2023-11-09T15:01:38-06:00 2022-12-31 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2022-01-01 141338428 ELLIS HOSPITAL D/B/A ELLIS MEDICINE ELLI 5186128667 1101 NOTT STREET SCHENECTADY NY 123082425 MARC MESICK VICE PRESIDENT/CFO 5186128667 2023-10-23 1 MARC MESICK XXX-XX-XXXX 1 THOMAS J GIUFRE P00841958 3154463600 2023-11-08 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ELLIS MEDICINE PAUL A MILTON 1101 NOTT STREET SCHENECTADY NY 123082425 447065375 0 1 X WWW.ELLISMEDICINE.ORG X 1885 NY THE MISSION OF ELLIS HOSPITAL (D/B/A ELLIS MEDICINE) IS TO MEET THE HEALTH AND WELLNESS NEEDS OF OUR COMMUNITY WITH EXCELLENCE. 16 12 3371 165 2807993 0 23501533 4872128 388264646 373612190 9197756 42013 13718507 9382007 434682442 387908338 0 0 0 0 242299278 259327813 0 0 0 190660192 191714231 432959470 451042044 1722972 -63133706 387739018 292453783 205973343 195848984 181765675 96604799 X THE MISSION OF ELLIS HOSPITAL (D/B/A ELLIS MEDICINE) IS TO MEET THE HEALTH AND WELLNESS NEEDS OF OUR COMMUNITY WITH EXCELLENCE. 0 0 346469469 353543868 SEE SCHEDULE O 18903363 11282638 SEE SCHEDULE O 15679915 9108162 SEE SCHEDULE O 381052747 1 1 0 1 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 0 1 0 0 1 3371 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NY X X ELLIS MEDICINE FINANCE DEPT 5186128645 1101 NOTT STREET SCHENECTADY NY 12308 PAUL A MILTON PRESIDENT / CEO 55.00 5.00 X X 721535 0 39794 DAVID BROWN TRUSTEE 1.44 X 0 0 0 PATRICIA BUHR TRUSTEE 3.31 X 0 0 0 CRISTINE CIOFFI ESQ TRUSTEE 2.43 X 0 0 0 DAVID HORAN CHAIR AS OF JUNE 2022 3.00 X X 0 0 0 MARK LITTLE TRUSTEE, CHAIR THRU JUNE 2022 2.38 X 0 0 0 STEPHEN PAGANO TRUSTEE 3.00 X 0 0 0 ARETA PIDWERBETSKY MD TRUSTEE 3.00 X 0 0 0 STEPHANIE ROBERTS ESQ TREASURER 2.73 X X 0 0 0 JANET SAPIO-MAYTA SECTETARY 3.05 X X 0 0 0 MARY THERRIAULT RN TRUSTEE 2.31 X 0 0 0 JOHN TOBISON TRUSTEE 2.03 X 0 0 0 GARY WOOD MD VICE CHAIR 3.27 X X 0 0 0 NICHOLAS MONTALTO MD TRUSTEE 3.00 X 154719 0 11733 MICHAEL COCCA TRUSTEE 3.00 X 0 0 0 THOMAS HARTMAN TRUSTEE 3.00 X 0 0 0 JAMES HURLEY TRUSTEE 3.00 X 0 0 0 ANTHONY SANTILLI MD TRUSTEE 3.00 X 0 0 0 MARC MESICK VICE PRESIDENT / CFO 55.00 5.00 X 462352 0 21126 AVINASH BACHWANI MD VP/CIO, THRU JANUARY 2022 55.00 X 163721 0 1062 DAVID M LIEBERS MD CMO 55.00 X 469815 0 39447 LESLYN WILLIAMSON EXECUTIVE DIRECTOR, THRU MAY 2022 55.00 X 326239 0 19674 TERRENCE CLARKE MD SURGEON 50.00 X 294956 0 21630 HERBERT REICH MD SURGEON 50.00 X 329696 0 16173 SONALI PATEL MD PHYSICIAN 50.00 X 306700 0 0 KEITH C WILLARD REGISTERED NURSE 112.00 X 652917 0 0 NANCY O BARNARD REGISTERED NURSE 71.00 X 326833 0 0 4209483 0 170639 368 0 1 0 CARDINAL HEALTH PO BOX 13862 NEWARK NJ 07188 MEDICAL SUPPLIER 10727679 MEDICAL STAFFING NETWORK PO BOX 840292 DALLAS TX 752840292 AGENCY LABOR STAFFING 8507141 COMMUNITY CARE PHYSICANS PC 2125 RIVER ROAD 103 SCHENECTADY NY 12309 PHYSICIAN SERVICES 6154346 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 631959156 INFORMATIONAL TECHNOLOGY 3614224 ABBOTT LABORATORIES 22400 NETWORK PLACE CHICAGO IL 606731224 MEDICAL SUPPLIER 3055798 40 2267797 2604331 4872128 GENERAL HOSPITAL 621990 349795811 349795811 MENTAL HEALTH SERVICES 621990 11282638 11282638 LONG TERM CARE 623000 9108162 9108162 LAB-PHYSICIAN REFERRALS 621500 2312810 2312810 SCHOOL OF NURSING 611430 1005039 1005039 107730 107730 373612190 1400882 1400882 913244 327524 585720 585720 261861 323859 54055077 376295 55461252 328989 -1406175 47306 -1358869 -1358869 3857333 3039272 818061 818061 340B REVENUE 621990 6234063 6234063 PURCHASE DISCOUNTS, REBATED, REFU 621990 941138 941138 FOOD SERVICES REVENUE 624210 923048 923048 -120023 983819 125592 -1229434 7978226 387908338 373934668 2807993 6293549 2628543 2628543 226575585 200816100 25759485 5284891 4630573 654318 13700245 11997175 1703070 11138549 9759494 1379055 2176449 2176449 809448 809448 207534 3534 204000 220479 220479 84137 84137 18978319 18070327 907992 1342451 365 1342086 900516 229137 671379 10208249 10208249 10630115 9127675 1502440 143641 80864 62777 1005126 999789 5337 17438125 15662833 1775292 3451191 3451191 MEDICAL SUPPLIES 82717691 81308193 1409498 EQUIPMENT RENTAL AND MA 14956815 8765451 6191364 PURCHASED SERVICES 13111369 8637432 4473937 BAD DEBTS 8064938 8064938 0 5267638 722418 4545220 451042044 381052747 69989297 0 390042 544580 54916754 3010677 36749499 38436356 11587117 12425216 838313 1196167 532637657 385866484 155161666 146771173 91568160 53345350 8340059 6063043 28187408 30661221 387739018 292453783 47380971 60967495 289698 356401 80295161 70595016 78007513 63930072 205973343 195848984 X 159340675 76898878 22425000 19705921 181765675 96604799 387739018 292453783 X -63133706 -11611957 -10415212 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 220479 220479 0 PART II-B, LINE 1: ELLIS HOSPITAL PAYS DUES TO THE HEALTHCARE ASSOCIATION OF NEW YORK STATE, IROQUOIS HEALTHCARE ALLIANCE, AMERICAN HOSPITAL ASSOCIATION AND ENVISION STRATEGY. THE PORTION OF THE DUES THAT WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES ARE SHOWN ON FORM 990, PART IX, LINE 11 D AND ABOVE IN SCHEDULE C, PART II-B, LINE 1I AND INCLUDE $21,315 - IROQUOIS, $10,180 - HANYS, $23,272 - AHA, $165,000- ENVISION STRATEGY, AND $712 -LEADINGAGE NY. 0 1 X 22425000 2781278 -533433 4967164 19705681 20793290 20174096 118075 18660461 22425000 14976093 12474744 283304 6940851 20793290 13046893 2526103 424057 1020960 14976093 14914562 2372491 -5374 4234786 13046893 0.30259 0.69741 1 0 6460334 6460334 239437919 131038485 108399434 1313843 1269719 44124 282978831 253558280 29420551 2446730 2446730 146771173 INTEREST IN NET ASSETS OF FOUNDATION 20048173 DEFERRED TAX ASSET 666582 RIGHT OF USE ASSETS 9946466 30661221 ESTIMATED SELF-INSURANCE 12900001 ACCRUED VACATION PAYABLE 6979161 ACCRUED SICK PAYABLE 3205351 ESTIMATED PAYABLES TO 3RD PARTY PAYERS 3384054 CLAIMS PAYABLE 1710012 ACCRUED INTEREST PAYABLE 175479 ASSET RETIREMENT OBLIGATION 1378531 ACCRUED SALARIES 5133167 OTHER LIABILITIES 848827 457 PLAN DEFERRED COMPENSATION 6063043 ACCRUED PENSION LIABILITY 3274543 RIGHT OF USE LIABILITIES 9946466 FINANCE LEASE OBLIGATIONS 8931437 63930072 X PART IV, LINE 2B: THE ELLIS RESIDENTIAL AND REHABILITATION CENTER RESIDENTS SPENDING ACCOUNT IS INCLUDED IN LINE 2 AND LINE 21 ON FORM 990, PART X. THE TOTAL IS $4,571. THESE FUNDS BELONG TO THE RESIDENTS AND ARE DEPOSITED AND DISBURSED BY THE ELLIS RESIDENTIAL AND REHABILITATION DIRECTOR'S DESIGNEE. THE ELLIS HOSPITAL ACCOUNTING DEPARTMENT IS RESPONSIBLE FOR TRACKING THE FUNDS. MEDICAL/DENTAL STAFF DUES ACCOUNT IS INCLUDED IN LINE 2 AND LINE 21 ON FORM 990, PART X. THE TOTAL IS $351,830. THIS FUND CONTAINS DEPOSITS AND DISBURSEMENTS AS DIRECTED BY THE MEDICAL/DENTAL STAFF APPOINTED OFFICERS. THE ELLIS HOSPITAL ACCOUNTING DEPARTMENT IS RESPONSIBLE FOR DEPOSITING AND DISBURSING THE FUNDS ON THE MEDICAL/DENTAL OFFICER'S BEHALF. THE ACCOUNTING DEPARTMENT ALSO ISSUES IRS FORMS 1099 BASED ON THE DISBURSEMENTS. PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE AVAILABLE FOR GENERAL HEALTH SERVICES, PURCHASE OF EQUIPMENT, AWARDS AND EQUIPMENT, AND HEALTH EDUCATION AND RESEARCH. PERMANENTLY RESTRICTED NET ASSETS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES. PART X, LINE 2: THE HOSPITAL AND VNS ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE PHARMACY IS A DISREGARDED ENTITY AND, AS SUCH, TAKES ON THE SECTION 501(C)(3) STATUS ACCORDED TO THE HOSPITAL. ELLIS MEDICINE RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN FIFTY PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. ELLIS MEDICINE DID NOT RECOGNIZE THE EFFECT OF ANY UNCERTAIN INCOME TAX POSITIONS IN EITHER 2022 OR 2021. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2019 THROUGH 2022. ELLIS MEDICINE IS SUBJECT TO INCOME TAX ON ANY INCOME FROM UNRELATED BUSINESS ACTIVITIES. AT DECEMBER 31, 2022 AND 2021, ELLIS MEDICINE HAS A NET DEFERRED TAX ASSET OF APPROXIMATELY $667,000 AND $650,000, RESPECTIVELY, WHICH RELATE TO NET OPERATING LOSSES AVAILABLE FOR INCOME TAX PURPOSES. THE LOSSES EXPIRE IN VARYING AMOUNTS THROUGH 2037. A VALUATION ALLOWANCE IS RECORDED AGAINST DEFERRED TAX ASSETS WHEN THERE IS UNCERTAINTY REGARDING USE IN FUTURE PERIODS. 1 1 X 1 X 300.000000000000 0 1 1 0 1 1 1253339 91662 1161677 0.00260 112704118 55134213 57569905 0.13000 113957457 55225875 58731582 0.13260 510691 0 510691 0.00120 10974804 3855387 7119417 0.01610 2765 0 2765 0.00000 11488260 3855387 7632873 0.01730 125445717 59081262 66364455 0.14990 1 8064938 153631 57084115 70750954 -13666839 X 1 1 1 1 ELLIS HOSPITAL 1101 NOTT STREET SCHENECTADY NY 12308 WWW.ELLISMEDICINE.ORG 4601001H X X X X 82 BED SKILLED NURSING FACILITY ELLIS HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X HTTP://WWW.ELLISMEDICINE.ORG/PAGES/COMMUNITY-REPORT.ASPX X HTTPS://WWW.HEALTHYCAPITALDISTRICT.ORG/INDEX.PHP?MODULE=RESOURCELIBRARY&CON X 1 22 1 HTTP://WWW.ELLISMEDICINE.ORG/PAGES/COMMUNITY-REPORT.ASPX 0 1 X 300.