCAL FAITH BASED AND SOCIAL JUSTICE INITIATIVES | 742389210 | 501(c)(3) | |
| barrio comprehensive family health care center | ||||||||
| 3066 E Commerce | San Antonio | TX | 78220 | $500,000 | ACCESS TO CARE | 741724391 | 501(c)(3) | |
| Greater Austin Black Chamber of Commerce | ||||||||
| 912 E 11th St STE A | Austin | TX | 78702 | $5,500 | SUPPORT DIVERSE COMMUNITIES AND ECONOMIC DEVELOPMENT | 742330169 | 501(c)(6) | |
| Con Mi Madre | ||||||||
| 1925 San Jacinto Blvd | austin | TX | 78712 | $6,000 | COLLEGE READINESS FOR YOUNG LATINA WOMEN | 262034766 | 501(c)(3) | |
| Emilyann Theater Inc | ||||||||
| PO BOX 801 | Wimberly | TX | 78676 | $5,500 | MARKETING | 742862924 | 501(c)(3) | |
| The DAISY Foundation | ||||||||
| 11995 Dunbar Rd | Glen Ellen | CA | 95442 | $8,350 | AWARD FOR INTERNAL NURSES | 912009739 | 501(c)(3) | |
| foundation communities | ||||||||
| 3036 S 1st St STE 200 | austin | TX | 78704 | $50,000 | BEHAVIORAL HEALTH | 742539401 | 501(c)(3) | |
| Integrated Care Collaboration | ||||||||
| 8627 N Mopac Expressway STE 300 | Austin | TX | 787598362 | $678,352 | COMMUNITY COLLABORATION | 311624871 | 501(c)(3) | |
| Leadership Austin | ||||||||
| 1609 shoal Creek Blvd STE 202 | Austin | TX | 78701 | $10,000 | DEVELOP LEADERS TO FURTHER CIVIC ENGAGEMENT AND IMPACT COMMUNITIES SERVED | 742967463 | 501(c)(3) | |
| March of Dimes Foundation | ||||||||
| 11044 Research BLVD STE A-2100 | Austin | TX | 78759 | $40,000 | PREMATURE BIRTH PREVENTION | 131846366 | 501(c)(3) | |
| Principle Broadcasting foundation | ||||||||
| PO BOX 117 | Dripping Springs | TX | 78620 | $7,500 | MARKETING | 742934151 | N/A | |
| Revolution Soccer Club | ||||||||
| PO BOX 1404 | Pflugerville | TX | 78691 | $25,000 | MARKETING | 830395956 | 501(c)(3) | |
| Round Rock Chamber of Commerce Inc | ||||||||
| 212 East Main St | Round Rock | TX | 78664 | $12,500 | COMMUNITY ENGAGEMENT AND ECONOMIC DEVELOPMENT | 741983423 | 501(c)(6) | |
| San Juan Diego Catholic High School | ||||||||
| 800 Herndon Lane | Austin | TX | 78750 | $60,000 | INTERNSHIP PROGRAM | 710866044 | 501(c)(3) | |
| Santa Cruz Catholic School | ||||||||
| 1100 Main St | Buda | TX | 78610 | $6,000 | MARKETING | 260217637 | 501(C)(3) | |
| Texas A & M University | ||||||||
| Clinical BLDG 1 | bryan | TX | 77807 | $250,000 | SUPPORT FOR EDUCATION AND WORKFORCE DEVELOPMENT | 746000531 | Gov't | 8441 ST HWY 47 STE 3100 |
| Texas Tech University Health Sciences Center | ||||||||
| 3601 4th St MS 7755 | Lubbock | TX | 79430 | $200,000 | MARKETING | 756002622 | 501(c)(6) | |
| The John Paul II Life Center | ||||||||
| 1600 W 38th St | Austin | TX | 78731 | $37,500 | PRENATAL RESOURCES AND SUPPORT | 208785471 | 501(c)(3) | |
| The university of texas at austin | ||||||||
| 1 University Station A 8000 | Austin | TX | 787120187 | $70,000 | SUPPORT EDUCATION AND WORKFORCE DEVELOPMENT | 746000203 | Gov't | |
| YMCA of Greater WIlliamson County | ||||||||
| PO BOX 819 | Round rock | TX | 78680 | $41,550 | HEALTHY LIFESTYLES AND HEALTH PROMOTION | 742206558 | 501(c)(3) | |
| spinehope | ||||||||
| PO BOX 684261 | AUstin | TX | 78768 | $10,000 | SUPPORT CHILDREN WITH SPINAL DEFORMITIES | 262126362 | 501(c)(3) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 17 | Total501c3OrgCnt |
| Total Other Org | 5 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Nurse Scholarship | GrantTypeTxt |
| Recipient | 36 | RecipientCnt |
| Cash Grant | $108,000 | CashGrantAmt |
| Non Cash Assistance | 2014 Nurse Scholarship Recipients | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds | The Seton Healthy Communities Fund Committee is responsible for the administration of grant funds. The Committee includes employees as well as executives and is charged with reviewing requests from other organizations and determining whether they meet the Network's charitable request guidelines. The requesting organizations submit letters specifying the amount of contribution requested and details of its program. Each entity must provide its IRS 501(c)(3) determination letter (as evidence of tax-exempt status), a history of its use of funds, a list of other funding sources and a list of Board of Directors. Requestors also are asked to identify the Organization's purpose, the activities that reflect consistency with its stated purpose and provide a description as to how funds will be used. Generally, a successful requesting organization will spend at least 60 percent of its annual expenses on program activities, ensure that fundraising expenses are reasonable over time and will not have a persistent deficit in net current assets. In awarding funds, the Grants Committee looks for organizations that: - Have a mission aligned with Seton's mission, vision and values (e.g.: improving the health of those we serve, particularly the poor and vulnerable); - Can demonstrate that the event or activity will enhance access to health-related services and human service needs; improve health outcomes; provide health-related education, information and support; and/or offer sustainable impact; - Provide outreach in Seton's service area; Support a diverse population; support workforce development and/or help sustain a relationship with a potential or existing Seton stakeholder. Generally, the committee, pursuant to its policies and procedures, confirms prior to any award that grantees are organizations whose headquarters and work are based in Central Texas, or the work for which we granted them a sponsorship is in Central Texas, and post-award we generally receive confirmation of how the funds were used. |
| Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | The Seton Healthy Communities Fund Committee is responsible for the administration of grant funds. The Committee includes employees as well as executives and is charged with reviewing requests from other organizations and determining whether they meet the Network's charitable request guidelines. The requesting organizations submit letters specifying the amount of contribution requested and details of its program. Each entity must provide its IRS 501(c)(3) determination letter (as evidence of tax-exempt status), a history of its use of funds, a list of other funding sources and a list of Board of Directors. Requestors also are asked to identify the Organization's purpose, the activities that reflect consistency with its stated purpose and provide a description as to how funds will be used. Generally, a successful requesting organization will spend at least 60 percent of its annual expenses on program activities, ensure that fundraising expenses are reasonable over time and will not have a persistent deficit in net current assets. In awarding funds, the Grants Committee looks for organizations that: - Have a mission aligned with Seton's mission, vision and values (e.g.: improving the health of those we serve, particularly the poor and vulnerable); - Can demonstrate that the event or activity will enhance access to health-related services and human service needs; improve health outcomes; provide health-related education, information and support; and/or offer sustainable impact; - Provide outreach in Seton's service area; Support a diverse population; support workforce development and/or help sustain a relationship with a potential or existing Seton stakeholder. Generally, the committee, pursuant to its policies and procedures, confirms prior to any award that grantees are organizations whose headquarters and work are based in Central Texas, or the work for which we granted them a sponsorship is in Central Texas, and post-award we generally receive confirmation of how the funds were used. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHELLE ROBERTSON | ||||||||||||||
| ACTING PRESIDENT & CEO (START 11/14) (Sch. O) | $412,926 | $0 | $204,520 | $0 | $50,644 | $0 | $7,800 | $0 | $4,600 | $0 | $680,490 | $0 | $47,279 | $0 |
| JESUS GARZA | ||||||||||||||
| PRESIDENT & CEO SHF/TRUSTEE (SCH O) | $817,619 | $0 | $1,259,430 | $0 | $151,598 | $0 | $7,800 | $0 | $27,735 | $0 | $2,264,182 | $0 | $129,140 | $0 |
| THOMAS E GALLAGHER | ||||||||||||||
| ACTING CFO/TRUSTEE (SCH O) | $600,398 | $0 | $432,580 | $0 | $102,490 | $0 | $7,800 | $0 | $26,190 | $0 | $1,169,458 | $0 | $65,930 | $0 |
| GREGORY SHEFF MD | ||||||||||||||
| TRUSTEE (SCH O) | $496,217 | $0 | $147,280 | $0 | $58,681 | $0 | $7,800 | $0 | $14,554 | $0 | $724,532 | $0 | $54,691 | $0 |
| CHARLES J BARNETT | ||||||||||||||
| TRUSTEE (END 2/15) (SCH O) | $551,931 | $0 | $1,421,180 | $0 | $205,210 | $0 | $7,800 | $0 | $32,446 | $0 | $2,218,567 | $0 | $171,669 | $0 |
| TRAVIS FROEHLICH | ||||||||||||||
| TRUSTEE (SCH O) | $139,850 | $0 | $141,585 | $0 | $169,017 | $0 | $2,795 | $0 | $16,831 | $0 | $470,078 | $0 | $0 | $0 |
| TIMOTHY GEORGE MD | ||||||||||||||
| TRUSTEE (SCH. O) | $0 | $1,264,400 | $0 | $0 | $0 | $2,708 | $0 | $2,497 | $0 | $25,803 | $0 | $1,295,408 | $0 | $0 |
| JAMES O LINDSEY MD | ||||||||||||||
| TRUSTEE/VP MED AFFAIRS (SCH O) | $0 | $0 | $55,886 | $0 | $413,779 | $0 | $0 | $0 | $13,107 | $0 | $482,772 | $0 | $0 | $0 |
| YVONNE VANDYKE | ||||||||||||||
| TRUSTEE (SCH O) | $272,734 | $0 | $128,015 | $0 | $25,242 | $0 | $7,800 | $0 | $13,393 | $0 | $447,184 | $0 | $16,446 | $0 |
| PAULA CAMPBELL | ||||||||||||||
| FORMER OFFICER (END 5/14) | $217,622 | $0 | $242,200 | $0 | $321,024 | $0 | $5,102 | $0 | $13,641 | $0 | $799,589 | $0 | $33,114 | $0 |
| GERALD HILL | ||||||||||||||
| FORMER OFFICER (END 6/11) | $0 | $120,855 | $0 | $0 | $0 | $0 | $0 | $2,588 | $0 | $11,629 | $0 | $135,072 | $0 | $0 |
| DOUGLAS D WAITE | ||||||||||||||
| FORMER OFFICER (END 6/13) | $0 | $0 | $68,453 | $0 | $508,260 | $0 | $0 | $0 | $12,826 | $0 | $589,539 | $0 | $0 | $0 |
| ALAN STRAUSS | ||||||||||||||
| CFO (start 11/14) | $5,065 | $501,703 | $0 | $535,825 | $0 | $142,343 | $0 | $7,800 | $0 | $11,205 | $5,065 | $1,198,876 | $0 | $0 |
| JOHN BRINDLEY | ||||||||||||||
| PRES. & CEO SMCA & SSC | $484,230 | $0 | $350,585 | $0 | $65,599 | $0 | $7,800 | $0 | $22,190 | $0 | $930,404 | $0 | $0 | $0 |
| GREGORY HARTMAN | ||||||||||||||
| PRES. & CEO UMB/CEC/CAMP | $470,845 | $0 | $341,561 | $0 | $57,434 | $0 | $7,800 | $0 | $19,738 | $0 | $897,378 | $0 | $0 | $0 |
| ROBERT BONAR JR MD | ||||||||||||||
| PRESIDENT & CEO - SFH/DELL | $563,489 | $0 | $431,987 | $0 | $90,495 | $0 | $7,800 | $0 | $24,070 | $0 | $1,117,841 | $0 | $67,114 | $0 |
| CHRISTOPHER HARTLE | ||||||||||||||
| SR. VP MANAGED CARE | $429,836 | $0 | $220,311 | $0 | $46,081 | $0 | $7,800 | $0 | $18,549 | $0 | $722,577 | $0 | $42,550 | $0 |
| TRENNIS JONES | ||||||||||||||
| SR. VP/CHIEF ADMIN. OFFICER | $206,972 | $0 | $222,890 | $0 | $292,270 | $0 | $5,310 | $0 | $9,039 | $0 | $736,481 | $0 | $36,090 | $0 |
| TIMOTHY LEE LAFREY | ||||||||||||||
| CHIEF OPERATIONS OFFICER | $612,112 | $0 | $356,923 | $0 | $83,786 | $0 | $7,800 | $0 | $9,220 | $0 | $1,069,841 | $0 | $70,930 | $0 |
| FRANK MAZZA | ||||||||||||||
| ASSOC. CHIEF MED OFFICER | $118,136 | $0 | $94,245 | $0 | $467,465 | $0 | $4,011 | $0 | $15,284 | $0 | $699,141 | $0 | $19,587 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a Travel for companions | Travel expense reimbursements are made for business travel according to our accountable plan. If travel expense reimbursements are requested by senior leadership for companions who travel as required for business, these amounts are added as compensation to the employee's W-2. