Community Benefit Reports
2009: Year at a Glance
As we close the first decade of the millennium, we reflect back on a very challenging time of healthcare financing and delivery, both locally and nationally. In Sonoma County alone, the last 10 years have seen significant events that changed the landscape of local healthcare delivery. From the collapse of the Health Plan of the Redwoods to the dominance of Kaiser Permanente in the market, it has become evident that there is more demand than supply for commercially insured patients and that the organizations providing the highest quality and most affordable health care will thrive.
Sutter Medical Center of Santa Rosa is also working to overcome significant image issues. While we are proud to provide access and quality health care to the poor and uninsured, we want our community to know that we provide this same care to everyone. In order to sustain our mission to care for the indigent, we must attract more commercially-insured patients. We have also had to dispel the belief that we are closing (or have closed), a misperception that still lingers a year following the announcement that we are planning to build a new hospital!
Despite these challenges, there is positive evidence of a bright future for SMCSR. We received two very significant awards in 2009 that recognize the high quality care we provide to our community, despite the financial challenges of caring for poor. First, we received the highest ratings possible in our cardiac surgery and cardiology programs from Health Grades, an independent health ratings organization. Our cardiac program is named in the top 5 in the state of California and in the top 10% nationwide! Additionally, we received the Sutter Health President’s Award for most improved in the Sutter Health system which is a testament to the commitment of our organization to not compromise the quality of care while still remaining focused on increasing access to care, regardless of ability to pay. We are excited to be a part of the newly formed West Bay Hospitals region. The regionalization effort within Sutter Health is an important step in strengthening individual affiliates in order to be competitive in their local markets. The streamlining of functions and the sharing of best practices will move us toward “Destination 2012” as a system and will position SMCSR to be the Sonoma County leader in high quality, affordable health care.
Our commitment to community benefit remains equally strong. Below are some highlights from 2009 followed by our annual report.
Santa Rosa Family Medicine Residency Program
Despite significant efforts to establish the residency as a separate entity and as a consortium of local stakeholders and financial partners, the consortium dissolved in mid-2009 due to contract issues. However, the Residency remains strong and continues to be a vital community asset. SMCSR’s commitment to this program, despite annual losses in the millions, ensures that our local family medicine pipeline is robust and that the local community health centers that serve the poorest in our communities, have skilled physicians providing care.
Commission of Local Children’s Dental Health Survey
During the course of conducting the needs assessment, it became clear that Sonoma County lacks quality local data on children’s oral health. In order to support the efforts of local groups addressing this issue, the CHIC is conducting a county-wide in-mouth survey of 1250 kindergarten and 3rd graders across 17 Sonoma County schools to determine the prevalence of dental caries. The survey was completed early in 2009 and was presented to many stakeholders in different venues, including the County Board of Supervisors, who are continuing in their evaluation of water fluoridation in our county. Other groups working on local oral health issues are using this report as a platform for advocacy, grant seeking, and program planning.
Sonoma County Healthcare Workforce Development Program
The Healthcare Workforce Development Program (HDWP) is in its 7th year of funding and is about to launch the 6th annual Summer Health Career Institute. In addition to the summer program, the HWDP has several other components, including a Pipeline Prep program which assists students at Santa Rosa Junior College that are interested in education and training for a health career. The program provides tutoring, financial assistance, academic and career counseling and case management services designed to help at risk students stay in school and accomplish their goals. To date, the HWDP has reached nearly 20,000 students and their families in Sonoma County.
The Sonoma County Department of Health Services, in partnership with Sutter Medical Center of Santa Rosa and other area hospitals, contracted with the Healthy Communities Institute to develop a web-based information system which will provide an easy to understand presentation of health, environmental, and other quality of life indicators for stakeholders in the community. Healthy Sonoma, launched in summer of 2009 and contains approximately 120 specific key indicators designed to measure and report on the health of the community in a variety of categories. The key indicators will provide information gathered from diverse sources including the California Health Interview Survey, the California Highway Patrol, U.S. Environmental Protection Agency, U.S. Department of Agriculture, and the Bureau of Labor Statistics. The website will also include access to: resources including over 1,000 community-level interventions and “promising practices” from counties nationwide; features to help users work with government and non-government groups to effect change, and will include “211 Resource”, information and referral services that link people seeking assistance with local services. We will be using this resource to present our next community health needs assessment.
2009 Community Benefit Report
The following report represents the first report of activities from a three- year plan driven by a community needs assessment conducted in 2007-08 for the planning cycle 2008-2010.
How to Read This Report
The community benefit totals are divided into two line items: benefits for the poor/underserved, and benefits for the broader community. The services for the poor/underserved include traditional charity care and Medi-Cal and are calculated on a cost to charge ratio. Benefits for the broader community include non-billed services, cash donations, in-kind donations, education, and research. (Note: Sutter Medical Center of Santa Rosa will follow new CHA guidelines that disallow the reporting of unreimbursed costs of Medicare as community benefit. Therefore, these costs are no longer represented in our community benefit numbers). Please see below for detailed definitions of each of the above categories:
- Traditional Charity Care- Free or discounted health services provided to the uninsured and underinsured populations.
- 2) Unpaid Costs of Public Programs - The “shortfall” created when the facility receives payments below the costs of treating public beneficiaries such Medi-Cal patients.
- 3) Non-billed services - Activities with no individual patient bill, therefore no deduction from revenue is shown in the traditional statement of revenues and expenses (i.e. support groups)
- 4) Cash donations - Dollars donated by a facility to another not-for-profit agency or program
- 5) In-kind donations - Any service or staff time donated to the community.
- 6) Education - Any community, patient, and medical education including, but not limited to, community lectures, nursing student rotations, and in-service training for existing staff.
2009 Community Benefit Value
In 2009, Sutter Medical Center of Santa Rosa contributed $15,858,986 to programs that benefit the poor/underserved and the broader community including $3.4 million in traditional charity care. These contributions represent more than 10% of our net patient revenue. Benefits for the poor/underserved totaled $ 7,484,000. Benefits for the broader community totaled $7,057,000. For a full listing of community benefit activities or to receive a hard copy of this report or the most recent community health needs assessment, please contact Penny Vanderwolk at 707-576-4009.