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.ELLISMEDICINE.ORG/FINANCIAL-ASSISTANCE/FAQS.ASPX X HTTP://ELLISMEDICINE.ORG/PDF/CHARITY-CARE-APPLICATION.PDF X HTTP://WWW.ELLISMEDICINE.ORG/BLOB/PUBLICNOTICESFILES.ASHX?ID=274 X X X X X 1 X 0 X X X X 1 X 0 1 ELLIS HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THE SCHENECTADY COUNTY PUBLIC HEALTH SERVICES (A LOCAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT), WITH KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THAT COMMUNITY; ORGANIZATIONS REPRESENTING THE INTERESTS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY; AND ANY WRITTEN COMMENTS RECEIVED ON THE HOSPITAL FACILITY'S MOST RECENTLY CONDUCTED CHNA AND MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY. 1. COMMUNITY MEETINGS: THE FOLLOWING MEETINGS OF THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY (SCHC) WERE CONDUCTED TO PLAN FOR, DEVELOP, COMMENT UPON, AND ADOPT THE 2022-2024 COMMUNITY HEALTH ASSESSMENT, COMMUNITY HEALTH IMPROVEMENT PLAN, AND COMMUNITY SERVICE PLAN, AS WELL AS THE MEETINGS IN 2022 THAT WERE HELD TO CONTINUE ADDRESSING THE PRIORITY NEEDS IDENTIFIED.DATES, TOPICS, AND ATTENDEE ORGANIZATIONS ARE LISTED. ALL MEETINGS WERE HELD VIA VIDEO CONFERENCE DUE TO THE COVID-19 PANDEMIC:OCTOBER 21, 2021 (VIDEO CONFERENCE)TOPICS:-UPDATE ON COVID-19 RESPONSE (DATA, VACCINE, ETC.) -2022-2024 COMMUNITY HEALTH IMPROVEMENT PLAN PLANNING CYCLE - SURVEY TO GATHER COMMUNITY FEEDBACK - 1 GROUP PRIORITIZATION MEETING ON DECEMBER 16, 2021 WITH MORE TIME FOR DISCUSSION - WRITING WILL HAPPEN IN 2022 -UPDATE ON CHIP SUD PREVENTION WORKATTENDEES: ATTENDANCE WAS NOT CAPTURED AT THIS MEETING DUE TO TECHNICAL DIFFICULTIES.DECEMBER 16, 2021 (VIDEO CONFERENCE)TOPICS: THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY MET VIA WEBEX ON DECEMBER 16, 2021, AND HCD PRESENTED THE 9 HEALTH ISSUES AND THEIR RANKING AND DATA POINTS. DISCUSSION FROM THE GROUP INCLUDED IF ANY OTHER LOCAL CONSIDERATIONS SHOULD BE MADE (NEWER DATA, CURRENT WORK, ETC.) AND VOTING ON WHAT PRIORITY AREAS SHOULD BE CHOSEN FOR THIS CYCLE. THE COMPLETE PRESENTATION CAN BE FOUND HERE: (HTTPS://WWW.HEALTHYCAPITALDISTRICT.ORG/CONTENT/SITES/HCDI/CHNA2022/PRIORITIZATION-PROCESS-SCHENECTADY-SUMMARY.PDF). ATTENDEES: CAPITAL DISTRICT PHYSICIANS HEALTH PLAN, CAPITAL DISTRICT TOBACCO-FREE COMMUNITIES, CRHC HEALTH HOME, ELLIS FAMILY HEALTH CENTER, ELLIS MEDICINE, ELLIS MEDICINE FOOD FARMACY, ELLIS PEDIATRIC HEALTH CENTER, HEALTHY CAPITAL DISTRICT, HOMETOWN HEALTH CENTERS, NEW CHOICES PREVENTION, SAFE HOUSE SCHENECTADY, SCHENECTADY CITY SCHOOL DISTRICT, SCHENECTADY COMMUNITY ACTION PROGRAM, SCHENECTADY COUNTY PROBATION DEPARTMENT, SCHENECTADY COUNTY PUBLIC HEALTH SERVICES, SCHENECTADY COUNTY PUBLIC LIBRARY, SHEILA FERRUCCI, ESQ., ST. MARY'S HEALTHCARE, CANCER PREVENTION IN ACTION, ST. PETERS HEALTH PARTNERS COMMUNITY PROGRAMS, ST. PETERS HEALTH PARTNERS, SUNNYVIEW REHABILITATION HOSPITAL, THE DAILY GAZETTE, UNIVERSITY AT ALBANY SCHOOL OF PUBLIC HEALTH.JANUARY 20, 2022 (VIDEO CONFERENCE)TOPICS: THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY MET VIA WEBEX ON JANUARY 20, 2022. THE DISCUSSION INCLUDED AN OVERVIEW OF PREVENTION AGENDA AND LAST CHIP CYCLE'S TOPIC AREAS PRESENTED BY SCHENECTADY COUNTY HEALTH SERVICES, AS WELL AS AN OVERVIEW OF THIS CYCLE'S PROCESS & DATA REVIEW. SCHENECTADY COUNTY PUBLIC HEALTH SERVICES ALSO LED A DISCUSSION OF THE PRIORITY AREAS AND NYSDOH PRESCRIBED INTERVENTIONS, AND THEN THE ATTENDEES SELECTED THE TWO PRIORITIESATTENDEES: CAPITAL DISTRICT TOBACCO FREE COMMUNITIES, SCHENECTADY COUNTY OFFICE OF COMMUNITY SERVICE, CATHOLIC CHARITIES CARE COORDINATION SERVICES/PROJECT SAFE POINT, THE FOOD PANTRIES FOR THE CAPITAL DISTRICT, ELLIS MEDICINE, HEALTHY CAPITAL DISTRICT, SCHENECTADY COUNTY PUBLIC HEALTH SERVICES, THE SCHENECTADY FOUNDATION, ST. PETER'S HEALTH PARTNERS, ELLIS FOOD FARMACY, ELLIS FAMILY HEALTH CENTER, CANCER SERVICES PROGRAM, CDPHPAPRIL 21, 2022 (VIDEO CONFERENCE)TOPICS: AN OVERVIEW OF PRIORITY AREAS WAS PRESENTED BY SCHENECTADY COUNTY PUBLIC HEALTH SERVICES, INCLUDING COVID-19 AND MENTAL HEALTH & SUBSTANCE MISUSE.ATTENDEES: ATTENDANCE WAS NOT CAPTURED AT THIS MEETING DUE TO TECHNICAL DIFFICULTIES.JULY 21, 2022 (VIDEO CONFERENCE)TOPICS: AN OVERVIEW OF COMMUNITY HEALTH NEEDS ASSESSMENT/COMMUNITY HEALTH IMPROVEMENT PLAN PROGRESS WAS GIVEN BY SCHENECTADY COUNTY PUBLIC HEALTH SERVICES AND ELLIS MEDICINE INCLUDING: - FOCUS AREA 1: PREVENT COMMUNICABLE DISEASES VACCINE PREVENTABLE DISEASES: COVID-19 - FOCUS AREA 2: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS ACTION PLANTHERE WAS ALSO A PRESENTATION BY NEW CHOICES PREVENTION SERVICES AND A DISCUSSION OF MENTAL HEALTH & SUBSTANCE USE PEER SERVICES FROM THE ELLIS MEDICINE PEER PROGRAM AND CATHOLIC CHARITIES CARE COORDINATION SERVICES.ATTENDEES: CATHOLIC CHARITIES CARE COORDINATION SERVICES, ELLIS MEDICINE, SCHENECTADY ARC, SCHENECTADY COUNTY PUBLIC HEALTH, ELLIS LIVING ROOM, NEW CHOICES RECOVERY CENTER, CDPHP, ST. PETER'S HEALTH PARTNERS, CANCER PREVENTION IN ACTION, ALTAMONT PROGRAM, C.O.C.O.A. HOUSE INC., SAVE OUR STREETS INC., CAPITAL DISTRICT TOBACCO-FREE COMMUNITIES, HEALTHY CAPITAL DISTRICT, ELLIS FAMILY HEALTH CENTER, HOMETOWN HEALTH CENTERS, CORNELL COOPERATIVE EXTENSION, SCHENECTADY COUNTY PUBLIC LIBRARYOCTOBER 20, 2022 (VIDEO CONFERENCE)TOPICS: -CHA/CHIP/CSP UPDATE NATALIE PREHODA, SCPHS-HOMETOWN HEALTH CENTERS SCHOOL HEALTH CLINICS DR. EVANS, HOMETOWN HEALTH CENTER-YOUTH TOBACCO SERVICES CARA ZAMPI, TOBACCO FREE COMMUNITIES-ELLIS MEDICINE BACK TO SCHOOL CLINICS KRISTINE CHAMBERS, ELLIS FAMILY HEALTH CENTER-HEALTHY ALLIANCE OVERVIEW AND SCHENECTADY MATERNAL AND CHILD HEALTH COMMUNITY HEALTH WORKER HUB JULIE ADAMEC, HEALTHY ALLIANCE-NARCAN TRAININGS JENNIFER HAYDEN, SCPHS OFFICE OF COMMUNITY SERVICES-MENTAL HEALTH FIRST AID JENNIFER HAYDEN, SCPHS OFFICE OF COMMUNITY SERVICES-OTHER AGENCY UPDATES FROM ATTENDEESATTENDEES: CATHOLIC CHARITIES CARE COORDINATION SERVICES, ELLIS MEDICINE, SCHENECTADY COUNTY PUBLIC HEALTH, ELLIS LIVING ROOM, NEW CHOICES RECOVERY CENTER, ST. PETER'S HEALTH PARTNERS, CAPITAL DISTRICT TOBACCO-FREE COMMUNITIES, ELLIS FAMILY HEALTH CENTER, HEALTHY ALLIANCE, BETHESDA HOUSE, CAPITAL DISTRICT CENTER FOR INDEPENDENCE, HOMETOWN HEALTH CENTER, PROJECT SAFEPOINT, FOOD PANTRIES OF THE CAPITAL DISTRICT, SCHENECTADY COUNTY PROBATION DEPARTMENT, CHILDREN'S HEALTH HOME OF UPSTATE NY. 2. ENGAGEMENT OF CONSUMERS THROUGH COMMUNITY SURVEY: THE HEALTHY CAPITAL DISTRICT (HCD) CONDUCTED ITS FOURTH COMMUNITY HEALTH SURVEY OF CAPITAL REGION RESIDENTS FROM SEPTEMBER 13TH TO NOVEMBER 3RD, 2021. THE SURVEY WAS CONDUCTED ONLINE AND IN PAPER FORMAT AND WAS OFFERED IN ENGLISH- AND SPANISH-LANGUAGE VERSIONS. THE SURVEY WAS COLLABORATIVELY CREATED AND DISTRIBUTED BY HCD AND ITS HOSPITAL AND HEALTH DEPARTMENT PARTNERS. THE AIM OF THE SURVEY WAS TO IDENTIFY THE MAJOR NEEDS, GAPS, AND PRIORITIES FACING CAPITAL REGION RESIDENTS REGARDING THE FOLLOWING ASPECTS OF PUBLIC HEALTH: PUBLIC HEALTH PRIORITIES, SOCIAL DETERMINANTS OF HEALTH, HEALTHCARE ACCESS & BARRIERS, MENTAL HEALTH, SUBSTANCE MISUSE, COVID-19 VACCINATION, PREVENTION & COMMUNICATION STRATEGIES. A RANDOM SAMPLING DESIGN WAS APPLIED TO RECRUIT A REPRESENTATIVE SAMPLE OF RESIDENTS OF THE CAPITAL DISTRICT (INCLUDING THE COUNTIES OF ALBANY, COLUMBIA, GREENE, RENSSELAER, SARATOGA, AND SCHENECTADY).SOCIODEMOGRAPHIC INFORMATION WAS ALSO COLLECTED TO GAUGE THE REPRESENTATIVENESS OF THE SURVEYED SAMPLE OF RESIDENTS AND TO COMPARE RESULTS BY COUNTY, INCOME LEVEL, AND RACE/ETHNICITY. SURVEY QUESTIONS AND RESPONSE OPTIONS WERE DEVELOPED BY HCD, IN COLLABORATION WITH THE PREVENTION AGENDA WORKGROUP, AND WERE BASED ON PRIOR EDITIONS FROM 2018, 2016, AND 2013, AS WELL AS OTHER RESOURCES FROM MONTEFIORE MEDICAL CENTER, THE KAISER FAMILY FOUNDATION, AND THE U.S. PREVENTIVE SERVICES TASK FORCE.RESPONSE PERCENTAGES ARE BASED ON 2,104 RESPONSES FROM INDIVIDUALS WHO INDICATED THEY LIVE IN THE COUNTY OF ALBANY (N=547), RENSSELAER (N=268), SCHENECTADY (N=426), SARATOGA (N=194), COLUMBIA (N=387), OR GREENE (N=282). THE SURVEY TOOK APPROXIMATELY 7 MINUTES TO COMPLETE AND 62% OF THOSE WHO OPENED THE ONLINE SURVEY COMPLETED.WHEN ASKED TO RANK THE SERIOUSNESS OF PUBLIC HEALTH ISSUES "IN YOUR COMMUNITY," SCHENECTADY RESIDENTS SURVEYED CHOSE MENTAL HEALTH, SUBSTANCE USE, AND TOBACCO USE AS MOST SIGNIFICANT. THE TOP FIVE TOPICS LISTED AS "VERY SERIOUS" BY OVERALL PERCENTAGE WERE:#1 COVID-19 50.8%#2 OBESITY 50.4% #3 MENTAL ILLNESS INCLUDING SUICIDE 49.5%#4 MISUSE OF DRUGS OR ALCOHOL 44.2%#4 VIOLENCE 44.2%THE DATA COLLECTED IN THIS SURVEY WAS USED TO INFORM THE RANKING OF HEALTH ISSUES IN SCHENECTADY COUNTY AS PART OF THE COMMUNITY HEALTH IMPROVEMENT PLAN AND COMMUNITY SERVICE PLAN FOR 2022-2024.CONTINUED ON SCHEDULE O ELLIS HOSPITAL PART V, SECTION B, LINE 6A: THE PORTION OF THE CHNA WHICH INCLUDES COMPILED PUBLIC HEALTH DATA AND THE RESULTS OF THE COMMUNITY SURVEY WAS PREPARED BY THE HEALTHY CAPITAL DISTRICT (HCD), DESIGNATED AND PARTIALLY FUNDED BY THE STATE OF NEW YORK AS A REGIONAL POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP) HEALTH RESEARCH AND PLANNING ENTITY, WHOSE HOSPITAL MEMBERS INCLUDE ELLIS HOSPITAL, ALBANY MEDICAL CENTER (INCLUDING AFFILIATES COLUMBIA