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | Ascension Health, a related organization of Seton Family of Hospitals, uses the following methods to establish the compensation of the Organization's CEO: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the Organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The Organization that paid the salaries of the individuals listed in Schedule J, Part II, paid out of the supplemental nonqualified retirement plan in the amounts as noted: Michelle Robertson - $47,279 Thomas Gallagher - $65,930 Gregory Sheff - $54,691 Charles J. Barnett - $171,669 Jesus Garza - $129,140 Yvonne Vandyke - $16,446 Paula Campbell - $33,114 Robert Bonar, Jr. - $67,114 Christopher Hartle - $42,550 Trennis Jones - $36,090 Timothy Lee Lafrey - $70,930 Frank Mazza - $19,587 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (29 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part I, Line 1 Doing Business As | Seton Healthcare Associates Brackenridge Hospital Volunteers Brackenridge Hospital Brackenridge Professional Building Brain and Spine Center at Brackenridge Hospital Caldwell County Physician Associates Childhood Cancer & Blood Disorders Center Children's Health Express Children's Hospital of Austin Auxiliary Children's Therapy Gym Dell Children's Craniofacial and Reconstructive Surgery Center Dell Children's Imaging Center Dell Children's Medical Center of Central Texas Dell Children's Medical Center Emergency Medical Group Friends Auxiliary of Seton Highland Lakes Good Health Commons Ignite Women's Health Insure a Kid Luling CRNA Group SEBD Children's Care-A-Van SEBD Professional Support Services Seton Bastrop Health Plaza Seton Bertram Healthcare Center Seton Bastrop Physical Therapy and Fitness Center Seton Burnet Healthcare Center Seton Cancer Screening Seton Cardiovascular Imaging Center Seton Central Outpatient Pharmacy Seton Community Health Centers Seton Diagnostic Center Seton Edgar B. Davis Hospital Volunteer Services Seton Edgar B. Davis Hospital Seton Family of Doctors Seton Family of Physicians Seton Health Plaza Seton Heart Specialty Care and Transplant Center Seton Highland Lakes Seton Highland Lakes Home Health Seton Highland Lakes Hospice Seton Highland Lakes Hospital and Health Centers Seton Highland Lakes Hospital Seton Highland Lakes Medical Group Seton Highland Lakes Rehabilitation Services Burnet Seton Highland Lakes Rehabilitation Services Marble Falls Seton Hospital Auxiliary Seton Kozmetsky Community Health Center Seton Lampasas Healthcare Center Seton League House Seton Lockhart Family Health Center Seton Luling Family Medicine Clinic Seton Marble Falls Diagnostic Center Seton Marble Falls Healthcare Center Seton McCarthy Community Health Center Seton Medical Center Austin Seton Medical Center Hays Seton Medical Center Outpatient Rehabilitation Seton Medical Center Williamson Outpatient Rehabilitation Services Seton Medical Center Williamson Community Care Van Seton Medical Center Williamson Pediatric Rehabilitation Services Seton Medical Center Williamson Volunteers Seton Medical Center Williamson Women's Imaging Seton Medical Center Williamson Seton Medical Center Seton Northwest Aquatic Therapy Seton Northwest Hospital Seton Northwest Sleep Lab Seton Northwest Sports Medicine and Hand Therapy Center Seton Northwest Volunteers Seton Northwest Seton Occupational Health Clinic Seton Pflugerville Healthcare Center Seton Pflugerville Seton Physical Therapy & Fitness Center Seton Premier Staffing Seton RiverBend Home Health Seton Shoal Creek Hospital Seton Smithville Regional Hospital Seton Southwest Hospital Seton Southwest Rehab and Sports Medicine Services Seton Southwest Volunteers Seton Topfer Community Health Center Seton Towers Nursing Home Seton Williamson Children's Therapy Gym at Cedar Park Seton Shivers Center SHL Care-A-Van SHL CRNA Group SHL Professional Support Services SMCA Sports and Neuro Rehab St. Vincent Healthcare Ventures Texas Child Study Center The Big Pink Bus The Children's Blood and Cancer Center The Clinical Education Center at Brackenridge Towers Nursing Home Trauma Medical Group University Medical Center at Brackenridge University Medical Center Brackenridge Seton Kingsland Healthcare Center |
| Form 990, Part III, Line 4a Program Service Description - Part 1 | Seton furthers this goal through delivery of inpatient services, ambulatory specialty services, care to the elderly and indigent, patient education, community health awareness programs, resident medical training and translational research. In addition to care delivery, navigation and support services for patients, Seton is working to innovate and redesign the healthcare delivery system, particularly for the poor and the vulnerable. Seton's concern for all human life and the dignity of each person leads the organization to provide medical services to people in the community irrespective of a patient's race, creed, national origin, economic status or ability to pay. Seton's community benefit contributions are described in detail to portray the full breadth and depth of the organization's commitment to the population it serves. Commitment to Providing Community Benefit Seton is a network of six general medical-surgical hospitals, a pediatric hospital, three rural hospitals, a mental health hospital, several strategically located outpatient service facilities, three primary community health care clinics targeted specifically for the uninsured with just over 1,761 licensed beds, and one home health agency, hospice and nursing home facility. Seton is the leading provider of healthcare services in Central Texas, serving an 11-county area of 1.9 million people, and seeks to improve the physical, mental, social and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, Seton has developed an array of programs to help achieve its mission. Seton serves a disproportionate market share of Medicaid and self-pay patients. While the hospital system serves 42.4% of the total inpatient needs of the community, it also supports 52.3% of Medicaid patients and 54.6% of self-pay patients in our service area. Specifically: - Medicare reimburses for 38.1% of inpatient discharges in Central Texas. With an aging population, the percentage of patients covered by Medicare will continue to increase. - Medicaid reimburses for 16.5% of inpatient discharges in Central Texas, while commercial insurance covers 34.8% of discharges. Employer-sponsored insurance has declined over the last 10 years. - Self-pay and "other" is the payer for 10.7% of Central Texas resident discharges. While 18.9% of Central Texas' under-65 population is uninsured, many more are under-insured in programs that do not cover the costs of care. Community Investments Two of the most significant investments Seton has made in the health and wellbeing of the community include Texas 1115 Healthcare Transformation Medicaid Waiver and the Community Care Collaborative (CCC). 1115 Waiver Delivery System Reform Incentive Payment (DSRIP) Seton provides 20 DSRIP projects through the Texas 1115 Medicaid Waiver, administered through the Texas Health and Human Services Commission (HHSC) and the Centers for Medicare and Medicaid Services (CMS). Many of the projects challenge patients and providers to approach care differently. All projects address one or more priorities identified on the 2012 Community Health Needs Assessments. All DSRIP projects are on track to successfully provide required outcomes and Seton receives payments based on achievement of metrics. In the first two years (Oct 2012 - Sept 2014) of DSRIP implementation, there were 265,478 patient encounters and 41,288 patients served. DSRIPs are designed to: - Care primarily for Medicaid recipients or low income individuals without insurance, - Improve the health of the population, - Lower costs through efficiencies and improvements. Areas of focus include: - Low income individuals, - Patients with chronic disease, - Special populations that are particularly vulnerable including children, pregnant women, homeless individuals, and those with behavioral health conditions. The start of the fifth and final year of the DSRIP projects timeline began in FY15. Seton is actively collecting outcome data on these projects. Seton has also taken an active leadership role across the state to extend DSRIP beyond September 30, 2016 to continue support and innovation to the Central Texas safety net. The 20 Seton DSRIP Projects: 1. Behavioral Health Assessment & Resource Navigation: Provide free behavioral health assessments and navigate individuals to community behavioral health providers. - Patient Impact: 5,720 Individuals - Target Population: University Medical Center Brackenridge inpatients (UMCB) and ED patients 2. Behavioral Health School Campus Counseling I: Increase access to behavioral health services on school campuses. - Patient Impact: 5,875 Individuals - Target Population: AISD school children 3. Behavioral Health School Campus Counseling II: Increase access to behavioral health services on school campuses. - Patient Impact: 590 Individuals - Target Population: AISD school children 4. Care Transitions: Coordinate and monitor care for patients with chronic diseases from hospital to home. - Patient Impact: 5,876 Individuals - Target Population: Adults discharged from a Seton hospital in Travis County |
| Form 990, Part III, Line 4a Program Service Description - Part 2 | 5. Chronic Care Management - Adults: Provide treatment and care coordination for adults with chronic condition(s) or serious injury. - Patient Impact: 2,600 Individuals - Target Population: Adults discharged from a Seton hospital in Travis County 6. Chronic Care Management - Community Clinics: Provide treatment and care coordination for adults with chronic condition(s) or serious injury. - Patient Impact: 2,350 Individuals - Target Population: Adults seen at Seton Community Clinics 7. Chronic Care Management - Pediatrics: Provide specialty treatment and care coordination for children with high disease complexity. - Patient Impact: 1,050 Individuals - Target Population: Children and adolescents 8. Culturally Competent Care Training: Provide staff training to increase awareness of the diverse populations and cultures served. - Patient Impact: 6,420,000 Encounters - Target Population: UMCB and later to include Seton Medical Center Austin (SMCA) & Seton Northwest Hospital (SNW) 9. Diabetes Chronic Care: Standardize testing routines for individuals at-risk or with diabetes and communicate the discharge plan directly to provide follow up. - Patient Impact: 9,500 Individuals - Target Population: Adult inpatients at UMCB, SNW, & SMCA 10. ED Patient Navigation: Navigate emergency department to a medical home. - Patient Impact: 400 Individuals - Target Population: Individuals who qualify for Burnet County or Seton Highland Lakes (SHL) Indigent Care 11. Family & Child Obesity: Deliver a multi-delivery approach to prevent and treat childhood obesity. - Patient Impact: 1,025 Individuals - Target Population: Travis County children, adolescents, and their families 12. Language Services Resource Center: Centralize language services and add qualified healthcare interpreters. - Patient Impact: 76,670 encounters - Target Population: Spanish-speaking UMCB patients; later other Seton hospitals in Travis County 13. Obstetrics Care Navigation: Provide pre- and post-natal navigation for Hispanic women. - Patient Impact: 600 individuals - Target Population: Hispanic women 14. Palliative Care Program: Create palliative care program for individuals with chronic or terminal illness. - Patient Impact: 6,239 encounters - Target Population: UMCB inpatients and/or community clinics patients 15. Post-Graduate Training for Psychiatric Specialties: Provide new psychiatric residencies and fellowships. - Patient Impact: 21,000 encounters - Target Population: Inpatients and outpatients throughout Travis County 16. Psychiatric Emergency Department: Create a new psychiatric emergency department. - Patient Impact: 5,475 individuals - Target Population: UMCB emergency department patients in psychiatric crisis 17. Psychiatric Telemedicine: Expand inpatient and ED telepsychiatry services. - Patient Impact: 1,859 encounters - Target Population: Patients at Seton hospitals in Travis County 18. Substance Use Disorder Navigation: Navigate individuals at risk of a substance use disorder to intervention and treatment. - Patient Impact: 3,917 encounters - Target Population: UMCB inpatients and emergency department patients 19. Women's Oncology Care Navigation: Provide navigation services from cancer diagnosis to treatment, as well as cancer survivorship support services for women. - Patient Impact: 450 individuals - Target Population: Travis County women receiving treatment at Shivers or cancer survivors 20. Women's Oncology Care Screening: Expand mobile mammography and cervical screenings. - Patient Impact: 8,762 individuals - Target Population: Women age 40-64 for breast cancer screenings and/or age 21-64 for cervical screening |
| Form 990, Part III, Line 4a Program Service Description - Part 3 | Community Care Collaborative (CCC) The CCC 501(c)(3) was created in July 2013 through a public-private partnership between Seton Healthcare Family and Central Health, the Travis County Health District, to provide a coordinated continuum of services to a defined patient population through a new integrated delivery system. This population includes approximately 75,000 uninsured adults residing in Travis County. Through CCC, healthcare providers in Travis County join together to provide patient centered care through a "no wrong door" approach. Wherever eligible patients present for care, be it the emergency room, community clinic or elsewhere, the system will provide care and navigation services to ensure individuals receive appropriate levels of services and are connected to a medical home. Some care is provided through 15 additional DSRIP projects delivered by CCC partners and contracted organizations. The system is building a coordinated continuum of services that is easily navigated by and feels seamless to the patient. The overarching goal of CCC is to provide the principles of CMS' triple aim of high quality, cost effective, patient centered care to improve health outcomes through expanded care coordination, types of care and patient management. In Fiscal Year 2015, CCC: 1) Formalized a plan for coordination of the Integrated Delivery System. 2) Conducted substantial evaluation of the existing Medical Assistance Program (MAP) Indigent Care Program, sliding fee scale and charity care programs. 