MEMORIAL HOSPITAL AND SARATOGA HOSPITAL), AND ST. PETER'S HEALTH PARTNERS (INCLUDING ST. PETER'S HOSPITAL, SUNNYVIEW REHABILITATION HOSPITAL, ALBANY MEMORIAL HOSPITAL, SAMARITAN HOSPITAL OF TROY, AND SETON HEALTH/ST. MARY'S HOSPITAL OF TROY). ELLIS HOSPITAL PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED TO MEET NOT ONLY FEDERAL REQUIREMENTS, BUT ALSO TO SERVE AS THE NEW YORK STATE-REQUIRED COMMUNITY SERVICE PLAN (CSP) FOR ELLIS HOSPITAL AND THE NEW YORK STATE-REQUIRED COMMUNITY HEALTH ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR SCHENECTADY COUNTY PUBLIC HEALTH SERVICES, A UNIT OF COUNTY GOVERNMENT. IN ADDITION, IT WAS INTENDED TO INFORM THE COMMUNITY SERVICE ACTIVITIES OF THE MEMBER ORGANIZATIONS OF THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY (SCHC). AS OF THE 2022 CHNA, ACTIVE MEMBERS OF SCHC PARTICIPATING IN THE SELECTION AND PRIORITIZATION PROCESS WERE:-CAPITAL DISTRICT PHYSICIANS HEALTH PLAN -CAPITAL DISTRICT TOBACCO-FREE COMMUNITIES -CRHC HEALTH HOME-ELLIS HOSPITAL-ELLIS FAMILY HEALTH CENTER-ELLIS MEDICINE FOOD FARMACY -ELLIS PEDIATRIC HEALTH CENTER -HEALTHY CAPITAL DISTRICT -HOMETOWN HEALTH CENTERS-NEW CHOICES PREVENTION-SAFE HOUSE SCHENECTADY-SCHENECTADY CITY SCHOOL DISTRICT-SCHENECTADY COMMUNITY ACTION PROGRAM -SCHENECTADY COUNTY PROBATION DEPARTMENT-SCHENECTADY COUNTY PUBLIC HEALTH SERVICES-SCHENECTADY COUNTY PUBLIC LIBRARY -SHEILA FERRUCCI, ESQ.-ST. MARY'S HEALTHCARE, CANCER PREVENTION IN ACTION -ST. PETERS HEALTH PARTNERS COMMUNITY PROGRAMS-ST. PETERS HEALTH PARTNERS-SUNNYVIEW REHABILITATION HOSPITAL-THE DAILY GAZETTE-UNIVERSITY AT ALBANY SCHOOL OF PUBLIC HEALTH ELLIS HOSPITAL PART V, SECTION B, LINE 11: THE GLOBAL COVID-19 PANDEMIC EMERGENCY STRUCK EARLY IN 2020 IN NEW YORK STATE INCLUDING SCHENECTADY (WHICH IS ON A DIRECT HIGHWAY ROUTE JUST 150 MILES NORTH OF THE PANDEMIC'S INITIAL U.S. EPICENTER IN NEW YORK CITY), WHERE ELLIS HOSPITAL IS THE ONLY GENERAL HOSPITAL WITH THE ONLY INTENSIVE CARE UNIT (ICU) AND SCPHS IS THE ONLY MUNICIPAL HEALTH DEPARTMENT WITH A PUBLIC HEALTH MISSION AND CAPACITY. ONE OF THE EARLIEST IDENTIFIED COVID-19 DEATHS IN THE CAPITAL REGION WAS OF A SCHENECTADY RESIDENT ON MARCH 23, 2020. FROM MID-MARCH 2020 THROUGH THE END OF 2021, ELLIS, SCPHS, AND COMMUNITY-BASED AGENCIES WERE FORCED TO PIVOT FROM THE PREVIOUSLY-DETERMINED COMMUNITY HEALTH PRIORITIES AND TO DEVOTE NEARLY ALL MEDICAL AND NON-MEDICAL COMMUNITY SUPPORT RESOURCES TO GOVERNMENT-MANDATED COVID EMERGENCY RESPONSE ACTIVITIES. ADDITIONALLY, COMMUNITY HEALTH MOMENTUM WHICH HAD DEVELOPED OVER THE PAST SEVERAL YEARS CONTRIBUTED TO A COORDINATED COMMUNITY-WIDE COVID RESPONSE, AND TO AT LEAST SOME AMOUNT OF CONTINUED EFFORTS TO ADDRESS THE PRE-COVID NEEDS. ELLIS ALSO UTILIZED ITS UNIQUE RESOURCES TO PROVIDE COMMUNITY EDUCATION AS WELL AS TO SUPPORT ESSENTIAL HEALTH WORKERS THROUGHOUT THE REGION. ELLIS' CHIEF OF MEDICAL STAFF, IS A SPECIALIST IN INFECTIOUS DISEASE, WAS AMONG THE FEW MEDICAL PROFESSIONALS ESPECIALLY KNOWLEDGEABLE DURING THE EARLY STAGES OF THE PANDEMIC. ELLIS PRODUCED WEEKLY TWO-MINUTE VIDEOS FEATURING THIS PHYSICIAN AND OFFERING FACTUAL EDUCATION REGARDING ASPECTS OF THE DISEASE, AND ELECTRONICALLY DISTRIBUTED THESE TO A LIST WHICH REACHED 10,000 PEOPLE. WHEN THE INITIALLY AVAILABLE VACCINES REQUIRED HIGHLY SPECIALIZED REFRIGERATION EQUIPMENT AND HANDLING TECHNIQUES, AVAILABLE IN THE REGION ONLY AT ELLIS AND ONE OTHER HOSPITAL, ELLIS STEPPED UP TO VACCINATE NOT ONLY ITS OWN ESSENTIAL HEALTH WORKERS, BUT ALSO HOSPITAL STAFFS AND HEALTH CARE WORKERS FROM NUMEROUS OTHER HOSPITALS AND HEALTH CARE SYSTEMS IN THE AREA.ELLIS HOSPITAL HAS PROVIDED, AND WILL CONTINUE TO PROVIDE, ACCESS TO CRITICAL TREATMENT AND PREVENTION SERVICES TO THE SCHENECTADY COMMUNITY THROUGH ONE OF THE MOST VIRULENT PANDEMICS IN RECENT MEMORY, COVID-19. SINCE MARCH 2020, THE STAFF AT ELLIS HOSPITAL HAVE PROVIDED INPATIENT CARE TO WELL OVER 2,000 PATIENTS DIAGNOSED WITH COVID-19. ELLIS OPENED A DEDICATED COVID-19 CARE UNIT EARLY IN THE PANDEMIC TO PROVIDE SPECIALIZED CARE TO THESE PATIENTS, AND SEVERAL OVERFLOW UNITS TO ACCOMMODATE ADDITIONAL PATIENT LOAD WHEN THE NUMBER OF CASES SURGED. ELLIS WILL CONTINUE TO CARE FOR HOSPITALIZED PATIENTS WITH COVID-19 IN ITS SPECIALIZED COVID-19 CARE UNIT AND INTENSIVE CARE UNIT. ELLIS WAS THE FIRST HOSPITAL IN THE CAPITAL REGION TO OFFER REMDESIVIR AS A TREATMENT FOR PATIENTS, AS AN EARLY PARTICIPANT IN THE GILEAD EXPANDED ACCESS TRIAL BEGINNING IN APRIL 2020. ELLIS HOSPITAL'S INFECTIOUS DISEASE DEPARTMENT ALSO WORKED WITH REGENERON TO PROVIDE ACCESS TO THEIR MONOCLONAL ANTIBODY INFUSIONS TO PATIENTS DIAGNOSED WITH COVID-19 THROUGH OUR INFUSION CENTER AND IN THE COMMUNITY. ELLIS WILL CONTINUE TO PROVIDE ACCESS TO THIS AND OTHER NEW TREATMENTS FOR COVID-19 TO ITS PATIENTS.BEGINNING ON DECEMBER 14, 2020, THE ELLIS HOSPITAL TEAM ADMINISTERED OVER 14,000 DOSES OF COVID-19 VACCINES, INITIALLY TO STAFF OF CAPITAL REGION HOSPITALS, AND OTHER LOCAL HIGH-RISK WORKERS IN THE HEALTH CARE FIELD, AND THEN TO THE PUBLIC, IN WHAT WAS A CRITICALLY IMPORTANT PUBLIC HEALTH EFFORT FOR THE COMMUNITY. ELLIS CURRENTLY PROVIDES SPACE FOR SCHENECTADY PUBLIC HEALTH SERVICES TO HOST ITS COVID-19 COMMUNITY TESTING AND VACCINATION SITE AT THE MCCLELLAN STREET HEALTH CENTER CAMPUS AND WILL CONTINUE TO DO SO FOR THE FORESEEABLE FUTURE. AS A TEACHING HOSPITAL, ONE OF THE IMPORTANT ROLES ELLIS HOSPITAL PLAYS IS PROVIDING HIGH-QUALITY MEDICAL EDUCATION PROGRAMS TO HELP HEALTH CARE PROVIDERS BETTER SERVE THE NEEDS OF THE COMMUNITY. ELLIS MEDICINE'S DEPARTMENT OF INTERNAL MEDICINE HOSTED ONLINE GRAND ROUNDS EDUCATIONAL WEBINARS ON COVID-19 BEGINNING IN MARCH 2020 TO ENSURE COMMUNITY HEALTH CARE PROVIDERS HAD ACCESS TO THE LATEST INFORMATION ON THE PANDEMIC. THESE EDUCATIONAL PROGRAMS ARE RECORDED, AND MADE AVAILABLE THROUGH THE MEDICAL EDUCATION COMMITTEE'S WEBSITE AT HTTPS://WWW.ELLISCME.ORG/. THE PROGRAMS INCLUDED: MARCH 20, 2020 "COVID-19: A GLOBAL PANDEMIC- INFORMATION FOR PROVIDERS" DAVID PRATT, MD, MPHMARCH 27, 2020 "COVID-19 PANDEMIC: UPDATE MARCH 27" DAVID PRATT, MD, MPHAPRIL 3, 2020 "ALLOCATION OF SCARCE MEDICAL RESOURCES IN PANDEMICS" DR. GEORGE GIOKAS, DR. MARTIN STROSBERG, FATHER ANTHONY GREEN, AND GWEN BONDIAPRIL 17, 2020 "LOPIRAMIR/RITINAVIR, REMDESIVIR AND HYDROXYCHLOROQUINE FOR COVID-19 TREATMENT: HELP, HYPE OR HARM?" PETER F. WEINBERG, MD, ROBERT DACHS, MD, & DOUGLAS FINCH, MDAPRIL 24, 2020 "COVID-19: CLINICAL AND THERAPEUTIC ASPECTS A CLINICIAN'S PERSPECTIVE" PETER F. WEINBERG, MDMAY 1, 2020 "COVID-19 UPDATE" CAROLYN JONES-ASSINI, MD, ALI MIRZA, MD, DOUGLAS FINCH, MD, GEORGE GIOKAS, MD, J. ANTONIO REYES, MD & JEHANZEB KHAN, MDMAY 15, 2020 "THE NEED FOR PHYSICIAN SELF CARE IN THE MIDST OF A PANDEMIC" DR. ANTHONY SANTILLI & DR. CAROLYN JONES-ASSINIMAY 22, 2020 "COVID-19: INTERNET STORIES FROM CHINA AND BEYOND" KOKWAI YAP, MDMAY 29, 2020 "IMPROVING COMMUNICATION SKILLS IN THE MIDST OF A PANDEMIC & AHA GUIDELINES FOR COAGULAPATHIES AND DVT PREVENTION IN COVID PATIENTS" DR. PATRICIA FORD AND DR. SUNITHA SUKAMARANJUNE 12, 2020 "MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN" DR. ROBERT DACHSOCTOBER 9, 2020 "SARS-COV-2 PLUS SEASONAL INFLUENZA: DOUBLE TROUBLE FOR THE WINTER OF 2020-2021?" DAVID PRATT, MD, MPHOCTOBER 23, 2020 "NEUROLOGIC MANIFESTATION OF COVID-19" RICHARD B. BROOKS, MDFEBRUARY 12, 2021 "HOW THE PANDEMIC HAS EFFECTED OUR COMMUNITY'S MENTAL HEALTH" DR. DAVID OLSENFEBRUARY 26, 2021 "COVID UPDATE: VACCINES AND VARIANTS" ROBERT DACHS, M.D.MAY 14, 2021 "AMC COVID 19 TREATMENT ALGORITHM" DR. GREGORY WUSEPTEMBER 17, 2021 "COVID-19 UPDATE" ROBERT DACHS, MD, MICHAEL LIN, MD, AND DEAN LIMERI, MDJANUARY 21, 2022 "OUTPATIENT MANAGEMENT OF THE ACUTELY INFECTED COVID-19 PATIENT" DR. ROBERT DACHSAPRIL 1, 2022 "NON-INVASIVE VENTILATION FOR THE NON-INTENSIVIST IN THE AGE OF COVID" DR. GREGORY WUOCTOBER 14, 2022 "THE OUTPATIENT TREATMENT OF COVID-19: WHAT'S NEW SINCE WE LAST SPOKE?" DR. ROBERT DACHSDECEMBER 2, 2022 "RATIONING HEALTHCARE DURING A PANDEMIC" DR. TERENCE MEEHAN & DR. ANTHONY SANTILLIJANUARY 27, 2023 "VACCINE DEVELOPMENT" JEFFREY KENNEDY, M.D.CONTINUED ON SCHEDULE O ELLIS HOSPITAL PART V, SECTION B, LINE 24: IN 2022, SELF PAY PATIENTS MAY BE BILLED CHARGES FOR SERVICES RENDERED. ELLIS DOES NOT HAVE A MECHANISM TO KNOW PRE-SERVICE UNLESS ELLIS HAS SPOKEN TO THE PATIENT PRIOR TO THE DATE OF SERVICE, THAT THERE IS NO INSURANCE COVERAGE. FOR INPATIENT ACCOUNTS, THERE IS A DEPARTMENT THAT IS RESPONSIBLE TO CONTACT THE PATIENT WHILE IN-HOUSE TO ASSIST WITH ANY PAYMENT ARRANGEMENTS. THIS INCLUDES ASSISTING THE PATIENT IN OBTAINING HEALTHCARE COVERAGE THROUGH THE NYS MARKETPLACE, NYS MEDICAID, OR FAP. SELF PAY PATIENTS ARE PROVIDED A 50% DISCOUNT OF CHARGES IF NO INSURANCE IS OBTAINABLE OR IF THE PATIENT REFUSES TO OBTAIN COVERAGE. ELLIS ALSO HAS PRESUMPTIVE ELIGIBILITY PROCESS FOR PATIENTS WHO HAVE NOT PAID THEIR BILL IN FULL PRIOR TO GOING TO BAD DEBT. THE PATIENT MEETS "SCORING CRITERIA" FOR ELLIS FAP, THE BALANCES WILL BE WRITTEN OFF TO PRESUMPTIVE ELIGIBILITY, TO SAFEGUARD AGAINST SEND POTENTIAL FAP QUALIFYING PATIENTS TO BAD DEBT. 16 1 - ELLIS HOSPITAL MENTAL HEALTH CLINIC 1023 STATE ST SCHENECTADY NY 12307 MENTAL HEALTH SERVICES 2 - GLENVILLE HEALTHCARE CENTER 115 SARATOGA ROAD SUITE 200 GLENVILLE NY 12302 PRIMARY CARE SERVICES, BLOOD DRAW 3 - ELLIS HOSPITAL BARIATRIC CENTER 2125 RIVER RD NISKAYUNA NY 12309 BARIATRIC CARE SERVICES 4 - ELLIS BLOOD DRAW STATION 2 CHELSEA PLACE CLIFTON PARK NY 12065 BLOOD DRAW 5 - ELLIS HOSPITAL PRIMARY CARE 1201 NOTT STREET SCHENECTADY NY 12308 PRIMARY CARE SERVICES 6 - ELLIS HOSPITAL NEUROLOGY 1101 NOT STREET B6 SCHENECTADY NY 12308 OUTPATIENT NEUROLOGY 7 - ELLIS HOSPITAL PROS PROGRAM 1023 STATE ST SCHENECTADY NY 12307 MENTAL HEALTH SERVICES 8 - ELLIS HOSPITAL REHABILITATION SERVICES 650 MCCLELLAN STREET SCHENECTADY NY 12304 PHYSICAL THERAPY SERVICES 9 - MEDICAL CENTER OF CLIFTON PARK 103 SITTERLY ROAD CLIFTON PARK NY 12065 24/7 EMERGENT CARE, LAB, MEDICAL IMAGING, PRIMARY CARE AND SPECIALTY SERVICE 10 - BLOOD DRAW- NISKAYUNA 2123 RIVER RD NISKAYUNA NY 12309 PROVIDE BLOOD DRAW SERVICES 11 - ELLIS CUSHING MEDICAL ARTS BUILDING 624 MCCLELLAN STREET SCHENECTADY NY 12304 FAMILY AND PRIMARY CARE SERVICES 12 - ELLIS MEDICINE PRIMARY CARE BALLSTON SPA 990 STATE ROUTE 67 BALLSTON SPA NY 12020 PRIMARY CARE MEDICINE 13 - ELLIS HOSPITAL MCCLELLAN ST HEALTH CENT 600 MCCLELLAN STREET SCHENECTADY NY 12304 MEDICAL CENTER 14 - ELLIS MEDICINE PRIMARY CARE- MALTA 2537 ROUTE 9 MALTA NY 12020 PRIMARY CARE MEDICINE 15 - ELLIS PRIMARY CARE PLUS 624 MCCLELLAN STREET SCHENECTADY NY 12304 PRIMARY CARE MEDICINE 16 - ELLIS MEDICINE URGENT AND PRIMARY CARE 200 HARBORSIDE DRIVE SCHENECTADY NY 13205 URGENT AND PRIMARY CARE PART I, LINE 3C: APPEALS PROCESS IF INCOME OVER 300% FPG:1. A FORMAL LETTER WRITTEN TO THE PATIENT FINANCIAL SERVICES DEPARTMENT FOR RE-CONSIDERATION MUST BE RECEIVED WITHIN 2 WEEKS OF DENIAL NOTIFICATION2. CONSIDERATION OF CHANGE IN WAGES THAT WOULD PROVIDE A DIFFERENT RESULT THAN THE CURRENT PAYSTUB OR OTHER PROOF OF INCOME. PROOF OF CHANGE IN WAGES MUST BE RECEIVED IN THIS CASE.3. A REVIEW OF PRIOR PAYMENT HISTORY WILL BE CONDUCTED.4. ALL CASES NEED TO BE BELOW 400% OF THE FEDERAL POVERTY LEVEL TO BE CONSIDERED.5. WITHIN 14 DAYS OF RECEIVING THE LETTER, REVIEW OF THE SUPPORTING DOCUMENTATION WILL TAKE PLACE AND THE DIRECTOR WILL INFORM THE MANAGER OF SELF PAY/CUSTOMER SERVICE OF THE DECISION MADE AND ADVISE TO UPHOLD OR OVERTURN THE ORIGINAL DENIAL DECISION. PART I, LINE 7: ELLIS HOSPITAL USED A COST-TO-CHARGE RATIO DERIVED FROM OUR WORKSHEET 2- RATIO OF PATIENT CARE COST TO CHARGES. THE ADJUSTED PATIENT CARE COST IS DIVIDED BY ADJUSTED PATIENT CARE CHARGES RESULTING IN THE RATIO. PART I, LN 7 COL(F): THE EXPLANATION OF BAD DEBT EXPENSE CAN BE FOUND IN THE ATTACHED FINANCIAL STATEMENTS, PAGES 13 THROUGH 19. SCHEDULE H, PART I, LINE 6A DURING THE TAX YEAR, ELLIS FILED ITS COMMUNITY SERVICE PLAN/COMMUNITY HEALTH IMPROVEMENT PLAN ANNUAL REPORT (EQUIVALENT TO A COMMUNITY BENEFIT REPORT) WITH THE NEW YORK STATE DEPARTMENT OF HEALTH, JOINTLY WITH THE SCHENECTADY COUNTY PUBLIC HEALTH SERVICE. ELLIS MADE AVAILABLE TO THE PUBLIC A COPY OF THE MOST RECENT (2022, 2019, 2016, 2013) FOUR CHNAS AND THE MOST RECENTLY COMPLETED AND FILED IRS FORM 990 (2021) LISTING COMMUNITY BENEFITS BY POSTING THEM TO ITS PUBLIC WEBSITE. PART II, COMMUNITY BUILDING ACTIVITIES: ELLIS HOSPITAL'S COMMUNITY-BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES. ELLIS SUCCESSFULLY RESTRUCTURED HEALTH CARE SERVICES IN SCHENECTADY FOLLOWING THE NEW YORK STATE-MANDATED HOSPITAL CONSOLIDATION AND HAS SINCE BEEN WORKING TO IMPROVE THE EFFICIENCY AND EFFECTIVENESS OF SERVICES TO ITS COMMUNITY BY ALIGNING ITS INNOVATIVE APPROACHES TO COMMUNITY HEALTH WITH THE SERVICES PROVIDED BY OTHER LOCAL COMMUNITY-BASED PUBLIC AND NOT-FOR-PROFIT ORGANIZATIONS. ELLIS IS NOW THE SOLE ACUTE CARE HOSPITAL IN SCHENECTADY COUNTY, AND IS ONE OF THE LARGEST PRIMARY CARE PROVIDERS, HAVING ASSUMED RESPONSIBILITY FOR THE SERVICES OF TWO FORMER HOSPITALS WHICH CLOSED DURING THE STATE'S "RIGHTSIZING" PROCESS. IN THIS IMPORTANT ROLE, ELLIS HAS ENGAGED THE COMMUNITY AND DEVELOPED COALITIONS WITH COMMUNITY PARTNERS IN ORDER TO ENSURE ACCESS TO A FULL RANGE OF HEALTHCARE SERVICES, WITH SPECIAL ATTENTION PAID TO DISADVANTAGED MEMBERS OF OUR COMMUNITY. ELLIS HAS UNDERTAKEN A NUMBER OF SIGNIFICANT CAPITAL PROJECTS TO CONSOLIDATE CARE, ENHANCE ACCESS TO CARE, AND IMPROVE THE OVERALL QUALITY, EFFICIENCY, AND COST-EFFECTIVENESS OF OUR LOCAL HEALTH CARE SYSTEM. ELLIS SERVED AS CO-LEAD AGENCY (WITH SCHENECTADY COUNTY PUBLIC HEALTH SERVICES) OF THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY (SCHC). ELLIS HELPS TO MAINTAIN FOR SCHC AN E-MAIL LIST OF APPROXIMATELY 335 INDIVIDUALS FROM ABOUT 60 (SEE PART V, SECTION B, LINE 6B NARRATIVE) HEALTH CARE PROVIDERS, MANAGED CARE ORGANIZATIONS, COMMUNITY-BASED ORGANIZATIONS, AND LOCAL GOVERNMENT AGENCIES LOCATED IN OR SERVING PEOPLE IN SCHENECTADY. PRIOR TO THE COVID-19 PANDEMIC EMERGENCY, SCHC MET QUARTERLY AT THE ELLIS MCCLELLAN STREET HEALTH CENTER AUDITORIUM. THE FORMAL AGENDA (SEE PART V, SECTION B, LINE 5 NARRATIVE) INCLUDED PRESENTATIONS ON CURRENT TOPICS AND ACTIVITIES OF INTEREST, ALONG WITH REGULAR PRESENTATIONS ON LOCAL DSRIP AND PHIP INITIATIVES, AND PROVIDED TIME FOR INFORMAL INFORMATION SHARING AMONG THE PARTICIPANTS. AS A RESULT OF COVID-19 ALL MEETINGS DURING 2022 WERE CONDUCTED BY VIDEOCONFERENCE. SCHC SUPPORTS AD HOC COMMITTEES FOCUSED ON ADDRESSING LOCAL POPULATION HEALTH NEEDS. THESE HAVE INCLUDED GROUPS FOCUSED ON THE MOST SIGNIFICANT COMMUNITY HEALTH NEEDS OBESITY/DIABETES, TOBACCO/NICOTINE, AND SUICIDE/MENTAL HEALTH ALONG WITH THOSE INVESTIGATING EMERGING NEEDS AND RESPONSES, PARTICULARLY TRAUMA-INFORMED COMMUNITIES. THE COMMITTEES ENGAGE DIRECTLY AFFECTED MEMBER ORGANIZATIONS AND REPORT TO THE FULL GROUP. THE COMMITTEES ALSO HELP TO EMPHASIZE ACTIVITIES SUPPORTING THE IMPLEMENTATION STRATEGY.ELLIS IS A VOTING MEMBER OF THE HEALTHY CAPITAL DISTRICT (HCD), A COLLABORATIVE MEMBERSHIP ORGANIZATION SUPPORTED BY DUES FROM THE HOSPITALS, FEDERALLY QUALIFIED HEALTH CENTERS, NOT-FOR-PROFIT MANAGED CARE ORGANIZATIONS, AND COUNTY PUBLIC HEALTH DEPARTMENTS IN THE REGION. AN ELLIS EMPLOYEE SERVES ON THE HCDI BOARD OF DIRECTORS. IN ADDITION TO SERVING AS A NEUTRAL CONVENER SUPPORTING REGIONAL COLLABORATION, HCDI HAS BEEN DESIGNATED BY THE NEW YORK STATE DEPARTMENT OF HEALTH AS THE POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP) AGENCY FOR THE CAPITAL REGION. THE PHIP RECEIVES STATE FUNDING FOR RESEARCH AND REGIONAL HEALTH PLANNING SUPPORT.IN 2012, ELLIS AND ITS THEN-AFFILIATED VISITING NURSE SERVICE OF NORTHEASTERN NEW YORK (VNS) LED SIX COMMUNITY-BASED ORGANIZATIONS AND TEN HOSPITALS IN A TEN-COUNTY REGION COVERING 20% OF THE GEOGRAPHY OF THE STATE OF NEW YORK IN SUCCESSFULLY RECEIVING A CONTRACT AS A MEDICARE COMMUNITY-BASED CARE TRANSITIONS PROGRAM (CCTP). ALTHOUGH THE CCTP WAS HIGHLY SUCCESSFUL IN REDUCING READMISSIONS AMONG THE PATIENTS IT SERVED, IT DID NOT ACHIEVE THE PATIENT VOLUME REQUIRED BY CMS, AND THE CONTRACT FOR THIS REGION WAS NOT RENEWED BY CMS IN 2014. ELLIS AND ITS REGIONAL PARTNERS CONTINUED TO DELIVER CCTP-LIKE SERVICES TO PATIENTS INSURED BY A REGIONAL NOT-FOR-PROFIT MANAGED CARE ORGANIZATION. A DSRIP "CARE TRANSITIONS" PROJECT SUSTAINED FUNDING FOR CERTAIN PATIENTS.ELLIS AND VNS ALSO LED COMMUNITY PROVIDERS AND COMMUNITY-BASED ORGANIZATIONS IN ESTABLISHMENT OF ONE OF THE FIRST THREE STATE-RECOGNIZED HEALTH HOMES IN UPSTATE NEW YORK. HEALTH HOMES RECEIVE CAPITATED STATE FUNDING TO DELIVER CARE MANAGEMENT SERVICES TO AT-RISK MEDICAID BENEFICIARIES, SPECIFICALLY THOSE WITH TWO OR MORE CHRONIC CONDITIONS, A SEVERE AND PERSISTENT MENTAL HEALTH DIAGNOSIS, OR A DIAGNOSIS OF HIV/AIDS. MUCH OF THE CARE MANAGEMENT IS DELIVERED BY "DOWNSTREAM" COMMUNITY-BASED AGENCIES INCLUDING CATHOLIC CHARITIES CAREGIVERS SERVICE AND THE ALLIANCE FOR POSITIVE HEALTH. IN 2018, ELLIS WITHDREW FROM PROVIDING HEALTH HOME SERVICES IN SCHENECTADY, BUT REMAINS AS A "DOWNSTREAM PROVIDER" FOR THE REGIONAL CAPITAL REGION HEALTH CONNECTIONS HEALTH HOME.ELLIS ALSO PROVIDES SERVICES AND EXPERTISE AT NO CHARGE TO COMMUNITY ORGANIZATIONS. MEETING ROOMS, INCLUDING AUDITORIUMS AT BOTH THE NOTT STREET AND MCCLELLAN STREET CAMPUSES, ARE MADE AVAILABLE AT NO CHARGE FOR CERTAIN COMMUNITY MEETINGS AND GROUPS, INCLUDING RED CROSS BLOOD DRIVES. MANY BOARD MEMBERS, PHYSICIANS AND OTHER STAFF DONATE THEIR SERVICES TO COMMUNITY ORGANIZATIONS. AS EXAMPLES, FACULTY PHYSICIANS AT THE FAMILY MEDICINE RESIDENCY SERVE AS OFFICERS OR BOARD MEMBERS OF SUCH ORGANIZATIONS AS CORNELL COOPERATIVE EXTENSION, SOUTHERN MEDICAL ASSOCIATION, NEW YORK COLLEGE OF OSTEOPATHIC MEDICINE EDUCATION AND RESEARCH COMMITTEE, HEPATITIS C TASK FORCE OF THE CAPITAL REGION, NEW YORK STATE ACADEMY OF FAMILY PHYSICIANS, AND HOMETOWN HEALTH CENTERS (FQHC) CREDENTIALING COMMITTEE. A FORMER MEMBER OF THE ELLIS BOARD OF TRUSTEES SERVED AS CHAIR OF THE BOARD OF HOMETOWN HEALTH CENTERS, AND THE CURRENT MEMBER OF THE ELLIS BOARD CHAIRS THE CITY OF SCHENECTADY