3) Initiated development of a New Benefits Plan for the poor and the vulnerable covered population (up to 375% FPL) in Travis County. Expanding Awareness: Education and Health Promotion Recognizing that it is essential to educate people about the types of behavior that can improve healthy life styles, Seton has invested significantly in quality health education programs and materials. CPR: In FY15, Seton delivered CPR training to 10,981 persons in Central Texas, including Seton associates, personnel of the Austin, Del Valle, Eanes, Hays, Hutto, Lockhart, Pflugerville, Round Rock and Smithville school districts, local EMS personnel and many non-clinical citizens as well. Health Education: Seton offers healthcare related classes to local residents designed to support a persons' physical, mental, social and spiritual needs. Classes are targeted to specific populations and are offered at Seton point-of-service locations throughout the region. People can find these classes on Seton's webpage or through a referral. Many classes are free or available at reduced rates for seniors or uninsured patients. The Web class listing currently features classes or seminars in categories, including: - Essentials of childbirth, prepared childbirth, refresher Lamaze, baby care basics, breastfeeding - Breast cancer support group and educational breast cancer seminar, mammography, screening - Car seat safety - Children's heart support group - Childhood cancer - Clinical support groups - Cardiac, Stroke, Pulmonary and Bariatric - Community asthma program; school asthma program; family asthma class - Diabetes education and support group - Educational breast cancer seminar - First aid & CPR - Fitness - Health & safety fair (Family Extravaganza) - Heart care provider CPR - Heart screenings - Marathon training - Movement classes - Natural cooking - Nutrition - Osteoporosis diagnosis and treatment - Preoperative hip & knee replacement - Pulmonary rehabilitation - Self defense - Sibling class - Spiritual health - Urinary incontinence SetonBabyTalk.com is focused on perinatal and pediatric topics, where visitors can find information about Seton's birthing facilities, resources for a healthy pregnancy and find a doctor who delivers at Seton. The Ignite program focuses on education and screenings related to women's health and fitness. Health Education Services Throughout the year, Seton sponsors a number of health education presentations and ongoing services in the community. Cancer Care and Education In FY15, events supporting cancer care and education included: - Cancer Case Management Services: The Seton Cancer Care Team provides vital case management services plus a variety of physical, emotional and spiritual support programs to adult Central Texas cancer patients and their families. Oncology nurse navigators used navigation tracking systems to monitor, diagnose, and track outcome results for 2,586 patients in FY15. - Cancer Survivorship: The Cancer Survivorship team enrolled 162 new patients and provided navigation to 318 patients during FY15. Of these patients, 80% received a survivorship care plan and treatment summary within three months of enrolling in the program, 90% were established with a primary care provider within 12 months of enrolling in the program, and 64% began a wellness activity (improvement in diet or exercise) within 12 months of enrolling. |
| Form 990, Part III, Line 4a Program Service Description - Part 4 | - Support for Cancer and Other Health Conditions: Seton is also active in providing health education in a variety of other critical areas impacting cancer care, including nutrition and physical activity for the prevention and lowering of risk of cancer, as well as nutrition for cancer survivors. - Cancer Registry: The Seton Cancer Registry tracks all cancer diagnoses, treatment, and long term outcomes for any patient diagnosed or treated within Seton Healthcare Family. In FY15, the Seton Cancer Registry abstracted over 4,200 cases of cancer. - Breast Health and Cancer Awareness: Seton's Cancer Screening, Prevention and Early Detection Program provides reduced cost mobile mammography services to underserved Central Texas women at locations in their communities, supplemented by the Delivery System Reform Incentive Payment Program (DSRIP). In FY15, the program provided mobile mammography screenings to 2,639 underserved women. - Skin Cancer: Corporate and employee screening programs and participation in collaborative community education efforts, such as an annual skin cancer screening, also promote early detection. For example, in FY15 the 28th Annual City-Wide Skin Cancer Screening conducted by Seton, provided screenings for 208 persons. - Cervical Screening: Seton Cancer Screening also provided cervical screening to underserved Central Texas women providing Pap smears and follow up care to 550 women. All patients both screened and referred to Seton's Cancer Screening, Prevention and Early Detection Program are case managed by RN's that navigate patients to definitive diagnoses and specialty care. During FY15, Seton Cancer Screening navigated 1,586 patients. Support for Other Health Conditions Seton is also active in providing health education in a variety of other critical areas, including: - Seton Diabetes and Nutrition Education Center: In FY15, Seton held three free "Ask the Expert" programs for community members with diabetes, provided free blood glucose testing and risk factor counseling at twenty three health events (listed below) and delivered two public diabetes-prevention seminars for at-risk persons. We also provided dietitians to present "Stop Diabetes at Work" at multiple corporate worksites throughout the year. Presentations and education provided at: - Texas Department of Health and Human Services - Texas Association of School Boards - Texas Department of Transportation - City of Austin - University of Texas - Women of Central Texas - City of Georgetown - Williamson County - Employee Retirement System - Asian Community and Education Foundation - Capital Metro - Farmers Insurance - Gila Corporation - 3M - Texas State University - Office of Attorney General - Calendar Holdings - National Black Forum of Public Administrators - Charity Dynamics - Texas Legislative Council - Southwest Key - Texas Parks and Wildlife Department - Texas Department of Veterans Affairs - Seton's Generations Program - Seton's Very Important Hearts Rehab Support Group - Central Texas African American Family Support Services Conference - Freescale - Nurse Triage Call Center: Seton's Nurse Triage Call Center makes Registered Nurses available around the clock, 24-hours a day, 7 days a week, free of charge to assist callers with urgent care needs and schedule doctors' appointments to avoid unneeded emergency room visits. The Call Center nurses are able to schedule same and next-day appointments for callers at participating clinics. The Call Center received 88,591 calls during FY15. - Perinatal Outreach Education: The Perinatal Outreach Education program coordinates the Neonatal Transport Team, which serves a 19-county area in Central Texas. The program provides educational hands-on classes to hospitals within that area and serves as the liaison between Seton and the referring hospitals that transfer mothers and babies into our facilities. In addition, the Perinatal Outreach Program hosts an annual two-day Perinatal Conference. Additional services the Perinatal Outreach Programs offers or facilitates include: - Maternal Fetal Monitoring physician and nurse consultation services - High Risk Maternal and Neonatal Transport team - Continuing education for healthcare professionals - Neonatal Grand Rounds for physicians and other medical professionals - Consultation and technical assistance on emerging perinatal issues - Coordination of education and training for perinatal healthcare personnel within the network - Children's Safety: The Dell Children's Medical Center Injury Prevention Program and Safe Kids Austin delivered programs and services to patients and their caregivers within the hospital as well as, to families in our surrounding community. Internal programs/services offered by Dell Children's Injury Prevention program include: The Safety Station, located in the Family Resource Center (FRC) at Dell Children's Medical Center of Central Texas, provides safety resources for patient families. These resources consist of convertible, combination and high-back booster seats, multi-sport and bicycle helmets, as well as sleep sacks for <1 year old children for safe sleep environments. This service operates in collaboration with the FRC staff. - In FY15, the Safety Stations had 457 customer interactions with an average of 51 visitors per month. 306 customers came from DCMC, and 150 from other network facilities. A total of 496 safety devices were distributed, including 436 child safety seats, 18 helmets and 6 sleep sacks. Total value of these items equated to $22,400. Dell Children's Injury Prevention Program subsided approximately $20,898 of these items. |
| Form 990, Part III, Line 4a Program Service Description - Part 5 | - In FY15, DCMC Injury Prevention program staff provided patient caregivers a total of 153 prescriptions to receive safety devices in the Safety Station. A total of 137 (90%) of these prescriptions were filled. Community programs/services/coalitions offered by Dell Children's Injury Prevention program include: - Kohl's Kids In Cars: A community based program that promotes and provides child safety seats and booster seats for children. This program works directly with local elementary schools to identify children who need proper vehicle restraint devices. Eligibility for the booster program includes children age four and older who are less than 100 lbs. and 4'9" tall. This program distributed 255 booster seats in FY15. In FY15, the program conducted 16 community events, 2 held at AISD elementary schools. In addition, over 9,755,700 media impressions were obtained through English and Spanish PSAs through radio, television, and Capital Metro bus ads. 9 Child Safety Seat Inspection Station events were held, with 108 car seats inspected. A significant Seton educational initiative centered on children's safety is Safe Kids Austin Led by Dell Children's Medical Center of Central Texas. Safe Kids Austin is one of more than 450 grassroots Safe Kids Worldwide coalitions in 16 countries that bring together health and safety experts, educators, corporations, foundations, governments and volunteers to prevent accidental injuries in children. The mission of Safe Kids Austin is to reduce childhood injury and death in children ages 14 and under. Most of those injuries and deaths are due to motor vehicle crashes, pedestrian injuries, bike crashes, drowning, fires, burns, poisoning, choking and falls. - Safe Kids Austin Community Coalition is led by Dell Children's Medical Center's Injury Prevention Program and is one of ten local coalitions in Texas that brings together health and safety experts, educators, corporations, foundations, governments and volunteers to educate and protect Texas families. Safe Kids Austin aims to reduce unintentional childhood injuries through a multifaceted strategy of public awareness, education, public policy, and community action in and around Austin. Safe Kids Austin currently consists of 49 members from local organizations, an increase of 36% from FY14. In FY15, Safe Kids Austin conducted 63 hours of Child Passenger Safety Seat Inspections over 24 events which involved 123 volunteer child passengers safety technicians. This equates to 17,749 volunteer technician hours. - Approximately 461 child safety seats were inspected, roughly 7 car seats per hour during inspection events. - 289 child safety seats were distributed, approximately 5 car seats per hour during inspection events. - Approximately 464 caregivers and 401 children participated. 2 Child Safety Technician Training Courses were conducted. These courses: - Involved 7 Safe Kids Austin Instructors, - Approximately 64 hours of course instruction, and - Resulted in 29 new nationally certified technicians. Safe Baby University (SBU): A teen parent program that targets students in local high schools that are pregnant or parenting. Students attend a one and a half day learning event that incorporates multiple structured courses and hands on learning activities. SBU ends with a car seat check event open only to students. Students receive multiple safety devices (i.e. stair gates, home safety kits, car seats, sleep sacks). - In FY15, 27 students directly participated from 1 local high school; 17 car seats were distributed; 12 portable Pack N' Play cribs and 5 stair gates were distributed. - 13 Safe Kids Volunteers assisted the 8 hour event equating for approximately 104 volunteer hours. - Pretest assessment (baseline was 38% correct) compared to post-test assessment (66% correct). Safe International Walk to School Day Event - 75 Parents, Teachers, Children from Maplewood Elementary school participated Safe Kids Austin distributed: - 200 reflectors - 500 safety books Expanding Continuing Medical Education Seton Family of Hospitals believes that, in order to provide the best health care to the community, its clinical personnel and community clinicians must receive ongoing medical education. In FY15, Seton provided 100 directly- and jointly-sponsored Continuing Medical Education activities that included 1,270 hours of instruction for 8,460 physician participants and 11,108 non-physician participants. |