MAYOR'S SMART CITY ADVISORY COMMITTEE.ANOTHER EXAMPLE OF ELLIS' COALITION BUILDING ACTIVITIES HAS BEEN ITS PARTICIPATION OVER THE YEARS IN THE SCHENECTADY COUNTY PUBLIC HEALTH SERVICES' FEDERALLY-FUNDED STRATEGIC ALLIANCE FOR HEALTH (SAH), WHICH BRINGS TOGETHER A HOST OF HEALTH CARE AND COMMUNITY ORGANIZATIONS TO ADDRESS CHRONIC DISEASE AND TO PROMOTE DISEASE PREVENTION AND WELLNESS. AN ELLIS REPRESENTATIVE PARTICIPATED WHEN THE SAH BOARD HELD REGULAR MEETINGS. ADDITIONALLY, ELLIS WORKS WITH A NUMBER OF COMMUNITY PARTNERS, SUCH AS THE AMERICAN HEART ASSOCIATION AND THE YMCA, TO PROVIDE HEALTH SCREENINGS TO UNINSURED AND UNDERINSURED POPULATIONS IN OUR SERVICE AREA. IN RECENT YEARS, ELLIS PROVIDED OFFICE SPACE AND OTHER IN-KIND SUPPORT FOR THE STATE-SPONSORED SCHENECTADY COUNTY CANCER SERVICES PROGRAM; AND ALSO PROVIDED NO-CHARGE OFFICE SPACE FOR THE VITA INCOME TAX PREPARATION VOLUNTEERS. IN COLLABORATION WITH COMMUNITY PARTNERS, ELLIS OFFERS OUTPATIENT SMOKING CESSATION COURSES AND SPONSORS PEER-DRIVEN MENTAL HEALTH AND CANCER PATIENT SUPPORT GROUPS. AND, ELLIS COOPERATES WITH COMMUNITY GROUPS TO FACILITATE ACCESS TO HEALTHY FOODS FOR PEOPLE THROUGH THE COMMUNITY. IN PAST YEARS, ACTING IN COLLABORATION WITH THE SCHENECTADY COUNTY PLANNING DEPARTMENT AND THE COOPERATIVE EXTENSION, ELLIS HOSTED A WEEKLY FARMERS' MARKET IN THE PARKING LOT OF THE ELLIS HEALTH CENTER DURING THE SUMMER MONTHS. AS PART OF A COUNTY GRANT, PHYSICIANS AT THE FAMILY HEALTH CENTER "PRESCRIBED" FRESH VEGETABLES TO AT-RISK PATIENTS. THE "PRESCRIPTION" CONSTITUTED A VOUCHER FOR NO-CHARGE LOCALLY-GROWN VEGETABLES WHICH WERE DISTRIBUTED AT A "FARM STAND" LOCATED AT THE ELLIS MCCLELLAN STREET HEALTH CENTER. DURING 2018-2022, A "FOOD FARMACY" FOOD PANTRY, SPECIFICALLY FOCUSED ON ENSURING THE AVAILABILITY OF HEALTHY FOOD TO PATIENTS RECENTLY DISCHARGED FROM THE HOSPITAL, WAS LOCATED AT THE ELLIS MCCLELLAN STREET HEALTH CENTER, FUNDED BY A DSRIP GRANT. IN OTHER RECENT YEARS, ELLIS OFFERED USE OF THE PARKING LOT AT THE MCCLELLAN STREET HEALTH CENTER TO THE SCHENECTADY INNER CITY MINISTRY (SICM) MOBILE MEALS TRUCK WHICH PROVIDES FREE BREAKFASTS AND LUNCHES FOR CHILDREN AGE 18 OR UNDER DURING THE SUMMER WHEN SCHOOLS ARE CLOSED. ONE-HUNDRED PERCENT OF CHILDREN ATTENDING THE SCHENECTADY CITY SCHOOL DISTRICT (SCSD) SCHOOLS ARE ELIGIBLE FOR FREE SCHOOL LUNCHES.MEDICAL RESIDENTS FROM THE ELLIS FAMILY MEDICINE RESIDENCY DONATE THEIR TIME AND EXPERTISE TO STAFF FREE COMMUNITY-BASED MEDICAL CLINICS. RESIDENT-STAFFED FREE CLINICS AT THE SCHENECTADY CITY MISSION - AND, SINCE 2018, AT BETHESDA HOUSE SERVE UNINSURED, HOMELESS INDIVIDUALS IN THE CITY OF SCHENECTADY. ELLIS STAFF MEMBERS ALSO SIT ON NUMEROUS COMMUNITY BOARDS AND HEALTHCARE COALITIONS TO TARGET IMPROVEMENTS IN SUCH AREAS AS DIABETES, LONG TERM CARE, CANCER, HOSPITAL READMISSION RATES, WORKFORCE DEVELOPMENT, AND HEALTHY LIVING. PART III, LINE 2: THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS ON PART III, COST TO CHARGE RATIO WAS APPLIED AT 100%. BAD DEBTS ALREADY REPRESENTED AS EXPENSE ON FINANCIALS, THEREFORE NO NEED TO APPLY RCC HERE. PART III, LINE 3: IN 2022, UNDER THE FINANCIAL ASSISTANCE POLICY, THERE WAS NO SLIDING SCALE. THIS MEANS THAT IF A PATIENT QUALIFIED FOR FINANCIAL ASSISTANCE, THE PATIENT BALANCE WAS WRITTEN OFF AT 100% TO CHARITY CARE. THE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 4: SEE ATTACHED FINANCIAL STATEMENTS, PAGES 13 THROUGH 19. PART III, LINE 8: ELLIS BELIEVES THAT THE MEDICARE SHORTFALL REPORTED ON PART III LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT. FIRST, ELLIS IS THE ONLY ACUTE CARE GENERAL HOSPITAL IN SCHENECTADY, AND THUS PROVIDES VITAL HEALTH CARE SERVICES FOR MEDICARE BENEFICIARIES WHICH WOULD OTHERWISE BE UNAVAILABLE IN THE COMMUNITY. SECOND, THE INCOME LEVEL AND POVERTY RATE IN THE COMMUNITY DEMONSTRATE THE CHALLENGES WHICH WOULD BE FACED IF ELLIS WERE NOT ABLE TO PROVIDE CARE TO ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. FOR EXAMPLE, THE MEDIAN HOUSEHOLD INCOME FOR THE CITY IS ONLY ABOUT TWO-THIRDS THAT OF THE COUNTY AS A WHOLE WHICH IN TURN IS BELOW THAT OF THE STATE. THE POVERTY RATE IN THE CITY IS OVER 1.65 TIMES HIGHER THAN THAT OF THE COUNTY AS A WHOLE. (US CENSUS BUREAU, STATE AND COUNTY QUICKFACTS, AS ACCESSED JULY 25, 2023) THIRD, MEDICARE BENEFICIARIES ARE AMONG THOSE AFFECTED BY INCOME DISPARITIES WITHIN SCHENECTADY. OVER ONE THIRD (34.3%) OF THE RESIDENTS OF THE LARGELY MINORITY (72% NON-WHITE) HAMILTON HILL NEIGHBORHOOD ARE BELOW THE FEDERAL POVERTY LEVEL; 49% OF THESE RESIDENTS ARE 65 YEARS OF AGE OR OLDER (2017-2021 AMERICAN COMMUNITY SURVEY). RESIDENTS OF THIS NEIGHBORHOOD ARE AMONG THE HEAVIEST USERS OF HOSPITAL SERVICES. FINALLY, ABOUT 25% OF ELLIS' MEDICARE DISCHARGES ARE DUAL-ELIGIBLE (ENROLLED IN BOTH MEDICARE AND MEDICAID) WHO, BY VIRTUE OF THEIR MEDICAID ELIGIBILITY, ARE LOW-INCOME INDIVIDUALS. HENCE, THE FINANCIAL LOSSES INCURRED IN TREATING MEDICARE PATIENTS DETRACT FROM THE ABILITY OF THE HOSPITAL TO SERVE OTHER LOW-INCOME PATIENTS AND RESIDENTS, AND THE ABILITY OF THE HOSPITAL TO FUNCTION IN SPITE OF THESE LOSSES REPRESENTS A COMMUNITY BENEFIT. PART III, LINE 9B: THE COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. IF PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE UNDER OUR PRESUMPTIVE CHECK, THOSE ACCOUNTS ARE WRITTEN OFF IMMEDIATELY AND THERE ARE NO COLLECTION EFFORTS. IF THE PATIENT DOESN'T QUALITY BASED ON THE PRESUMPTIVE CHECK, THOSE PATIENTS ARE TREATED THE SAME AS EVERYONE ELSE UNTIL SUCH TIME AS THEY APPLY FOR ASSISTANCE. IF A PATIENT HAD ASSISTANCE IN THE PAST AND THE TIMEFRAME HAS EXPIRED, THEY ARE REQUIRED TO RE-APPLY AS THERE ARE MANY SITUATIONS THAT MAY IMPACT WHETHER OR NOT A PATIENT WILL QUALIFY FOR ASISSTANCE. AS SOON AS ASSISTANCE IS APPROVED, ANY COLLECTION EFFORTS THAT MAY HAVE BEGAN ARE HAULTED IMMEDIATELY. PART VI, LINE 2: THE COMMUNITY HEALTH NEEDS ASSESSMENTS REQUIRED EACH THREE YEARS PURSUANT TO FEDERAL AND STATE LAW CONSTITUTE THE PRIMARY METHOD WHICH ELLIS USES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. THESE ASSESSMENTS CONSUME SUBSTANTIAL HOSPITAL RESOURCES AND GENERATE COMPREHENSIVE REPORT DOCUMENTS.TWO ADDITIONAL COMPREHENSIVE ASSESSMENT DOCUMENTS HAVE BEEN PRODUCED FOR THE SCHENECTADY COMMUNITY IN RECENT YEARS. 1) IN 2014, AS PART OF THE STATE-REQUIRED DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM (DSRIP), ELLIS AND OTHER HOSPITALS IN NEW YORK'S CAPITAL REGION ENGAGED THE HEALTHY CAPITAL DISTRICT INITIATIVE (HCDI) TO PRODUCE A COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSED SPECIFICALLY ON THE NEEDS OF MEDICAID BENEFICIARIES WHICH WERE TO BE SERVED BY THE DSRIP PROGRAM. THE 224-PAGE ASSESSMENT IS POSTED ON THE STATE HEALTH DEPARTMENT WEBSITE: HTTPS://WWW.HEALTH.NY.GOV/HEALTH_CARE/MEDICAID/REDESIGN/DSRIP/PPS_APPLICATIONS/DOCS/ALBANY_MEDICAL_CENTER_HOSPITAL/3.8_ALBANY_MED_CNA.PDF2) THE SCHENECTADY COMMUNITY ACTION PROGRAM (SCAP), A SIGNIFICANT COMMUNITY PARTNER, IS REQUIRED AS A CONDITION OF ITS RECEIPT OF FEDERAL FUNDING TO CONDUCT PARALLEL COMMUNITY NEEDS ASSESSMENTS. A COMPREHENSIVE ASSESSMENT WAS CONDUCTED IN 2021. THE RESULTS, WHICH PARALLEL THE FINDINGS OF THE OTHER CHNAS, ARE AVAILABLE HERE: HTTP://SCAPNY.ORG/PUBLICATIONS/ .ELLIS MONITORS OTHER RESOURCES TO IDENTIFY AND ASSESS COMMUNITY HEALTH CARE NEEDS. THESE INCLUDE:1) INFORMATION FROM COMMUNITY ORGANIZATIONS AS REPORTED AT THE QUARTERLY MEETINGS OF THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY.2) PATIENT SATISFACTION DATA AS REPORTED FROM FORMAL (E.G., CAHPS) AND INFORMAL (E.G., NURSING ROUNDS) SOURCES.3) COMMUNITY LEADER COMMENTS OBTAINED FROM FORMAL MEETINGS (E.G., CHAMBER OF COMMERCE) AND INFORMAL CONTACT (E.G., PERIODIC MEETINGS WITH THE MAYOR, STATE LEGISLATORS, AND THE LOCAL MEMBER OF CONGRESS).4) AN ANNUAL, ANONYMOUS, FORMAL ASSESSMENT OF ELLIS EMPLOYEE SATISFACTION, AS WELL AS EMPLOYEE COMMENTS RECEIVED THROUGH SUCH SOURCES AS THE COMPLIANCE PROGRAM AND UNION MEETINGS.5) COMPARATIVE DATA OBTAINED FROM REGIONAL ORGANIZATIONS INCLUDING THE MEDICARE MSSP ACO (INNOVATIVE HEALTH ALLIANCE OF NEW YORK) AND THE MEDICAID DSRIP SYSTEM (ALLIANCE FOR BETTER HEALTH).6) COMPARATIVE DATA OBTAINED FROM REGULATORY AGENCIES, SUCH AS THE NEW YORK STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS), AND FEDERAL HOSPITAL COMPARE.7) COMMENTS RECEIVED FROM PATIENTS AND COMMUNITY MEMBERS THROUGH THE ELLIS WEBSITE ( HTTPS://WWW.ELLISMEDICINE.ORG/PAGES/CONTACT.ASPX ) AND OTHER ONLINE COMMUNICATIONS TOOLS SUCH AS FACEBOOK AND TWITTER. PART VI, LINE 3: ELLIS MEDICINE PROVIDES FINANCIAL ASSISTANCE INFORMATION (IN BOTH ENGLISH AND SPANISH) ABOUT PROGRAMS AVAILABLE TO ASSIST PATIENTS IN PAYING FOR THEIR BILLS, INCLUDING FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR UNDER ELLIS'S FINANCIAL ASSISTANCE POLICY. SUCH INFORMATION IS INCLUDED: 1) THROUGH TELEPHONE CONTACT INFORMATION PRINTED ON PATIENT INVOICES,2) ON ITS PUBLIC WEBSITE (HTTP://WWW.ELLISMEDICINE.ORG/FINANCIAL-ASSISTANCE/DEFAULT.ASPX) 3) IN READILY AVAILABLE AND PUBLICLY DISTRIBUTED BROCHURES, AND 4) THROUGH FLYERS AND POSTERS VISIBLE THROUGHOUT THE ORGANIZATION. APPLICATIONS FOR FINANCIAL ASSISTANCE ARE AVAILABLE ONLINE AT THE ELLIS WEBSITE NOTED ABOVE. ADDITIONALLY, ELLIS EMPLOYS FINANCIAL ADVOCATES WHO ASSIST PATIENTS IN DETERMINING THE AVAILABILITY OF AND THEIR ELIGIBILITY FOR GOVERNMENT PROGRAMS INCLUDING MEDICAID, SUBSIDIZED INSURANCE PROGRAMS THROUGH THE NEW YORK STATE OF HEALTH EXCHANGE, AND FREE OR LOW-COST CARE THROUGH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE FINANCIAL ADVOCATES THEN ASSIST PATIENTS WITH COMPLETING THE NEEDED PAPERWORK, INCLUDING BEDSIDE VISITS AS NECESSARY. FOR MORE THAN A DECADE, ELLIS MEDICINE HAS INCLUDED AFFIRMATIVE FINANCIAL ASSISTANCE OUTREACH AS PART OF ITS COMMUNITY-BASED POPULATION HEALTH PROGRAMS. PRIOR TO CREATION OF THE HEALTH INSURANCE ENROLLMENT PROGRAMS BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 (PPACA), ELLIS OFFERED MEDICAID ENROLLMENT THROUGH EMPLOYEES "DEPUTIZED" BY THE SCHENECTADY COUNTY DEPARTMENT OF SOCIAL SERVICES, THROUGH MEDICAID FACILITATED ENROLLERS EMPLOYED BY THE NOT-FOR-PROFIT HEALTH CAPITAL DISTRICT INITIATIVE (HCDI), AND THROUGH FIDELIS, AT THAT TIME THE LARGEST NOT-FOR-PROFIT MEDICAID MANAGED CARE ORGANIZATION SERVING SCHENECTADY COUNTY.WITH THE ADVENT OF THE PPACA, ELLIS BEGAN INVITING ON-SITE SERVICES OF HEALTH INSURANCE NAVIGATORS (ALSO KNOWN AS "IN PERSON ASSISTORS") FROM ALL FOUR NOT-FOR-PROFIT ORGANIZATIONS (PUBLIC POLICY AND EDUCATION FUND, HEALTHY CAPITAL DISTRICT INITIATIVE, CAPITAL DISTRICT BLACK CHAMBER OF COMMERCE, AND UNIVERSITY AT ALBANY SCHOOL OF SOCIAL WELFARE) DESIGNATED AS SERVING SCHENECTADY COUNTY PURSUANT TO THE PPACA. NAVIGATORS SEE UNINSURED RESIDENTS AT BOTH THE NOTT STREET AND ELLIS MCCLELLAN STREET HEALTH CENTER CAMPUSES, AS WELL AS AT OTHER COMMUNITY LOCATIONS. ELLIS-EMPLOYED FINANCIAL ADVOCATES ALSO COMPLETED STATE-APPROVED TRAINING AND ARE QUALIFIED AS NEW YORK STATE CERTIFIED APPLICATION COUNSELORS (CACS); TRAINED TO HELP PEOPLE ENROLL BOTH IN MEDICAID AS WELL AS IN "EXCHANGE" INSURANCE PRODUCTS.ADDITIONALLY, ELLIS OFFERS ITS FINANCIAL ADVOCATES INFORMATION LINE (518-243-3460) THROUGH WHICH PATIENTS WITHOUT INSURANCE CAN RECEIVE INFORMATION ABOUT HOW MUCH THEIR CARE WILL COST AT ELLIS MEDICINE, INCLUDING INSURANCE ENROLLMENT AND PAYMENT PLANS. ANOTHER TELEPHONE RESOURCE (518-243-1695) PROVIDES CALLERS WITH ESTIMATES OF THE TOTAL COST OF PROCEDURES AND HOSPITALIZATIONS, AS MORE AND MORE PATIENTS ARE PAYING HIGHER DEDUCTIBLES AND ARE CONCERNED ABOUT THE COST TO THEM OUT-OF-POCKET. THIS IS PARTICULARLY SIGNIFICANT IN ELLIS' PRIMARY SERVICE AREA, AS THE LARGEST LOCAL EMPLOYER HAS CONVERTED TO A HIGH-DEDUCTIBLE HEALTH INSURANCE PLAN FOR MOST OF ITS EMPLOYEES. PART VI, LINE 4: FOR THE PURPOSES OF DETERMINING COMMUNITY NEEDS PURSUANT TO THE REQUIREMENTS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010, ELLIS HOSPITAL DEFINES THE "COMMUNITY" IT SERVES AS CONSISTING OF SCHENECTADY COUNTY, INCLUDING THE CITY OF SCHENECTADY AND THE TOWNS OF DUANESBURG, GLENVILLE, PRINCETOWN, NISKAYUNA, AND ROTTERDAM. THERE ARE SEVERAL REASONS FOR THIS DEFINITION:- THE GEOGRAPHY OF SCHENECTADY COUNTY IS VERY SIMILAR TO THE PRIMARY SERVICE AREA (PSA) OF THE HOSPITAL. ELLIS USES AN INDUSTRY-STANDARD DEFINITION (THE CONTIGUOUS ZIP CODES IN WHICH THE FIRST 60% OF THE HOSPITAL'S INPATIENTS LIVE) TO DETERMINE ITS PSA. ELLIS' PSA CONSISTS OF THE ENTIRE RANGE OF 123NN ZIP CODES (12302, 12303, 12304, 12305, 12306, 12307, 12308, AND 12309), WHICH CONSTITUTES ALL OF THE CITY OF SCHENECTADY AND MOST OF THE POPULATION OF THE REMAINDER OF SCHENECTADY COUNTY, AS WELL AS THE 12065 ZIP CODE REPRESENTING THE TOWN OF CLIFTON PARK IN SOUTHERN SARATOGA COUNTY. (THE DESIGN OF THE ZIP CODE SYSTEM IS NOT ALIGNED WITH COUNTY OR OTHER POLITICAL BOUNDARIES. THE RURAL WESTERNMOST PORTION OF SCHENECTADY COUNTY IS NOT INCLUDED IN THE ZIP CODE-DEFINED PSA DUE TO LOW POPULATION, WHILE CERTAIN AREAS OF ALBANY AND SARATOGA COUNTIES DO FALL WITHIN THE SCHENECTADY ZIP CODES.) ALTHOUGH ELLIS ACTIVELY SERVES PEOPLE WITHIN ITS SECONDARY SERVICE AREA (SSA), THE GEOGRAPHIC BOUNDARIES OF THOSE ADDITIONAL ZIP CODES (THE ADDITIONAL CONTIGUOUS ZIP CODES IN WHICH THE NEXT 20% OF INPATIENTS LIVE, FOR AN APPROXIMATE TOTAL OF 80% OF INPATIENT VOLUME) STRETCH ACROSS FIVE COUNTIES AND INCLUDE PORTIONS OF THE SERVICE AREAS OF AT LEAST SIX OTHER HOSPITALS. RETAINING A FOCUS ON THE SCHENECTADY COMMUNITY WILL PERMIT DEVELOPMENT OF AN ACTIONABLE IMPLEMENTATION PLAN WHICH CAN TARGET COHESIVE POPULATIONS.- POPULATION AND HEALTH DATA ARE COMMONLY AVAILABLE BY COUNTY. THE NEW YORK STATE DEPARTMENT OF HEALTH AND OTHER STATE GOVERNMENT AGENCIES MAINTAIN DATA BY COUNTY, THE HEALTHY CAPITAL DISTRICT INITIATIVE PROVIDES COMPARISON DATA BY COUNTY WITHIN THE REGION, AND DATA COLLECTED BY THE UNITED STATES CENSUS ARE FREQUENTLY AT THE COUNTY AND CITY LEVEL. ALTHOUGH CONVENIENCE IS NOT IN AND OF ITSELF A REASON TO DEFINE "COMMUNITY," THE AVAILABILITY OF SOLID DATA, INCLUDING BASELINE AND COMPARISON DATA, WILL PROVIDE A BETTER BASIS FOR PLANNING, AND AN EXTERNALLY-VERIFIABLE SOURCE FOR OUTCOME MEASURES.- ELLIS HAS ESTABLISHED STRONG PARTNERSHIPS WITH OTHER HEALTHCARE AND COMMUNITY SERVICE ORGANIZATIONS WHICH ARE LOCATED IN AND SERVE SCHENECTADY COUNTY. THE "MEDICAL HOME GROUP," A LOOSE AFFILIATION OF COMMUNITY ORGANIZATIONS CREATED AT THE TIME OF THE THREE-HOSPITAL CONSOLIDATION, HAS EVOLVED INTO THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY; OVER 60 COMMUNITY GROUPS INCLUDING BUSINESSES, LOCAL GOVERNMENT AGENCIES, HEALTHCARE AND SOCIAL SERVICES PROVIDERS AND COMMUNITY AGENCIES, FAITH-BASED ORGANIZATIONS, AND ADVOCACY GROUPS WHOSE LEADERS MEET QUARTERLY AT ELLIS. BY FOCUSING "COMMUNITY" ON A POPULATION WELL-SERVED BY A COORDINATED ARRAY OF PHYSICAL HEALTH, BEHAVIORAL HEALTH, AND COMMUNITY SERVICE ORGANIZATIONS IN COORDINATION WITH STRONG LOCAL GOVERNMENT AGENCIES, A COMMUNITY-WIDE ACTION PLAN CAN LEVERAGE THE HOSPITAL'S IMPLEMENTATION PLAN THROUGH THE EFFICIENT AND EFFECTIVE USE OF MULTIPLE RESOURCES.- SELECTION OF SCHENECTADY COUNTY AS THE "COMMUNITY" IS CONSISTENT WITH REGULATORY REQUIREMENTS TO ASSURE INCLUSION OF "MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS," AS THESE POPULATIONS REPRESENT A GREATER SHARE OF THE POPULATION IN SCHENECTADY COUNTY THAN THEY WOULD IF DIFFUSED AMONG THE FIVE COUNTIES OF THE SECONDARY SERVICE AREA.SCHENECTADY COUNTY (2022 ESTIMATED POPULATION: 160,093) IS, GEOGRAPHICALLY, THE SECOND SMALLEST COUNTY IN UPSTATE NEW YORK. IT CONSISTS OF FIVE TOWNS, TWO PRIMARILY RURAL AND THREE PRIMARILY SUBURBAN, SURROUNDING THE CENTRALLY-LOCATED CITY OF SCHENECTADY (2022 ESTIMATED POPULATION: 68,809). THE COUNTY IS LOCATED IMMEDIATELY WEST OF THE STATE CAPITAL OF ALBANY AND MANY OF ITS RESIDENTS COMMUTE TO JOBS IN ALBANY AND THE OTHER COUNTIES COMPRISING NEW YORK'S CAPITAL REGION.SCHENECTADY COUNTY PUBLIC HEALTH SERVICES (SCPHS), A UNIT OF COUNTY GOVERNMENT, IS RESPONSIBLE FOR ALL PUBLIC HEALTH AND ENVIRONMENTAL HEALTH ACTIVITIES AND ENFORCEMENT THROUGHOUT THE CITY AND COUNTY. THE COUNTY CONTAINS A SINGLE NON-PROFIT ACUTE CARE HOSPITAL ELLIS HOSPITAL (ALSO KNOWN BY THE TRADE NAME ELLIS MEDICINE), AND A SINGLE FEDERALLY QUALIFIED HEALTH CENTER (FQHC) HOMETOWN HEALTH CENTER. THERE IS ALSO A NON-PROFIT SPECIALTY HOSPITAL (SUNNYVIEW REHABILITATION HOSPITAL) WHICH IS A MEMBER OF THE ALBANY-BASED ST. PETER'S HEALTH PARTNERS SYSTEM. THERE IS ONE MEDICALLY UNDERSERVED POPULATION; THE HOMEBOUND POPULATION OF SCHENECTADY COUNTY (ID #06211). THE ENTIRE CITY OF SCHENECTADY IS A FEDERALLY-DESIGNATED HEALTH PROFESSIONS SHORTAGE AREA (HPSA) FOR THE MEDICAID POPULATION FOR MENTAL HEALTH AND DENTAL HEALTH, AND, SINCE 2019, FOR PRIMARY CARE. ELLIS HOSPITAL'S FQHC PARTNER, HOMETOWN HEALTH CENTERS, HAS BEEN DESIGNATED BY HRSA AS A NATIONAL HEALTH SERVICE CORPS PRACTICE SITE. SEE SCHEDULE O. PART VI, LINE 5: ELLIS MEDICINE FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH:1) A VOLUNTEER BOARD OF TRUSTEES THAT IS COMPRISED OF COMMUNITY MEMBERS AND EX-OFFICIO MEDICAL STAFF MEMBERS WHO SERVE THREE-YEAR TERMS, UP TO A THREE-TERM MAXIMUM. THE ELLIS BOARD CONSISTS OF 15 VOTING TRUSTEES 12 NON-CLINICIAN RESIDENTS OF THE CAPITAL REGION, PLUS TWO PHYSICIANS AND ONE NURSE. ELLIS DOES NOT HAVE A PARENT CORPORATION.2) MEDICAL PRIVILEGES AT ELLIS HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS AND OTHER CLINICAL PROVIDERS. AN OPEN MEDICAL STAFF CONSISTS OF OVER 700 AFFILIATED PHYSICIANS AND OTHER PROVIDERS; INCLUDING ON-SITE PHYSICIANS AND PODIATRISTS; TELEMEDICINE PROVIDERS; ADVANCED PRACTICE PROVIDERS; AND OTHER MEDICAL PROFESSIONALS INCLUDING THOSE IN RESEARCH AND TEACHING. ELLIS' MEDICAL STAFF IS LED BY A MEDICAL EXECUTIVE COMMITTEE (MEC). THE MEC PLAYS AN INTEGRAL PART IN THE HOSPITAL'S CORPORATE STRUCTURE AND DAILY OPERATIONS. THE MEC AND THE DEPARTMENT CHAIRS, WHO OVERSEE SPECIFIC CLINICAL SERVICES, WORK COLLABORATIVELY WITH THE HOSPITAL'S VOLUNTEER BOARD OF TRUSTEES, ADMINISTRATORS, AND STAFF TO ENSURE THE HIGHEST QUALITY OF CARE IS DELIVERED TO PATIENTS AND THAT THE COMMUNITY'S