| Form 990, Part III, Line 4a Program Service Description - Part 6 | Subjects Included: - 2015 Annual Pediatric Conference - Ebola Preparedness in the Hospital Environment - Brain Matters Child Neurology Update for Non-Neurologists - Cardiology Update for Primary Care 2014 - Catastrophic Brain Injury Guidelines - Management of a Potential Organ Donor - Clinical Documentation Improvement - Eliminating Catheter Associated Urinary Tract Infections at SETON - Evidence-based Best Practices for the Management of Prediabetes and Diabetes - Hand and Upper Extremity Symposium - Seton Healthcare Family Annual Ethics Conference - The Face of the New Eugenics - Adult Echo Case Conference - Annual Concussion Conference - Austin Dermatological Society Patient Viewing - Austin Trauma and Critical Care Conference - Austin Trauma and Critical Care Conference - Pediatric - Brain & Spine Case Conference - Breast Multidisciplinary Cancer Conference - Cardiology Fellow and Cath Lab Conference - Cardiopulmonary Chest Conference - Cath Lab Conference - Cedar Park Regional Medical Center Adult Cancer Management Conference - CEE: Seton's Performance Improvement Cohort (Spring) - Cerebrovascular Medicine Case Conference - Clinical & Teamwork Simulation - Clinical Documentation Improvement - Clinical Teamwork Simulation - Craniofacial Conference - Critical Care Case Presentation - Cutaneous Oncology Multidisciplinary Cancer Conference - CyberKnife System Clinical Training - Dell Children's Pediatric Trauma Grand Rounds - ENT Conference - Epilepsy Case Conference - Ethics Case Series - Gastrointestinal/Hepato-Biliary Pancreatic Multidisciplinary Cancer Conference, Case Presentations - Gastrointestinal-Hepato-Biliary Pancreatic Multidisciplinary Cancer Conference - General Surgery Grand Rounds - Gynecological Multidisciplinary Cancer Conference - Hand-Upper Extremity Case Conference - Head-Neck Multidisciplinary Cancer Conference - Heart Transplant MCS Selection Committee - Heart Transplant-Performance Improvement Committee - Institute of Reconstructive Plastic Surgery M&M - Introduction to COMPASS for Medical Providers - Introduction to COMPASS for Medical Providers (Ethics) - Malignant Hematology Cancer Conference - Neonatal Grand Rounds - Neuro Tumor Multidisciplinary Conference - Neurology Grand Rounds - New Med Staff Provider Orientation - Pediatric Cancer Management Conference - Pediatric Cardiology Cardiac Case Conference - Pediatric Emergency Medicine Grand Rounds - Pediatric Emergency Medicine M & M - Pediatric Fracture M & M - Pediatric Grand Rounds - Pediatric Interdisciplinary Case Conference - Pediatric Musculoskeletal Tumor Conference - Pediatric Neuro-Oncology Case Conference - Pediatric Neurosurgery Journal Club - Pediatric Neurosurgery M&M Meeting - Pediatric Spine M & M - Pediatric Surgery Morbidity and Mortality Conference - Pediatric Trauma Journal Club - Pediatric Trauma M&M - Physician Burnout - Psychiatry Faculty Development - Psychiatry Faculty Journal Club - Psychiatry Grand Rounds - Schwartz Center Rounds - Schwartz Grand Rounds - SCMHH Grand rounds - SMCA Gynecology Cancer Management Conference - SMCH Adult Cancer Management Conference - SMCH Grand Rounds - SMCHH Grand Rounds - SMCHH Mortality & Morbidity Conference - SMCHH Tumor Board Conference - SMCW Adult Breast Cancer Management Conference - SMCW Spine Case Conference - SMCW Trauma Physician Performance Improvement - SNW Cancer Management Conference - Spasticity Conference - Spine Case Conference - Surgical Endocrine Conference - Surgical GI Conference - Team STEPPS - Introduction - Team STEPPS - Master Training - Thoracic Oncology Multidisciplinary Cancer Conference - Trauma Physician Performance Improvement - Trauma Rounds Case Presentations - UMCB Adult Cancer Management Conference - UMCB Breast Cancer Management Conference |
| Form 990, Part III, Line 4a Program Service Description - Part 7 | Community Health Centers Seton operates three Community Health Centers ("the Centers"): Seton McCarthy, Seton Topfer and Seton Kozmetsky. Each offers primary care, laboratory, case management and health education services to Austin's working families. Family medicine, internal medicine and pediatric physicians, and nurse practitioners provide sick child care, well child check-ups and immunizations. The Centers also provide specialty care in endocrinology, orthopedics, psychiatry and Academy of Oriental Medicine of Austin. The Centers participate in the Patient Pharmacy Assistance Program (PPAP) for patients and use a sliding-scale co-pay to keep services within the reach of working families who otherwise would not be able to afford medical care. Comprehensive social services also support the Centers' medical mission. During FY15, the Centers provided: - 29,812 outpatient medical visits - 11,022 social service encounters - 6,974 immunizations In FY15, the Centers provided care and other services to 10,318 patients, 26% of whom did not have health insurance coverage. Seton Care Plus Seton Care Plus creates a managed care model for uninsured patients who are not eligible for Medicaid, the Children's Health Insurance Program (CHIP) or the Austin/Travis County Medical Assistance Program (MAP) or a subsidy for insurance through the Affordable Care Act (ACA) Marketplace. Just as with commercial insurance populations, use of medical services by program patients are tracked and monitored. Frequent users of emergency or hospital services can be identified and managed to assure they get the care they need and to better manage their conditions in a less expensive manner. The Seton Community Health Centers are the primary care home for the Seton Care Plus patients. Although there is a cost to Seton Family of Hospitals to operate the program, the benefits of preventing inappropriate use of emergency or hospital care are far greater. Direct patient benefits of the Seton Care Plus program include primary care, specialty care (only available through area specialists willing to provide discounted services to patients), inpatient and outpatient hospital care, diagnostic services and prescription benefits. The prescription benefit is a key factor in preventing inappropriate ER visits and unnecessary hospitalizations, as patients were assisted in applying for free or reduced medications through the Patient Pharmacy Assistance Program when the medication was available and for a copay with their Seton Care Plus card for those essential medications that do not have an assistance program. Seton provided funding for 7,015 prescriptions at an estimated savings of $1,053,613 in FY15. The following data shows the excellent results Seton Care Plus provides patients through comparison of the experience of participants in Seton Care Plus with the experience of Medicaid beneficiaries on certain key indicators: Utilization and Expense Comparison - Seton Care Plus and Texas Medicaid Benchmark Seton Care Plus: - Patient hospital days/1,000: 86 - Emergency visits/1,000: 214 Texas Star Medicaid: - Patient hospital days/1,000: 298.8 - Emergency visits/1,000: 643.3 In FY15, Seton Care Plus recorded a rate of 86 patient hospital days per 1,000 compared to a Texas Star Medicaid Benchmark rate of 298 patient hospital days per 1,000. Seton Care Plus recorded 214 emergency visits per 1,000, compared to a Texas Star Medicaid Benchmark rate of 643.3 emergency visits per 1,000. Primary & Specialty Care Clinics Seton operates the Paul Bass Clinic at University Medical Center Brackenridge, a primary care clinic for the uninsured and underinsured. Seton also provides care to the poor and the vulnerable through several Rural Health Clinics serving Caldwell, Burnet, Llano and Lampasas Counties. Seton operates two specialty care clinics for the uninsured: The Specialty Clinics at University Medical Center Brackenridge and the Specialty Clinic for Children. Both provide access to a variety of medical specialists for patients whose conditions require specialized treatment. The clinics also provide specialty referral options for the Austin/Travis County clinics, CommUnity Care, and an FQHC operated by Central Health, the Travis County health district. Mobile Primary Care Vans Three mobile primary care teams address the unmet health needs of children from low-income families in Travis, Burnet, Caldwell, Llano, and Lampasas Counties, by driving to area schools and churches to provide care. - Children's Health Express Van serves the Austin area and provides services at specified Austin public school sites. The program includes a specialized service to about 242 pregnant and parenting students and their babies at four Austin high schools. The team also provides care to medically fragile children at Any Baby Can, a local non-profit. During FY15, the Children's Health Express van conducted 1,201 primary care visits. - Seton Edgar B. Davis Hospital Children's Care-A-Van serves children in Caldwell County and surrounding counties by parking in local area schools and churches. The Care-A-Van responds to a need for affordable and accessible health care in this rural county, where pediatric care is scarce and there are no other providers for uninsured children or children enrolled in the Children's Health Insurance Program (CHIP) or Medicaid. The Children's Care-a-Van is one of two pediatric Medicaid providers to serve the entire county. The SEBD Care-A-Van provided services to 2,251 children in FY15. - Seton Highland Lakes Hospital Care-A-Van serves children in Burnet, Llano and Lampasas Counties by parking in local area schools and churches. The Care-A-Van responds to a need for affordable and accessible health care in this rural county, where pediatric care is scarce and there are no other providers for uninsured children or children enrolled in the Children's Health Insurance Program (CHIP) or Medicaid. The Care-A-Van provided services to 1,864 children in FY15. - Seton Patient Prescription Assistance Program (PPAP) improves access to medications for patients at Seton hospitals and outpatient settings. Seton provides assistance to uninsured patients with the often tedious and complex paperwork required by the pharmaceutical companies to receive these free medications. Patients benefit from reduced costs and ultimately better health. In FY15, there was $19,368,639.38 in prescription drugs provided to approximately 3,900 patients. |
| Form 990, Part III, Line 4a Program Service Description - Part 8 | - Insure-a-Kid: In 1999, the Michael and Susan Dell Foundation collaborated with Seton Family of Hospitals to create Insure-a-Kid, an outreach program to promote and enroll uninsured children in low-cost children's health insurance programs. Today, Insure-a-Kid is funded by Seton and other partners and has expanded its mission to help low-income individuals and families obtain coverage through government insurance programs. Using innovative web-based technology to screen and case-manage individuals, in FY15 Insure-a-Kid helped enroll more than 4,000 individuals in CHIP or Medicaid coverage. By enrolling individuals eligible for government-sponsored health insurance, charity dollars are used more efficiently for children and adults who may have no other option for care. Charity Contributions to Community Organizations During FY15, Seton provided $3.2 million to community organizations and non-profit providers. The Donations and Sponsorships Committee includes employees as well as executives and is charged with reviewing requests from other organizations and determining whether they meet Seton's charitable request guidelines. The requesting organizations submit letters specifying the amount of contribution requested and details of its program. Each entity must provide its IRS determination letter (as evidence of tax-exempt status), a history of its use of funds, a list of other funding sources and a list of board of directors. Requestors also are asked to identify the organization's purpose, the activities that reflect consistency with its stated purpose and provide a description as to how funds will be used. Generally, a successful requesting organization will spend at least 60% of its annual expenses on program activities to insure fundraising expenses are reasonable over time and will not have a persistent deficit in net current assets. In awarding funds, the Donations and Sponsorships Committee looks for organizations that: - Have a mission aligned with Seton's mission, vision and values (e.g., improving the health of those we serve, particularly the poor and the vulnerable); - Can demonstrate the event or activity will enhance access to health-related services and human service needs; improve health outcomes; provide health-related education, information and support; and/or offer sustainable impact; - Provide outreach in Seton's service area; support a diverse population; support workforce readiness and/or help sustain a relationship with a potential or existing Seton stakeholder. Awardees included: - Foundation Communities: Foundation Communities provides affordable, attractive homes and free on-site support services for thousands of families with kids, as well as veterans, seniors, and individuals with disabilities. Their innovative, proven model empowers residents and neighbors to achieve educational success, financial stability, and healthier lifestyles. Foundation Communities own and operate 18 communities all over Austin. The benefits of these communities