HEALTHCARE NEEDS ARE MET WITH EXCELLENCE. PHYSICIANS ALSO SERVE AS MEMBERS OF THE HOSPITAL'S BOARD OF TRUSTEES, AND THEY ARE DIRECTLY INVOLVED IN THE HOSPITAL'S ANNUAL BUDGET PROCESS: THEY RANK AND PRIORITIZE ALL CAPITAL ITEMS IN THE HOSPITAL'S CAPITAL BUDGET AND THEY SIGN OFF ON VOLUME PROJECTIONS FOR THE HOSPITAL'S ANNUAL OPERATING BUDGET.3) OPERATION OF A STATE-OF-THE-ART FULL SERVICE, FULLY STAFFED EMERGENCY ROOM - INCLUDING A MENTAL HEALTH CRISIS - UNIT AT THE NOTT STREET CAMPUS WHICH IS OPEN 24 HOURS-A-DAY, SEVEN DAYS-A-WEEK, 365 DAYS-A-YEAR. THE NEW FACILITY, WHICH COST $61 MILLION AND OPENED IN DECEMBER 2014, REPLACED TWO SMALLER AND LESS EFFICIENT FACILITIES WHICH HAD BEEN LOCATED WITHIN A MILE OF EACH OTHER. IN ADDITION, ELLIS PROVIDES SEVEN-DAYS-A-WEEK EMERGENT CARE SERVICES AT THE MEDICAL CENTER OF CLIFTON PARK (THE ONLY SUCH SERVICES IN SOUTHERN SARATOGA COUNTY), AND SEVEN-DAYS-A-WEEK URGENT CARE SERVICES AT MOHAWK HARBOR IN SCHENECTADY. ELLIS' INTENDS TO BE FULLY COMPLIANT WITH THE EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA) AND OTHER LAWS AND REGULATIONS REQUIRING SERVICES TO ALL THOSE IN NEED OF EMERGENCY CARE REGARDLESS OF THEIR ABILITY TO PAY. 4) THE WORK OF THE FOUNDATION FOR ELLIS MEDICINE, A 501 (C) (3) TAX-EXEMPT CHARITABLE ORGANIZATION WHOSE SOLE PURPOSE IS TO ENCOURAGE PHILANTHROPIC SUPPORT FOR ELLIS HOSPITAL. THE FOUNDATION WAS INITIALLY ESTABLISHED IN 1982 AS THE ELLIS HOSPITAL FOUNDATION AND IS GOVERNED BY A SEPARATE BOARD OF TRUSTEES. FUNDS RAISED THROUGH THE FOUNDATION'S ACTIVITIES ARE USED TO ASSIST THE HOSPITAL IN ACQUIRING STATE-OF-THE-ART MEDICAL EQUIPMENT AND TO SUPPORT A WIDE RANGE OF HEALTH CARE PROGRAMS AND SERVICES. 5) REINVESTING ITS SURPLUS FUNDS TO EXPAND/REPLACE/MODERNIZE ITS FACILITIES AND MEDICAL EQUIPMENT; SUPPORT PROGRAMS/ACTIVITIES AIMED AT IMPROVING QUALITY OF CARE AND PATIENT SAFETY; TRAIN AND EDUCATE ITS MEDICAL AND NURSING STAFFS; AND TO IMPROVE THE OVERALL DELIVERY OF AND ACCESSIBILITY TO HEALTH CARE SERVICES IN THE COMMUNITY.ELLIS MEDICINE DEMONSTRATES LEADERSHIP AS A CHARITABLE INSTITUTION BY ORGANIZING AND PARTICIPATING IN COMMUNITYWIDE EFFORTS FOR LOW-INCOME AND MEDICALLY UNDERSERVED POPULATIONS; REACHING OUT TO THE UNDERSERVED TO PROVIDE NEEDED PRIMARY AND PREVENTATIVE HEALTH CARE SERVICES AND HEALTH EDUCATION; ATTRACTING AND USING FUNDS TO PROVIDE FINANCIAL ASSISTANCE AND OTHER SUPPORT; PARTICIPATING IN MEDICAID AND OTHER FEDERAL, STATE, AND LOCAL HEALTH CARE REIMBURSEMENT PROGRAMS SUCH AS CHILD HEALTH PLUS; AND FORMALLY PLANNING FOR AND PROVIDING FINANCIAL ASSISTANCE WHILE MAINTAINING A POLICY OF PROVIDING CARE TO ALL PERSONS IN NEED. PART VI, LINE 6: ELLIS HOSPITAL IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL AND DURING 2022 WAS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NY X 1 1 X X X X 0 0 0 0 0 1 0 0 0 PAUL A MILTON PRESIDENT / CEO 636535 0 85000 0 0 0 12200 0 27594 0 761329 0 0 0 KEITH C WILLARD REGISTERED NURSE 652917 0 0 0 0 0 0 0 0 0 652917 0 0 0 DAVID M LIEBERS MD CMO 421910 0 34305 0 13600 0 18300 0 21147 0 509262 0 0 0 MARC MESICK VICE PRESIDENT / CFO 397725 0 64627 0 0 0 11600 0 9526 0 483478 0 0 0 LESLYN WILLIAMSON EXECUTIVE DIRECTOR, THRU MAY 2022 326239 0 0 0 0 0 7576 0 12098 0 345913 0 0 0 HERBERT REICH MD SURGEON 293696 0 0 0 36000 0 1434 0 14739 0 345869 0 0 0 NANCY O BARNARD REGISTERED NURSE 326833 0 0 0 0 0 0 0 0 0 326833 0 0 0 TERRENCE CLARKE MD SURGEON 242156 0 52800 0 0 0 11096 0 10534 0 316586 0 0 52800 SONALI PATEL MD PHYSICIAN 306700 0 0 0 0 0 0 0 0 0 306700 0 0 0 NICHOLAS MONTALTO MD TRUSTEE 100319 0 54400 0 0 0 3539 0 8194 0 166452 0 0 0 AVINASH BACHWANI MD VP/CIO, THRU JANUARY 2022 131092 0 32629 0 0 0 0 0 1062 0 164783 0 0 0 PART I, LINE 1A ELLIS HOSPITAL HAS A CORPORATE MEMBERSHIP AT THE MOHAWK GOLF CLUB THAT IS IN THE CEO'S NAME. HOWEVER THE CLUB IS USED FOR BUSINESS PURPOSES AND FUNCTIONS ONLY. PART I, LINE 6 THE CEO, CFO, AND VICE PRESIDENTS ARE PROVIDED AN INCENTIVE COMPENSATION PLAN. (ICP) THE ICP PROGRAM IS ADMINISTERED BY THE EXECUTIVE COMPENSATION COMMITTEE UNDER THE DIRECTION OF THE BOARD OF TRUSTEES. THE PLAN IS BASED ON PRESET GOALS, FINANCIAL BENCHMARKS, AND INDIVIDUAL GOALS. ALL PAYMENTS FROM THIS PROGRAM ARE BASED ON AUDITED RESULTS AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO ANY PAYMENTS BEING MADE. PAYMENTS ARE MADE ANNUALLY AFTER THE YEAR HAS BEEN COMPLETED. CRISTINE CIOFFI TRUSTEE 80856 SON IS EMPLOYEE 0 NICHOLAS MONTALTO MD TRUSTEE 154719 MEDICAL SERVICES 0 JANET SAPIO-MAYTA TRUSTEE 70774 SISTER IS EMPLOYEE 0 ANTHONY SANTILLI MD TRUSTEE 1542212 BUSINESS CONTRACT 0 SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS CRISTINE CIOFFI: SON PATRICK SHARKEY IS AN INTERVENTIONAL RADIOLOGY NURSE. ($80,856 -COMPENSATION). DR. NICHOLAS MONTALTO IS A PHYSICIAN FOR ELLIS HOSPITAL. HE IS ALSO THE CHIEF OF STAFF AND RECEIVED COMPENSATION OF $154,719.JANET SAPIO-MAYTA'S SISTER IS AN EMPLOYEE ($70,774 -COMPENSATION). EMPLOYEE IS NANCY SAPIO.DR. ANTHONY SANTILLI OWNS SCHENECTADY PULMONARY AND CRITICAL CARE ASSOCIATES WHICH IS CONTRACTED WITH ELLIS HOSPITAL. HE IS ALSO THE CHIEF OF STAFF ELECT AND RECEIVED COMPENSATION OF $1,542,212. FORM 990, PART III, LINE 4A ELLIS HOSPITAL (D/B/A ELLIS MEDICINE), THE SOLE PROVIDER OF ACUTE HOSPITAL CARE IN SCHENECTADY COUNTY, IS A VOLUNTARY, NOT-FOR-PROFIT, COMMUNITY AND TEACHING HOSPITAL WITH MORE THAN 400 LICENSED BEDS BETWEEN TWO INPATIENT CAMPUSES (ELLIS HOSPITAL AND BELLEVUE WOMAN'S CENTER), INCLUDING 52 INPATIENT MENTAL HEALTH BEDS (SEE ITEM 4B BELOW). ELLIS ALSO OPERATES SEVERAL PRIMARY CARE AND OUTPATIENT SITES, INCLUDING TWO OUTPATIENT CAMPUSES (MCCLELLAN STREET HEALTH CENTER IN THE CITY OF SCHENECTADY AND MEDICAL CENTER OF CLIFTON PARK IN SOUTHERN SARATOGA COUNTY) AND AN OUTPATIENT MENTAL HEALTH FACILITY (STATE STREET HEALTH CENTER). HEALTH CARE SERVICES ARE PROVIDED UNDER A SINGLE CORPORATE TAXPAYER IDENTIFICATION NUMBER (TIN) AND A SINGLE OPERATING CERTIFICATE ISSUED BY THE NEW YORK STATE DEPARTMENT OF HEALTH, THE HOSPITAL'S PRIMARY REGULATOR. THE HOSPITAL IS OVERSEEN BY A VOLUNTEER BOARD OF TRUSTEES DRAWN FROM THE COMMUNITY AND THE MEDICAL STAFF, INCLUDING THREE PHYSICIAN TRUSTEES. WITH THE MISSION TO "MEET THE HEALTH AND WELLNESS NEEDS OF OUR COMMUNITY WITH EXCELLENCE," ELLIS BALANCES STATE-OF-THE-ART TECHNOLOGY AND ADVANCED MEDICAL PROCEDURES WITH A 137-YEAR TRADITION OF COMMUNITY-BASED CARING AND A FIRM COMMITMENT TO QUALITY. ELLIS COUNTED 9,365 MEDICAL/SURGICAL INPATIENT DISCHARGES FROM THE ELLIS HOSPITAL (NOTT STREET) INPATIENT FACILITY, PERFORMED 5,536 AMBULATORY (OUTPATIENT) PROCEDURES, AND HANDLED 190,131 "REFERRED AMBULATORY VISITS" (E.G., LABORATORY TESTS, MEDICAL IMAGING) AT ALL LOCATIONS DURING 2022. IN 2022, ELLIS PROVIDED $4,732,991 IN FINANCIAL ASSISTANCE (CHARITY CARE) ON A "CHARGE" BASIS, TRANSLATING TO A "COST" BASIS OF $1,685,709. ELLIS HAS EARNED NUMEROUS RECOGNITIONS FOR CLINICAL EXCELLENCE AND COMMUNITY SERVICE. IN RECENT YEARS, THE ELLIS HOSPITAL EMERGENCY DEPARTMENT ACHIEVED CERTIFICATION AS A CERTIFIED AUTISM CENTER, THE FIRST HOSPITAL EMERGENCY DEPARTMENT IN THE NATION TO EARN THAT DESIGNATION GRANTED BY THE INTERNATIONAL BOARD OF CREDENTIALING AND CONTINUING EDUCATION STANDARDS (IBCCES). ELLIS WAS A NEW YORK STATE DESIGNATED STROKE CENTER, AND WAS THE FIRST HOSPITAL IN NEW YORK STATE TO RECEIVE THE AMERICAN STROKE ASSOCIATION'S (ASA) PERFORMANCE ACHIEVEMENT AWARD FOR STROKE. THE ELLIS STROKE CENTER HAS BEEN A RECIPIENT OF THE GOLD/GOLD PLUS AWARD, RECOGNIZED FOR USING THE ASA'S "GET WITH THE GUIDELINES" PROGRAM FOR IMPROVING THE QUALITY OF CARE AND PATIENT OUTCOMES. THE HOSPITAL'S BARIATRIC PROGRAM WAS AN ACCREDITED BARIATRIC SURGERY CENTER BY THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP) OF THE AMERICAN COLLEGE OF SURGEONS AND THE AMERICAN SOCIETY OF METABOLIC AND BARIATRIC SURGERY. ADDITIONALLY, THE SLEEP DISORDERS CENTER WAS ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE; THE BELANGER SCHOOL OF NURSING WAS ACCREDITED BY THE NATIONAL LEAGUE FOR NURSING ACCREDITING COMMISSION; THE FAMILY MEDICINE RESIDENCY WAS ACCREDITED BY BOTH THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION AND THE AMERICAN OSTEOPATHIC ASSOCIATION; ELLIS PRIMARY CARE PRACTICES HAVE ACHIEVED NATIONAL COMMISSION ON QUALITY ASSURANCE (NCQA) "PATIENT-CENTERED MEDICAL HOME" (PCMH) RECOGNITION; AND CERTAIN PRIMARY CARE PRACTICES PARTICIPATED IN THE FEDERAL CMS "CPC+" QUALITY PROGRAM. ELLIS HAS BEEN RECOGNIZED BY THE AMERICAN HEART ASSOCIATION (AHA) AS A "FIT-FRIENDLY WORKSITE AND RECEIVED THE AHA'S "INNOVATION AWARD" FOR PRESENTING A UNIQUE PROGRAM OF HEALTH AND WELLNESS TO EMPLOYEES. ELLIS HAS BEEN AWARDED BLUE DISTINCTION CENTER DESIGNATION BY BLUE CROSS BLUE SHIELD FOR CARDIAC CARE, BARIATRIC CARE, KNEE AND HIP REPLACEMENT, AND MATERNITY CARE. ELLIS WAS ALSO A PARTNERS IN PERFORMANCE EXCELLENCE GOLD BALDRIGE AWARD WINNER, RECOGNIZED FOR ITS DEDICATION AND WORK TO CREATE A CULTURE AND SYSTEMS WHERE INNOVATION AND PERFORMANCE EXCELLENCE BECOME THE ACCEPTED NORM. ELLIS HAS ALSO BEEN HONORED WITH THE FIVE RINGS