include: - Family-friendly environments in close proximity to schools and public transportation. - Community Learning Centers with free after-school and summer learning programs for children and teens, as well as adult education classes like English as a Second Language, money management, and fitness and nutrition. - Commitment to green building practices and sustainability, including reduced utility bills and community gardens. - On-site support services in the areas of education, financial stability, and health. Foundation Communities is committed to improving the health of individuals and communities. They provide vital health care services on-site, including access to integrated primary and mental health care and substance abuse counseling, as well as opportunities to engage in a wide range of physical activities, nutrition, and community health programs. Recently Seton supported Foundation Communities in launching Insure Central Texas to enroll hard-working families and individuals in new, affordable health insurance plans, providing them with peace of mind for the future. In 2014, over 5,600 Central Texas families were enrolled in affordable health insurance plans. Seton recognizes affordable housing and 100% health insurance coverage are both social determinants of health and are key components for the health of individuals and communities. Seton is proud to support Foundation Communities as a leader in the Austin community for these efforts particularly their impact on the poor and the vulnerable. - Leadership Austin: Since 1979, Leadership Austin has continued the mission of providing leadership training to those with a passion for Greater Austin. Leadership Austin believes all of Austin can engage in collaborative, inclusive, and sustainable leadership for our community. Leadership Austin offers emerging and community leaders a unique opportunity to be part of a group that has come together to: - Develop their personal and professional leadership skills; - Learn about the issues affecting Greater Austin through open and balanced civic discussion; and, - Build relationships with others who seek to grow as leaders and find solutions to the issues facing our region. Seton supports Leadership Austin to develop our leaders to further our civic engagement and to impact the communities we serve. - San Juan Diego Corporate Internship Work Study Program: San Juan Diego Corporate Internship Program (CIP) is unlike any other program in Austin and plays an integral role in San Juan Diego Catholic High School (SJDCHS). This distinctive program benefits all participants: the students, the school, and the sponsoring companies. Students offset the cost of their education while gaining valuable professional experience, and sponsoring companies lease employees to fill a full-time, entry-level position. |
| Form 990, Part III, Line 4a Program Service Description - Part 9 | In the Corporate Internship Program, a sponsoring company contracts with the CIP to fill a full-time, entry-level position with a team of students. A job-sharing team is composed of four students, each working five days per month. All SJDCHS students participate in CIP, and through their experience gain exposure to a variety of industries, including law, health care, technology, education, finance, and non-profit organizations. Standard student work duties vary. They may include entering data, creating presentations, receiving visitors and phone calls, filing, setting up conference rooms, sorting mail, copying, and faxing. Students work standard business hours, and CIP staff provides students with transportation to and from their workplaces. The program runs annually from August to June. Annually, Seton Healthcare Family offers employment opportunities for 41 students from SJDCHS to leverage their transferable skills and enhance their professional experience. Seton funds 10.25 FTE positions for these students. Students are hired in areas such as Health Information Management, Occupational Health, Human Resources, the Clinical Lab and Seton's Community Health Centers. - CommuniCare Health Centers (Barrio Comprehensive Family Health Center): CommuniCare Health Centers is a full-service primary healthcare system serving Hays County, Seton's southern service area. This Federally Qualified Health Center offers an array of primary care services including pediatric care, family medicine, senior care, women's health, dental, behavioral health, minor surgery clinic, WIC services, and vision care. In their multiple clinic locations, they utilize integrative primary care clinical practice, highly trained healthcare providers, state of the art diagnostic equipment, and electronic health records. CommuniCare is accredited by the Joint Commission, a recognition of quality that reflects an organization's commitment to meeting national safety and quality of care performance standards. In 2012, CommuniCare was designated as a "Primary Care Medical Home" by the Joint Commission. Seton relies on the services and care provided by CommuniCare to better meet the care and health needs of Hays County residents. - Ronald McDonald House Charities Central Texas: For 30 years, the Ronald McDonald House Charities of Central Texas have been making children with illnesses and injuries happier and healthier by keeping their families together at the Ronald McDonald House and four Ronald McDonald Family Rooms. By providing them with a "home-away-from-home" and a place where families can rest and refresh, they help families find strength during challenging times. The Ronald McDonald House is located across the street from Dell Children's Medical Center where children receive care that is often intensive and may result in long hospital stays away from home. Seton is proud to support this organization that provides housing and support services for our patients and their families. Other Charitable and Public Benefit Programs Volunteer Healthcare Clinic Laboratory and Hospitalization Services: The Volunteer Healthcare Clinic has served the Austin community for more than 45 years. The Clinic is a non-emergency primary care facility that serves low-income and uninsured residents of Travis County. It operates three evening sessions weekly and accommodates over 5,000 medical visits annually for approximately 2,000 individuals. Seton assists the clinic by providing financial contributions, clinical and operational guidance, laboratory services, lab and medical supplies, and after-hours medical call-center support. Seton League House: Located near Seton Medical Center, Seton League House is a bed-and-bath facility that provides families a nearby place to stay while loved ones are hospitalized. Seton League House offers overnight accommodations at reasonable rates designed to avoid placing a hardship on families. During FY15, Seton League House provided 12,074 guest days. Leading Collaborative Efforts in the Community Described below are just a few examples of the community partnerships and collaborations Seton Family of Hospitals has championed in Central Texas. Children's Optimal Health (COH): In 2006, Seton invited community leaders to discuss how their organizations could work together to optimize the health and well-being of children in Central Texas. Eighty-four agencies came together informally and identified four areas of focus: linking and leveraging our existing resources; coordinating community messaging and education; using technology; and examining research and best practices for ideas to use in solving community problems. In 2008, Seton and four other charter members committed to annual dues of $35,000 to fund the infrastructure needed to run a new organization. The dues from these organizations remain unchanged in FY15. Through a commitment to shared data, collaboration and ongoing communication, COH is using visual images and GIS mapping to inform policy, improve operations, promote research and mobilize the community to better the lives of our children and youth. In FY15, COH continued work with Dell Children's Medical Center of Central Texas by completing Child Maltreatment mapping which will be presented at a summit scheduled for July 15, 2016. COH has continued assessment mapping and metrics of the 5-year Go Austin/Vamos Austin. COH completed mapping of 2014-2015 Austin Independent School District, completed the Pflugerville and Round Rock Independent School Districts' Obesity Projects, and held a summit in collaboration with the Youth Substance Abuse Prevention Coalition which is now applying for a grant to continue the work of the coalition. This was a year of infrastructure work including rewriting data sharing documents to reflect the highest level of HIPAA and FERPA compliance, and to obtain yearly data draws from multiple Central Texas school districts. The goal of this level of compliance is to enable viewing of obesity and migration from a regional perspective, upgrading capacity to do interactive mapping, and identifying alternative ways to fund the ever increasing requests for COH spatial analysis. The new Dell Medical School is also a source of a great deal of collaboration and of great interest to COH. Community Care Collaborative (CCC): As mentioned above, CCC is a partnership, community collaboration and an integrated delivery system that provides high quality, cost effective, patient centered care to improve health outcomes through expanded care coordination and patient care management for low income residents. The current safety net system of Travis County has several inherent flaws and gaps in service that result in preventable hospitalizations and inappropriate emergency department usage. Some examples include: - Limited access to primary care and medical homes offering preventive care. - Serious shortages of specialty care providers causing delays in care. - Severely limited availability of behavioral health services, both inpatient and outpatient. - Little to no chronic disease management programs. |
| Form 990, Part III, Line 4a Program Service Description - Part 9.1 | Seton and Central Health, the Travis County Health District, jointly own and manage the operations and funding of CCC including the new integrated system of primary, specialty and acute care services. CCC collaborates with local universities, federally qualified health centers, independent providers and community based social service agencies to build capacity and serve health and social needs of low income residents. Care coordination and navigation within CCC and collaborating organizations is enabled by robust data sharing and service delivery. In FY15, Seton provided substantial financial investment to CCC to fund improvements to the integrated delivery system in partnership with Central Health. In addition to the financial contribution, Seton has dedicated administrative and clinical staff time and resources to support the mission and operations of CCC. The Integrated Care Collaboration (ICC): The ICC is a nonprofit alliance of health care providers in Central Texas dedicated to the collection, analysis and sharing of health information with the goal of improving health care quality and cost efficiency across the continuum of care. Since 1997, Seton Healthcare Family has provided staff and financial resources to this unique collaboration which stimulates creative thinking for managing health care for uninsured Central Texans through shared data, medical records and enrollment criteria. One of the ICC's primary functions is the operation and management of a regional Health Information Exchange called the ICare system. Through the analysis of clinical data in the ICare system, the ICC is able to identify needs in the Central Texas health care system and create programs to improve health outcomes for vulnerable populations. ICC Members are health and social services providers, payers and purchasers, including hospital systems, health care networks, community health centers, clinics, government agencies, nonprofit organizations, individual providers and others. During FY15, the ICC's ICare system increased captured data to 2,020,796 encounters with 509,508 unique uninsured or underinsured individuals. Health Alliance for Austin Musicians (HAAM): The Central Texas area has a thriving live music scene, which is a significant contributor to the local economy. For several years, musician advocates in Austin have been looking for ways to increase access to care for area musicians who cannot afford to pay for health insurance. Seton, the SIMS Foundation and the St. David's Foundation formed a unique collaboration to address this need. The resulting Health Alliance for Austin Musicians now provides access to primary health care, diagnosis and medical treatment through Seton, dental services through a collaboration of the Capital Area Dental Foundation and St. David's Foundation and mental health services through the SIMS Foundation. Dell Children's Medical Center of Central Texas/AISD Student Health Services: Dell Children's Medical Center of Central Texas, a member of Seton Family of Hospitals, provides health services for approximately 82,000 public school students in over 128 schools through a ground-breaking partnership with the Austin Independent School District (AISD). The program covers prevention, wellness services, state-mandated screenings, in-school medication, injured child care and management of chronic health conditions. It uses a unique software program that facilitates communication and collects data to improve services. The program identifies uninsured children who need additional medical care and connects them with care providers. The Student Health Services program was the first of its kind and has been replicated in schools throughout the country. The Robert Wood Johnson Foundation gave the program special national recognition. During FY15, 2,868 children were vaccinated by the Children's/AISD Student Health Services Immunization Team. Trauma Care Two of Seton's facilities are designated Level I Trauma Centers: University Medical Center Brackenridge (UMCB) for adult trauma and Dell Children's Medical Center of Central Texas for pediatric trauma. These are the only Level I Trauma Centers in Central Texas. Seton Medical Center Williamson is a designated Level II trauma center. All Centers provide trauma care to the Central Texas community, regardless of the patient's ability to pay. Adult Trauma Services University Medical Center Brackenridge had 2,312 trauma admissions and reported a total of 13,179 trauma-related visits during FY15. University Medical Center Trauma Services provided the following educational opportunities in FY15 to the Central Texas Trauma community: - Advanced Trauma Life Support (four courses serving 16 physicians per course) - Advanced Trauma Life Support (one instructor course serving 6 physicians) - Advanced Surgical Skills for Exposure in Trauma (two courses serving 20 physicians total) - Trauma Nursing Core Course (five courses serving 20 nurses per course) - Continuing Medical Education/Continuing Nursing Education - Trauma Rounds (once a month serving 20 physicians, 20 nurses, and 20 affiliated clinical staff) - Trauma Physician Performance Improvement (twice a month serving 30 physicians and physician extenders, residents, and interns) - Surgical Critical Care Case Presentations (once a month serving 15 physicians, 15 nurses and 20 affiliated clinical staff) - Continuing First Responder Education - participated in "When Seconds Count" - EMS and nursing continuing education symposium - Community Injury Prevention (Car Seat Distribution Program, primary focus low-income Spanish speaking families, three times a month serving five families per course) -Combined Acute and Critical Care RN Residency Trauma Days - (2 days of Trauma specific education for graduate nurses and nurses new to trauma) - Reality Education for Drivers Programs (Responsible Driving Practices program for adolescents and young adults ranging between ages 14-20); 16 total students - Stepping On classes (Fall Prevention program) 14 total students University Medical Center Brackenridge hosted the 7th Annual Trauma and Critical Care Conference at the AT&T Conference Center. This regional event featured nationally-recognized experts in trauma and academic medicine, who provided physicians, nurses, allied health professionals and pre-hospital personnel with cutting edge evidenced-based knowledge related to the care of critically injured patients in rural, urban and suburban hospitals. |
| Form 990, Part III, Line 4a Program Service Description - Part 9.2 | Seton Medical Center Williamson (SMCW) provided four Trauma Nursing Core Course (TNCC) provider classes to nurses in the community. SMCW provided one Trauma Care After Resuscitation (TCAR) course and four Matter of Balance courses to help reduce falls in the senior population in the community. Safety information was provided at 13 community events in FY15. Adult Trauma Research The trauma patient population is a unique area to focus inquiry for research activities. Many evidence-based practices have originated from trauma related research and have applications to other disease processes and outcomes. Multidisciplinary collaborative efforts through the UMCB trauma program produced timely clinical knowledge with application for practicing clinicians. In FY15, UMCB engaged in 11 Institutional Review Board approved study protocols and published the following trauma-related manuscripts: 1. Sabra JP, Cabanas JG, Bedolla J, Borgmann S, Hawley J, Craven K, Brown C, Ziebell C, Olvey S. "Medical Support at a Large-scale Motorsports Mass-gathering Event: The Inaugural Formula One United States Grand Prix in Austin, Texas". Prehospital and Disaster Medicine. July 2014, Volume 28, pages 1-7. 2. Pommerening MJ, DuBose JJ, Zielinski MD, Phelan HA, Scalea TM, Inaba K, Velmahos GC, Whelan JF, Wade CE, Holcomb JB, Cotton BA. "Time to first take-back operation predicts successful primary fascial closure in patients undergoing damage control laparotomy". AAST Open Abdomen Study Group. Surgery. August 2014, Volume 156, Number 2, pages 431-438. 3. Bui E, Joseph B, Rhee P, Diven C, Pandit V, Brown CV. "Contemporary management of radiation exposure and injury." Journal of Trauma and Acute Care Surgery. September 2014, Volume 77, Number 3, pages 495-500. 4. Crispo AL, Daley MJ, Pepin JL, Harford PH, Brown CVR. "Comparison of Clinical Outcomes in Nonintubated Patients with Severe Alcohol Withdrawal Syndrome Treated with Continuous-Infusion Sedatives: Dexmedetomidine versus Benzodiazepines". Pharmacotherapy. September 2014, Volume 34, Number 9, pages 910-917. 5. Crandall ML, Agarwal S, Muskat P, Ross S, Savage S, Schuster K, Tominaga GT, Shafi S, and American Association for the Surgery of Trauma - Committee on Patient Assessment and Outcomes. "Application of a uniform anatomic grading system to measure disease severity in eight emergency general surgical illnesses". Journal of Trauma and Acute Care Surgery. November 2014, Volume 77, Number 5, pages 705-708. 6. Sprunt JM, Brown CV, Reifsnyder AC, Shestopalov AV, Ali S, Fielder WD. "Computed tomography to diagnose blunt diaphragm injuries: not ready for prime time". American Surgeon. November 2014, Volume 80, Number 11, pages 1124-1127. 7. Zielinski MD, Jenkins D, Cotton BA, Inaba K, Vercruysse G, Coimbra R, Brown CVR, Alley DER, DuBose J, Scalea TM. "Adult respiratory distress syndrome risk factors for injured patients undergoing damage-control laparotomy: AAST multicenter post hoc analysis." Journal of Trauma and Acute Care Surgery. December 2014, Volume 77, Number 6, pages 886-891. 8. Klein AL, Brown CVR, Aydelotte J, Ali S, Clark A, Coopwood B. "Implementation of a surgical intensive care unit service is associated with improved outcomes for trauma patients." Journal of Trauma and Acute Care Surgery. December 2014, Volume 77, Number 6, pages 964-968. 9. Watkins L, Ali S, Clark A, Brown CVR. "Transmission-based contact precautions for multidrug-resistant organisms in trauma patients: Fewer days in isolation with no increase in hospital-associated infections." Journal of Trauma and Acute Care Surgery. December 2014, Volume 77, Number 6, pages 960-963. 10. Daley M, Ali S, Brown CV. "Late venous thromboembolism prophylaxis after craniotomy in acute traumatic brain injury." American Surgeon. February 2015, Volume 81, Number 2, pages 205-209. 11. Inaba K, Nosanov L, Menaker J, Bosarge P, Williams L, Turay D, Cachecho R, de Moya M, Bukur M, Carl J, Kobayashi L, Kaminski S, Beekley A, Gomez M, Skiada D, and the AAST TL-Spine Multicenter Study Group. "Prospective derivation of a clinical decision rule for thoracolumbar spine evaluation after blunt trauma: An American Association for the Surgery of Trauma Multi-Institutional Trials Group Study" Journal of Trauma and Acute Care Surgery. March 2015, Volume 78, Issue 3, pages 451-459. 12. Utter GH, Miller PR, Mowery NT, Tominaga GT, Gunter O, Osler TM, Ciesla DJ, Agarwal SK Jr, Inaba K, Aboutanos MB, Brown CV, Ross SE, Crandall ML, Shafi S. "ICD-9-CM and ICD-10-CM mapping of the AAST Emergency General Surgery disease severity grading systems: Conceptual approach, limitations, and recommendations for the future" Journal of Trauma and Acute Care Surgery. May 2015, Volume 78, Number 5, pages 1059-1065. Pediatric Trauma Services In July 2009, Dell Children's Medical Center of Central Texas (DCMC) became the only Level I Pediatric Trauma Center in Central Texas and one of 19 stand-alone verified Level I Pediatric Trauma Centers in the country. This significant achievement demonstrates the organization's commitment to the highest level of clinical care, provision of clinical education, research, injury prevention and advocacy. In May of 2015, the Center was again re-verified at Level 1 status and continues their dedication to the best clinical care, research and prevention efforts. To meet the needs of injured children, pediatric trauma centers must have a full complement of expertise and equipment standing ready to deliver high quality, safe and efficient care. At DCMC, the clinical care team is the backbone of the trauma program. This team of highly trained experts ensures all injured patients are provided the highest standard of care. In FY15, the Trauma Service treated/admitted 1,309 pediatric trauma patients to DCMC. Of these, 48% were Medicaid and 8% were uninsured. DCMC's Trauma Service participated in regional and state activities in an effort to improve care of injured children in our region and in our state. We also provided educational opportunities to the Central Texas trauma and Emergency Medical Service (EMS) community. Regional and State Activities: Six Educations to the Governor's EMS and Trauma Advisory Council (GETAC) Meetings: GETAC is unified, comprehensive, and effective EMS/Trauma System for a healthy, safe Texas. GETAC's mission is to promote, develop, and maintain a comprehensive EMS/Trauma System that will meet the needs of all patients and that will raise the standards for community health care by implementing innovative techniques and systems for the delivery of emergency care for the entire population. Four Educations to the EMS for Children Advisory Committee: The Emergency Medical Services for Children (EMSC) Advisory Committee is vital to the success of the EMSC State Partnership. The role of the advisory committee is to provide guidance to the State Partnership through vigilant exploration of the state of pediatric emergency medical care in Texas, identification of EMSC priorities, development of a strategic plan, and implementation and evaluation of EMSC strategy. |
| Form 990, Part III, Line 4a Program Service Description - Part 9.3 | Ten Educations to the Capital Area Trauma Regional Advisory Council (CATRAC): The mission of the Capital Area Trauma Regional Advisory Council is to facilitate coordination amongst trauma and emergency healthcare providers within Central Texas to ensure the most efficient, consistent, and expedient care of each patient, by developing and maintaining integrated quality processes in patient care, transportation, education, and prevention. Education: - Trauma Nursing Core Course (2 courses; 40 RN's). - Austin Trauma and Critical Care Conference-Pediatric session (120 educated physicians and RNs). - Clinical Save Awards-EMS education provided and awards presented to over 50 regional EMS personnel. - Multiple presentations to care providers were given by members of our clinical trauma team at local, regional, state and national conferences. Pediatric Trauma Research The pediatric Trauma Research Program focuses on the epidemiologic, clinical and behavioral study of childhood injury, injury prevention and trauma clinical care, with the ultimate goal of informing and guiding improved clinical practices. The Trauma Research Program includes five topic areas: - Child abuse prevention, detection and treatment, - Alcohol misuse by adolescents and their caregivers, - Psychological aspects of trauma, - Evaluation of injury prevention programs in the community, and - Investigation of best-practice clinical care for injured patients. In FY15, the group engaged in 31 Institutional Review Board (IRB) approved study protocols and published the following trauma-related manuscripts: Ali J, Sanchez J, Krishnan C, Streufert S, Lawson KA. Traumatic presentation of a solid pancreatic pseudopapillary neoplasm in a 7 year old girl. Journal of Pediatric Surgery Case Reports, 3:227-229. Notrica DM, Eubanks JW, Tuggle DW, Maxson RT, Letton RW, Garcia NM, Alder AC, Lawson KA, St Peter SD, Megison S, Garica-Filion P. Nonoperative Management of Blunt Liver and Spleen Injuries in Children: Evaluation of the ATOMAC Guideline using GRADE. Accepted in the Journal of Trauma. Recicar J, Barczyk A, Duzinski S, Lawson KA, Garcia NM, Letton R, Raines AR, Eubanks JW, Azarakhsh N, Grimes S, Notrica DM, Garcia-Filion P, alder A, Greenwell C, Megison S, Rettiganti M, Luo C, Maxson RT. Does Restraint Status in Motor Vehicle Crash with Rollover Predict the Need for Trauma Team Presence on Arrival? An ATOMAC Study. Journal of Pediatric Surgery, 2015, Epub ahead of print. Gettig K, Lawson KA, Garcia NM, Fox KA. Penetrating Knitting Needle Though the Mediastinum in a Child. Journal of Trauma Nursing 2015, 22:132-135. Ruttan T, Lawson KA, Piper K, Wilkinson M. Risk Factors Associated with Emergency Department Return Visits Following Trauma System Discharge. Accepted in Pediatric Emergency Care. Arzeno N, Lawson KA, Duzinski SV, Vikalo H. Designing Optimal Mortality Risk Prediction Scores that Preserve Clinical Knowledge. Journal of Biomedical Informatics. 2015, 56:P145-56. Grundstein A, Duzinski S. Impact of dangerous microclimate conditions within An enclosed vehicle on pediatric thermoregulation. Theoretical and Applied Climatology, 2015, 121 The Research Department coordinates a national multi-center research collaborative which brings 6 Level I Pediatric Trauma Centers together for research collaboration. The group has presented in the national arena and published numerous sentinel works in pediatric trauma care. The Research Department provides research education for Seton staff, physicians, medical students, residents and University of Texas students. The department currently leads two UT Medical Branch classes on pediatric trauma research, a UT School of Public Health practicum and thesis seminars and provides local education to members of the Seton team. Conducting Groundbreaking Clinical Research Seton adheres to the principle that patients have a right to receive care derived from scientific principles and data-based evidence. To that end, Seton furthers its mission by contributing funds and personnel to support research that helps advance health care. Seton's Center for Nursing Research Council provides a defined infrastructure to support nursing research, inform policy and procedure development, promote advanced nursing practice, practice change and support the implementation of evidence-based practice. The council supports nurses in identifying and investigating nursing problems through scientific inquiry, analysis, synthesis, dissemination and translation of research findings in an effort to improve nursing practice and patient care with evidence-based findings. The Nursing Research Council exists to support and promote the integration of nursing research and evidence-based practice (EBP). The Council works to advance and disseminate nursing knowledge and science with the goal of improving nursing practice and patient outcomes. The council is responsible to provide formal education to Seton nurses regarding the tenants of research, quality improvement and EBP, promote the integration and awareness of research efforts within Seton, provide oversight and support to RN-led research endeavors conducted at Seton, and approve RN-led research endeavors prior to IRB submission. Scientific inquiry in the nursing professional is an essential component for professional growth, advancement in healthcare delivery, improved work environment, and improved population health. The Seton Nursing Research department aims to develop a strong, robust nursing research council that will act as a consultant for all nursing research projects. FY15 Nursing Studies Report: In FY15 Seton had six nursing research projects approved through the IRB process. The projects include: Principal Investigator: Sadler, Holli T. Protocol Title: Evaluation of Mild Cognitive Impairment in Seton Total Health Subpopulation & Interventions to Improve Cognition in Hypertension and Diabetic Patients with Chronic Disease Site: UMCB Principal Investigator: Hauger, Sarmistha B. Protocol Title: RSV Hospitalizations: Impact of 2014 Palivizumab Guidelines Site: DCMC |
| Form 990, Part III, Line 4a Program Service Description - Part 9.4 | Principal Investigator: Hairston, Terrie Protocol Title: Understanding Interprofessional Communication Practices Site: DCMC Principal Investigator: Wakefield, Toni A. Protocol Title: Evaluation and Improvement of Decisional Uncertainty in Infant Dialysis Site: DCMC Principal Investigator: Rowin, Antoinette L. Protocol Title: Bridging the Gap: Developing a Competency Assessment Tool and Curriculum to Address Key Issues in Graduate Nurse Transition to Practice Site: UMCB Principal Investigator: Miller, Rebecca A. Protocol Title: Bridging the Gap: Examining the Role, Characteristics, and Turnover of the Magnet Program Director Site: SAO Providing Patient Services During FY15, Seton's facilities treated and discharged 77,407 adults and children in the community for a total of 340,721 patient days. Seton provided 634,493 hospital-based outpatient visits, 24,818 outpatient surgery visits, and 321,539 emergency visits. In addition, Seton's primary care and specialty care physician practices served the community by providing 913,584 patient visits. Unique Services Seton supports unique services unavailable elsewhere in the region including: - Central Texas' only Level I Trauma Centers: Dell Children's Medical Center of Central Texas (Pediatric) and University Medical Center Brackenridge (Adult); - Central Texas' only heart transplant center (Seton Medical Center Austin) certified by Medicare and named a destination site for technology to help sustain patients with failing hearts, including the use of Ventricular Assist Devices; - Regional High Risk Maternity and Neonatal Center providing care for high-risk moms and babies, micro preemies and multiple births; - A dedicated pediatric hospital - Dell Children's Medical Center of Central Texas serving a 46-county area dedicated solely to comprehensive medical and surgical care for children; - The community's only private inpatient mental health hospital, Seton Shoal Creek that serves patients of all ages: children, adolescents, adults and seniors; - LIVESTRONG Survivorship Center at Dell Children's Medical Center of Central Texas provides specialized care in a clinic that focuses on the needs of pediatric cancer survivors. Children are at risk for physical and psychological issues related to cancer and its therapy. The radiation, chemotherapy and surgery used to successfully treat childhood cancers may lead to what are called, "late effects" such as heart and lung problems, impaired growth, etc. Comprehensive Healthcare Services Inpatient & Outpatient Seton provides the following inpatient and outpatient medical services to the community at one or more locations: - Major (Level I) Trauma Centers verified by the American College of Surgeons - Urgent and 24-hour emergency care - Critical care services - Intermediate care services - General and subspecialty inpatient/outpatient surgical services including: thoracic, cardiovascular, open heart, urology, obstetrics/gynecology, plastics, maxillo-facial, ophthalmology, ENT, orthopedic, spine, trauma and pediatric - Internal medicine, family practice and subspecialties - Specialty outpatient clinic - Cardiovascular and telemetry services - Medical/Surgical services - Comprehensive Maternity Services, including high risk obstetrical, Level II and Level III (Neonatal) Nurseries - Advanced Neurosciences, including CyberKnife - Certified Stroke Centers - Certified Chest Pain Centers - Resuscitation Center Designations - Orthopedics - Oncology - Nephrology - Heart failure and heart transplant services; destination facility for Ventricular Assist Device (VAD) technology Diagnostic and Therapeutic Services - Physical, occupational and speech therapy - Extensive rehabilitation services - Wound Care Clinic - Invasive and non-invasive diagnostic cardiology/catheterization laboratory - Cardiac rehabilitation - Diagnostic radiology including: fluoroscopy, x-ray, CT Scan, nuclear medicine, special procedures and MRI - Outpatient surgery - Pastoral care - Social work/discharge planning/case management - Cardiopulmonary services - Laboratory services - Pharmaceutical services |
| Form 990, Part III, Line 4a Program Service Description - Part 9.5 | Pediatric Services - Children's Emergency Center and Level I Trauma Center - Children's Regional Heart Program - Children's Surgical Services - Children's Therapy Gym - Dell Children's Imaging Center - Juvenile Diabetes Team - Neonatal Intensive Care Unit - Pediatric Intensive Care Unit - Pediatric Critical Care Transport Team - Specialty Care Center - Child Life Department - The Childhood Cancer & Blood Disorders Center - Children's Asthma Program - Pediatric Dental Care Wellness/Education Services - Lactation education - Parent and family education for obstetrics - Diabetic education - High risk OB education - Cancer screenings/mammography - Nurse Triage Call Center - Nutrition Primary Care Services - Community Health Centers, Rural Health Clinics, specialty clinics for uninsured & underinsured - Physician and nurse practitioner visits - Pharmacy - Social Services - Health education (including diabetes education, nutrition and cooking classes) Inpatient Psychiatric Hospital Services - Acute inpatient adult psychiatric services - Acute children and adolescent psychiatric services - Psychiatric Intensive Care (locked): Inpatient de-tox and psychiatric stabilization - Electro-Convulsive Therapy - Adolescent Intensive Outpatient (12 hours per week) Programs: psychiatric and substance abuse - Adult Intensive Outpatient Programs: psychiatric and substance abuse Links to Additional Community Benefit Information Visit Seton Family of Hospitals' web site at www.seton.net for additional information about the health-related benefits Seton provides the Central Texas community. Financial Information Seton's financial information is contained in the appropriate forms for the Internal Revenue Service. Financial data that demonstrate Seton's commitment to assisting the most poor and vulnerable in the Central Texas community is outlined in detail in Schedule H. We prepared the data in accordance with the Catholic Health Association's (CHA) community benefit reporting guidelines. |
| Form 990, Part VI, Line 15a Process for Determining Compensation for CEO | IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF SETON FAMILY OF HOSPITALS, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. |
| Form 990, Part VI, Line 2 Business Relationship | Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by Seton Healthcare Family related entities. Sr. Helen Brewer, Charles Barnett, Christopher Ziebell, James Lindsey and Douglas Waite have a business relationship. |
| Form 990, Part VI, Line 15b Process for Determining Compensation for Other Officers | IN DETERMINING THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS PERFORMED BY SETON HEALTHCARE FAMILY, A RELATED ORGANIZATION OF SETON FAMILY OF HOSPITALS, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE AUDIT COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Seton Family of Hospitals has a single corporate member, Seton Healthcare Family. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Seton Family of Hospitals has a single corporate member, Seton Healthcare Family, who has the ability to elect members to the governing body of Seton Family of Hospitals. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Powers subject to approval by our single corporate member, Seton Healthcare Family, include: 1) The formation or acquisition of legal entities for which Seton Healthcare Family will serve as the sole or controlling entity, and subject to canonical requirements, approve the sale, transfer or substantial change in use of all or substantially all of the assets of the Corporation or the divesture, dissolution, closure, merger, consolidation, change in corporate membership or corporate reorganization of the Corporation, 2) Changes to the governing documents, if changes are inconsistent with the System requirements for governing documents, 3) Appoint, upon recommendation of the board of the Corporation, or remove, with or without cause, the members of the Board of Trustees of the Corporation, 4) The transfer of assets and the reallocation of debt among the Corporation and other Health Ministries in accordance with system policies, in consultation with the corporate board, and 5) Approve the incurrence of debt of the Corporation in accordance with System policies. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | MANAGEMENT, INCLUDING CERTAIN OFFICERS, WORKS DILIGENTLY TO COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. HISTORICALLY, MANAGEMENT HAS PRESENTED THE FORM TO THE BOARD, OR A DESIGNATED COMMITTEE, TO REVIEW AND ANSWER ANY QUESTIONS. IN ADDITION, PRIOR TO FILING THE RETURN ALL BOARD MEMBERS WERE PROVIDED THE FORM 990 AND MANAGEMENT TEAM MEMBERS WERE AVAILABLE TO ANSWER ANY BOARD MEMBERS' QUESTIONS. DURING 2015, THE HEALTH MINISTRY IMPLEMENTED A SYSTEM CONVERSION. DUE TO THE CHANGE IN SYSTEMS AND THE TAX FILING DEADLINE, THIS YEAR'S RETURNS WILL NOT BE REVIEWED BY THE BOARD PRIOR TO THE TAX FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The Organization has adopted the Conflict of Interest Policy of Seton Healthcare Family. The Corporate Responsibility Officer's (CRO) delegate will prepare a summary of the Conflict of Interest Disclosure Statements and submit it to the CRO for review. The CRO will submit a written report to the applicable Board or Board Committee on the results. Procedures for Addressing the Conflict of Interest: (1) An individual with a Conflict of Interest may make a presentation at the meeting of the Board of Trustees or Committee of the Board, but after such presentation, he or she shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in the conflict of Interest. (2) If deemed appropriate or advisable, the Chair of the Board or Committee of the Board, as the case may be, may appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. (3) After exercising due diligence, the Board of Trustees or Committee of the Board shall determine whether the Corporation can obtain with reasonable efforts a more advantageous transaction or arrangement from a person or entity that would not give rise to a Conflict of Interest. (4) If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a Conflict of Interest, the Board of Trustees or Committee of the Board shall determine by a majority vote of the disinterested directors or members, as the case may be, whether the transaction or arrangement is in the Corporation's best interest and for its own benefit, and whether the transaction is fair and reasonable to the Corporation; and thereafter, the Board of Trustees or Committee of the Board shall decide whether to enter into the proposed transaction or arrangement in conformity with such determinations. |
| Form 990, Part VI, Line 19 Required documents available to the public | The Organization will provide any documents open to public inspection upon request. |
| Form 990, Part VII, Section A Board Members | Compensation for board members is paid by Seton Healthcare Family, a related organization of Seton Family of Hospitals. The compensation the board members receive is for their roles as employees of related organizations. The board members of Seton Family of Hospitals do not receive any compensation for their role as board members. |
| Form 990, Part VII, Section B, Line 1, Column (B) Independent Contractor Reporting | Compensation of independent contractors is paid by and reported on the Form 1096, Annual Summary and Transmittal of U.S. Information Returns, of Ascension Health, EIN: 31-1662309. Expenses are allocated to and reimbursed by the filing organization to Ascension Health. As such, the organization has not reported independent contractors paid on Form 990, Part VII, Section B. |
| Form 990, Part VIII, Line 2f Other Program Service Revenue | Service Fees Contractual - Total Revenue: 447800, Related or Exempt Function Revenue: 447800, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Program Revenue - Total Revenue: 78833, Related or Exempt Function Revenue: 78833, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; other - Total Revenue: 1098757, Related or Exempt Function Revenue: 1098757, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | OTHER - Total Revenue: 58741926, Related or Exempt Function Revenue: 58660596, Unrelated Business Revenue: 16045, Revenue Excluded from Tax Under Sections 512, 513, or 514: 65285; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | RESTRICTED CONTRIBUTIONS USED FOR PROPERTY - 9110870; DEFERRED PENSION COSTS - -28844060; NET ASSETS RELEASED FROM RESTRICTION - 9764371; Investment in Unconsolidated Subsidiaries - -41001334; Transfers to Ascension Health - -16657677; Income from Unconsolidated Subsidiaries - 5088980; |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE TOPFER BUILDING CONDOMINIUM ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1345 PHILOMENA STREET | AddressLine1Txt |
| City | AUSTIN | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78723 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 743007869 | EIN |
| Primary Activities | COMMERCIAL BUILDING ASSOCIATION | PrimaryActivitiesTxt |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Total Income | $81,664 | TotalIncomeAmt |
| End Of Year Assets | $151,222 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SETON HEALTHCARE FAMILY | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (27 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Business Name Line2DisregardedEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | |||||||||||
| PO BOX 45998 | STLOUIS | MO | 63145 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3 | Type I | NA | false | |
| ASCENSION HEALTH | |||||||||||
| PO BOX 45998 | STLOUIS | MO | 63145 | 311662309 | national health system | MO | 501(c)(3 | Type I | ASCENSION HEALTH ALLIANCE | false | |
| SETON HEALTHCARE FAMILY | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 454364243 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | Type I | ASCENSION HEALTH | false | |
| AUSTIN CHILDREN'S CHEST ASSOCIATES II | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 260163261 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| BLUE LADIES MINERALS INC | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742971975 | OWN OIL AND MINERAL RIGHTS, REAL ESTATE | TX | 501(c)(3 | Type III-FI | SETON FUND OF THE DAUGHTERS OF CHARITY OF ST VINCENT DE PAUL INC | Yes (true) | |
| CMC FOUNDATION OF CENTRAL TEXAS | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 200468031 | FUNDRAISING | TX | 501(c)(3 | Type I | SETON HEALTHCARE FAMILY | Yes (true) | |
| SETONUT DELL MEDICAL SCHOOL UNIVERSITY PHYSICIANS GROUP (FKA SETONUT SOUTHW | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742869762 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON FAMILY OF HOSPITALS | Yes (true) | ESTERN UNIVERSITY PHYSICIANS GROUP) |
| INSTITUTE OF RECONSTRUCTIVE PLASTIC SURGERY OF CENTRAL TEXAS | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 262908163 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| PEDIATRIC CRITICAL CARE ASSOCIATES | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 421670843 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| SETON FAMILY OF PEDIATRIC SURGEONS | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 271311790 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| SETON HAYS FOUNDATION | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 262842608 | FUNDRAISING | TX | 501(c)(3 | Type I | SETON HEALTHCARE FAMILY | Yes (true) | |
| SETON MEDICAL GROUP | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742861106 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| SETON WILLIAMSON FOUNDATION | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 205330986 | FUNDRAISING | TX | 501(c)(3 | Type I | SETON HEALTHCARE FAMILY | Yes (true) | |
| THE SETON COVE INC | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742727509 | SPIRITUALITY CENTER | TX | 501(c)(3 | Type I | SETON HEALTHCARE FAMILY | Yes (true) | |
| SETON FUND OF THE DAUGHTERS OF CHARITY OF ST VINCENT DE PAUL INC | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742212968 | FUNDRAISING | TX | 501(c)(3 | Type I | SETON HEALTHCARE FAMILY | Yes (true) | |
| TRI-COUNTY CLINICAL | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 264562712 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| SETON FAMILY OF PHYSICIANS | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 264562522 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| SPECIALLY FOR CHILDREN-CHILDREN'S HOSPITAL SUBSPECIALISTS OF CENTRAL TEXAS | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742800601 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| TWENTY-SIX DOORS INC | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742855201 | TO HOLD TITLE TO REAL PROPERTY | TX | 501(c)(25 | SETON FUND OF THE DAUGHTERS OF CHARITY OF ST VINCENT DE PAUL INC | Yes (true) | ||
| FICKETT HEALTH LEGACY INC | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 272843709 | TO HOLD AND COLLECT INCOME FROM REAL PROPERTY | TX | 501(c)(25 | TWENTY-SIX DOORS INC | Yes (true) | ||
| PEDIATRIC SURGICAL SUBSPECIALISTS | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 208957311 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| ADULT INPATIENT MEDICAL SERVICES | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 452498998 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON FAMILY OF HOSPITALS | Yes (true) | |
| SETON ENT | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 273220659 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| HEALTHCARE COLLABORATIVE | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 273220767 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | Type I | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
| SETON CLINICAL ENTERPRISE CORPORATION | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 454364681 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | Type I | SETON HEALTHCARE FAMILY | Yes (true) | |
| SETON INSURANCE SERVICES CORPORATION | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 454364813 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | Type I | SETON HEALTHCARE FAMILY | Yes (true) | |
| CHILDREN'S BONE JOINT & SPINE CENTER | |||||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 452499113 | DELIVERY OF HEALTH CARE SERVICES | TX | 501(c)(3 | 9 | SETON CLINICAL ENTERPRISE CORPORATION | Yes (true) | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SETON PHYSICIAN HOSPITAL NETWORK | |||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742643825 | HEALTH SERVICES | TX | NA | C Corporation | Yes (true) |
| ADVANTAGE HEALTHCO INC | |||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742698151 | HEALTH SERVICES | TX | NA | C Corporation | Yes (true) |
| SETON HEALTH PLAN INC | |||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742725348 | HMO | TX | NA | C Corporation | Yes (true) |
| SETON MSO INC | |||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742870455 | HEALTH SERVICES | TX | NA | C Corporation | Yes (true) |
| SETON ACCOUNTABLE CARE ORGANIZATION INC | |||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 742677756 | HEALTH SERVICES | TX | NA | C Corporation | Yes (true) |
| SETON HEALTH ALLIANCE | |||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 453047469 | HEALTH SERVICES | TX | NA | C Corporation | Yes (true) |
| DELL CHILDREN'S HEALTH ALLIANCE (FKA SETON FAMILY OF PEDIATRICIANS) | |||||||||
| 1345 PHILOMENA STREET | AUSTIN | TX | 78723 | 271311909 | HEALTH SERVICES | TX | NA | C Corporation | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (37 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt | Business Name Line2OtherOrganizationName/BusinessNameLine2Txt |
|---|---|---|---|
| SETON HAYS FOUNDATION | |||
| C | $1,747,172 | ACTUAL AMOUNT PAID | |
| SETON WILLIAMSON FOUNDATION | |||
| C | $2,058,030 | ACTUAL AMOUNT PAID | |
| CMC FOUNDATION OF CENTRAL TEXAS | |||
| C | $7,306,572 | ACTUAL AMOUNT PAID | |
| SETON FUND OF THE DAUGHTERS OF CHARITY OF ST VINCENT DE PAUL INC | |||
| C | $14,825,535 | ACTUAL AMOUNT PAID | |
| Seton Accountable Care Organization Inc | |||
| P | $4,232,021 | actual amount paid | |
| Seton Medical Group | |||
| P | $147,567 | actual amount paid | |
| Seton Health Plan Inc | |||
| P | $8,932,211 | actual amount paid | |
| Pediatric Critical Care Associates | |||
| P | $63,478 | actual amount paid | |
| SetonUT Dell Medical School University Physicians Group (fka SetonUT Southw | |||
| P | $8,759,333 | actual amount paid | estern University Physicians Group) |
| The Topfer Building Condominium Association | |||
| P | $64,624 | actual amount paid | |
| Pediatric Surgical Subspecialists | |||
| P | $3,214,467 | actual amount paid | |
| Austin Children's Chest Associates II | |||
| P | $732,662 | actual amount paid | |
| Institute of Reconstructive Plastic Surgery of Central Texas | |||
| P | $1,174,248 | actual amount paid | |
| Seton Family of Physicians | |||
| P | $7,685,773 | actual amount paid | |
| Seton Family of Pediatric Surgeons | |||
| P | $6,437,867 | actual amount paid | |
| Tri-County Clinical | |||
| P | $11,186,548 | actual amount paid | |
| Seton ENT | |||
| P | $1,102,869 | actual amount paid | |
| Adult Inpatient Medical Services | |||
| P | $12,755,010 | actual amount paid | |
| Seton Fund of the daughters of charity of St Vincent de Paul Inc | |||
| P | $870,475 | actual amount paid | |
| CMC Foundation of Central Texas | |||
| P | $1,510,165 | actual amount paid | |
| Seton Williamson Foundation | |||
| P | $169,086 | actual amount paid | |
| Seton Hays Foundation | |||
| P | $111,141 | actual amount paid | |
| Specially for Children-Children's Hospital Subspecialists of Central Texas | |||
| P | $4,226,873 | actual amount paid | |
| The Seton Cove Inc | |||
| P | $225,075 | actual amount paid | |
| Healthcare Collaborative | |||
| P | $596,442 | actual amount paid | |
| Institute of Reconstructive Plastic Surgery of Central Texas | |||
| L | $1,107,994 | actual amount paid | |
| Seton Family of Pediatric Surgeons | |||
| L | $2,858,577 | actual amount paid | |
| SetonUT Dell Medical School University Physicians Group | |||
| L | $23,177,307 | actual amount paid | |
| Seton Family of Physicians | |||
| L | $5,299,742 | actual amount paid | |
| Specially for Children-Childrens Hospital Subspecialists of Central Texas | |||
| L | $3,371,909 | actual amount paid | |
| Austin Childrens Chest Associates II | |||
| L | $249,489 | actual amount paid | |
| PEDIATRIC CRITICAL CARE ASSOCIATES | |||
| L | $1,363,946 | actual amount paid | |
| Pediatric Surgical Subspecialists | |||
| L | $1,344,447 | actual amount paid | |
| Tri County Clinical | |||
| L | $2,055,598 | actual amount paid | |
| Seton Health Plan Inc | |||
| S | $600,975 | actual amount paid | |
| ASCENSION HEALTH | |||
| R | $16,657,677 | ACTUAL AMOUNT PAID | |
| Adult Inpatient Medical Services | |||
| L | $13,054,678 | Actual Amount Paid | |
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