AWARD BY INTELLICENTRICS, INC. FOR EXCELLENCE IN VENDOR CREDENTIALING AND CREATING A CULTURE OF VIGILANCE TO MAKE HOSPITALS SAFER FOR EMPLOYEES AND PATIENTS. THE ELLIS HOSPITAL COVID CARE TEAM RECEIVED THE "GOOD NEWS" AWARD FROM THE CHAMBER OF SCHENECTADY COUNTY FOR THEIR HEROIC ACTIONS DURING THE PANDEMIC. DURING RECENT YEARS, ELLIS HAS RECEIVED OTHER COMMUNITY SERVICE AWARDS FROM THE CHAMBER OF SCHENECTADY COUNTY ("CORPORATION OF THE YEAR"), THE CITY MISSION OF SCHENECTADY ("PARTNERS AWARD," SPECIFICALLY RECOGNIZING THE HOSPITAL'S SERVICES FOR THE UNDERSERVED), THE SCHENECTADY ARC ("EMPLOYER OF THE YEAR," RECOGNIZING THE HOSPITAL FOR PROVIDING EMPLOYMENT, WITH OPPORTUNITIES FOR GROWTH AND MEANINGFUL EXPERIENCE, TO INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES), THE SIGHT SOCIETY OF NORTHEASTERN NEW YORK ("HOSPITAL OF THE YEAR" FOR COMMITMENT AND COMPASSION TO GRIEVING FAMILIES ALONG WITH OUTSTANDING ACCOMPLISHMENTS AND BEST PRACTICES TO FACILITATE CORNEA DONATIONS), THE GOOSE HILL NEIGHBORHOOD ASSOCIATION ("COMMUNITY AWARD" FOR BEING A GOOD NEIGHBOR AND PROACTIVE COMMUNICATOR), AND THE SEVENTH NATIONAL LEARNING CONGRESS OF THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES ("SILVER MEDAL" FOR ORGAN DONATION). ELLIS OPERATES A STATE-OF-THE-ART EMERGENCY DEPARTMENT AT ELLIS HOSPITAL ON NOTT STREET WHICH TREATED 44,194 PATIENT VISITS IN 2022 (OF WHICH 8,532 (19%) WERE ADMITTED FOR INPATIENT CARE); THE BELLEVUE WOMAN'S CENTER WHICH DISCHARGED 1,968 NEWBORN BABIES IN 2022 (SEE LINE 4D); PRIMARY CARE PRACTICES (IN SCHENECTADY, GLENVILLE, AND CLIFTON PARK) AND NUMEROUS SPECIALTY MEDICAL SERVICES THROUGH THE ELLIS MEDICAL GROUP (EMG); AN 82-BED SKILLED NURSING FACILITY AND SHORT-STAY REHABILITATION FACILITY (SEE LINE 4C); TWO STAND-ALONE OFF-SITE BLOOD DRAW STATIONS; A BARIATRIC CARE LOCATION; A FAMILY MEDICINE RESIDENCY INCLUDING AN OSTEOPATHIC RESIDENCY; AND A SCHOOL OF NURSING. MEDICAL RESIDENTS ENROLLED IN THE FAMILY MEDICINE RESIDENCY PROVIDE PRIMARY MEDICAL CARE TO PATIENTS, THE MAJORITY OF WHOM ARE UNINSURED OR ARE PARTICIPANTS IN GOVERNMENT PROGRAMS SUCH AS MEDICAID AND CHILD HEALTH PLUS, THROUGH TWO CLINICS LOCATED AT THE ELLIS MCCLELLAN STREET HEALTH CENTER INCLUDING THE FAMILY HEALTH CENTER AND THE PEDIATRIC HEALTH CENTER. ELLIS OPERATES THE MEDICAL CENTER OF CLIFTON PARK (MCCP) LOCATED IN SOUTHERN SARATOGA COUNTY, ONE OF THE FASTEST-GROWING COMMUNITIES IN NEW YORK STATE. MCCP IS ALSO THE LOCATION FOR A PRIMARY CARE PRACTICE AND SEVERAL SPECIALTY PRACTICES. ELLIS OPENED A COMBINED URGENT CARE, PRIMARY CARE, AND LABORATORY FACILITY ON THE BUS LINE AT THE MOHAWK HARBOR DEVELOPMENT IN SCHENECTADY. WITH THE URGENT CARE COMPONENT OPEN SEVEN DAYS A WEEK, THE FACILITY OFFERS SCHENECTADY RESIDENTS (AS WELL AS EMPLOYEES OF THE DEVELOPMENT'S BUSINESSES, AND VISITORS TO ITS CASINO AND HOTELS), A CONVENIENT AND EASILY ACCESSIBLE "ONE-STOP ALTERNATIVE TO THE EMERGENCY DEPARTMENT FOR URGENT, BUT NON-EMERGENCY, HEALTH CARE NEEDS. URGENT AND EMERGENT CARE VISITS TO THE MCCP AND MOHAWK HARBOR LOCATIONS TOTALED 37,628 DURING 2022. FORM 990, PART III, LINE 4A, CONTINUED ELLIS SERVES THE COMMUNITY BY ADDRESSING IDENTIFIED HEALTH CARE PRIORITIES; INCLUDING ACCESS TO CARE, AND PREVENTION AND TREATMENT OF CHRONIC DISEASES; THROUGH A VARIETY OF PROGRAMS. IDENTIFICATION OF NEEDS INCLUDES SUCH MECHANISMS AS THE FEDERALLY REQUIRED COMMUNITY HEALTH NEEDS ASSESSMENT WITH ITS IMPLEMENTATION STRATEGY (SEE SCHEDULE H) AND THE STATE-MANDATED TRIENNIAL COMMUNITY SERVICE PLAN. THESE PLANS ARE BUILT COLLABORATIVELY THROUGH REGIONAL AND COMMUNITY PARTNERSHIPS. ON A REGIONAL BASIS, ELLIS IS A MEMBER OF THE HEALTHY CAPITAL DISTRICT INITIATIVE (HCDI) A STATE-FUNDED HEALTH DATA COLLECTION AND PLANNING ENTITY WHICH BRINGS TOGETHER THE COUNTY PUBLIC HEALTH DEPARTMENTS, NOT-FOR-PROFIT HOSPITALS, FQHCS, AND NOT-FOR-PROFIT INSURERS IN THE SIX-COUNTY CAPITAL REGION. IN 2013, 2016, AND 2019, AND 2021, HCDI CONDUCTED REGIONAL INFORMATION-GATHERING EXERCISES TO PROVIDE THE BASIS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) OF ITS MEMBER NOT-FOR-PROFIT HOSPITALS. THESE ARE AVAILABLE HERE HTTP://WWW.ELLISMEDICINE.ORG/PAGES/COMMUNITY-REPORT.ASPX AND THEY ARE FURTHER DESCRIBED IN SCHEDULE H. ON A COMMUNITY COLLABORATION BASIS, ELLIS PARTNERS WITH SCHENECTADY COUNTY PUBLIC HEALTH SERVICES (SCPHS), INCLUDING JOINT GRANT APPLICATIONS AND JOINT NEW YORK STATE DEPARTMENT OF HEALTH NEEDS ASSESSMENTS. THIS INCLUDES THE SCHENECTADY COUNTY STRATEGIC ALLIANCE FOR HEALTH (SAH), A COUNTY-LED, FEDERALLY-DESIGNATED AND FEDERALLY-FUNDED COLLABORATIVE FOCUSED ON PREVENTING CHRONIC DISEASE AND PROMOTING COMMUNITY HEALTH. ELLIS ALSO PROVIDES CO-LEADERSHIP, MEETING SPACE, AND RESOURCES FOR THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY (SCHC), A COMMUNITY COLLABORATIVE OF ABOUT 60 HEALTHCARE PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, AND LOCAL GOVERNMENT AGENCIES. SCHC TYPICALLY MEETS QUARTERLY TO DISCUSS COMMUNITY HEALTH NEEDS AND TO MONITOR PROGRESS ON ELLIS' IMPLEMENTATION STRATEGY. DURING 2022, ALL SCHC MEETINGS WERE HELD VIA TELECONFERENCE. FORM 990, PART III, LINE 4B ELLIS OPERATES A 52-BED INPATIENT MENTAL HEALTH UNIT, ALONG WITH DEDICATED OUTPATIENT MENTAL HEALTH SERVICES. THIS IS THE ONLY INPATIENT MENTAL HEALTH FACILITY IN SCHENECTADY COUNTY AND IS ONE OF ONLY TWO INPATIENT UNITS IN A 16-COUNTY REGION PROVIDING SERVICES TO ADOLESCENTS. ELLIS' MENTAL HEALTH SERVICES INCLUDE INPATIENT CARE FOR ADULTS AND ADOLESCENTS; OUTPATIENT CHILD, ADOLESCENT, AND ADULT MENTAL HEALTH SERVICES; CRISIS INTERVENTION, INCLUDING A 24-HOUR CRISIS INFORMATION HOTLINE; A PEER ADVOCACY PROGRAM; AND A SUPPORT AND EDUCATION GROUP FOR PEOPLE WITH MAJOR DISORDERS AND THEIR FAMILIES. THE "LIVING ROOM," A MENTAL HEALTH CRISIS DIVERSION PROGRAM OPERATED FROM THE STATE STREET HEALTH CENTER, PROVIDES PATIENTS WITH AN ALTERNATIVE TO THE EMERGENCY ROOM. ELLIS HAS RECEIVED A GRANT FROM THE SCHENECTADY COUNTY DRUG COURT TO PROVIDE ENHANCED MENTAL HEALTH SERVICES TO LOW-LEVEL OFFENDERS REFERRED BY THE JUDICIAL SYSTEM, AND A CONTRACT WITH THE SCHENECTADY COUNTY CORRECTIONAL FACILITY TO PROVIDE POST-INCARCERATION SUPPORT SERVICES, BOTH INCLUDING PEER SERVICES. THE ELLIS STATE STREET HEALTH CENTER, WHICH HOUSES THE OUTPATIENT MENTAL HEALTH CLINIC AND A PERSONALIZED RECOVERY ORIENTED SERVICES (PROS) SERVICE, WAS OPENED IN 2017. THIS NOT ONLY INCREASED THE SIZE AND IMPROVED THE QUALITY OF FACILITIES FOR ADULT OUTPATIENT MENTAL HEALTH; IT ALSO HAS BECOME PART OF AN INFORMAL "MEDICAL VILLAGE," WITH THE MENTAL HEALTH FACILITY, A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), ANOTHER LARGE COMMUNITY PRIMARY CARE CLINIC, AND A PHARMACY ALL LOCATED WITHIN ONE CITY BLOCK. IN 2022, THE ELLIS MENTAL HEALTH PROGRAMS HAD 692 INPATIENT DISCHARGES AND 35,687 OUTPATIENT VISITS. FORM 990, PART III, LINE 4C THE ELLIS RESIDENTIAL AND REHABILITATION CENTER (ERRC), AN 82-BED LONG-TERM SKILLED NURSING FACILITY (SNF) AND SHORT-STAY REHABILITATION FACILITY, HAS BEEN PROVIDING LONG TERM NURSING CARE SINCE 1989 AND SHORT STAY REHABILITATION SERVICES SINCE 2001. SPECIALIZING IN MEDICALLY COMPLEX CASES, ERRC OPERATES FROM ITS RENOVATED FACILITY ON THE ELLIS MCCLELLAN STREET HEALTH CENTER CAMPUS. THE FACILITY PROVIDES RESIDENTS WITH PRIVATE ROOMS AND SUCH AMENITIES AS A CYBER-CENTER, A HAIR SALON, AND A ROOF-TOP GARDEN. RESIDENT DAYS FOR 2022 WERE 25,500. FORM 990, PART VI, SECTION B, LINE 11B LINE 11A EXPLANATION - A COPY OF THE ELLIS HOSPITAL'S 990 WAS PREPARED AND SUBMITTED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER. AFTER CFO REVIEW WAS COMPLETED, THE FORM 990 INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, WAS GIVEN TO EACH VOTING MEMBER OF ELLIS' BOARD OF TRUSTEES FOR REVIEW. AFTER REVIEW BY THE BOARD OF TRUSTEES, AND UPON THE RECOMMENDATION OF THE AUDIT COMMITTEE, APPROVAL IS GIVEN FOR FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ELLIS HOSPITAL'S CONFLICT OF INTEREST POLICY APPLIES TO ALL HOSPITAL TRUSTEES, OFFICERS, EMPLOYEES, MEDICAL/DENTAL STAFF MEMBERS, DIRECTORS, MANAGERS, APPOINTEES WITH ADMINISTRATIVE AND/OR DECISION-MAKING RESPONSIBILITIES, VOLUNTEERS OR ANY OF THESE PARTIES' IMMEDIATE FAMILIES (COLLECTIVELY CALLED HOSPITAL AGENTS). THE ELLIS HOSPITAL CORPORATE BYLAWS REQUIRE HOSPITAL AGENTS AND OTHER SELECTED INDIVIDUALS AS IDENTIFIED BY THE VICE PRESIDENT, HUMAN RESOURCES AND THE CORPORATE COMPLIANCE OFFICER/DIRECTOR OF INTERNAL AUDIT (CCO), TO FILE A CONFLICT OF INTEREST DISCLOSURE STATEMENT WITH THE HOSPITAL ON A ANNUAL BASIS. WHEN THE STATEMENTS ARE COMPLETED THEY ARE RETURNED TO THE CCO. UPON RECEIPT, THE CCO WILL REVIEW THE DISCLOSURE AND, IF A POTENTIAL CONFLICT IS DISCLOSED, WILL MEET WITH THE HOSPITAL AGENT AND/OR HIS/HER APPROPRIATE SUPERVISOR TO DISCUSS THE DISCLOSURE AND NEED FOR ACTION IF ANY. ALL STATEMENTS FOR TRUSTEES ARE ALSO REVIEWED BY THE CCO, AND IF A POTENTIAL CONFLICT HAS BEEN DISCLOSED, HE/SHE WILL MEET WITH THE BOARD CHAIRPERSON TO DISCUSS THE DISCLOSURE AND NEED FOR ACTION, IF ANY. ALL POTENTIAL CONFLICTS INVOLVING THE BOARD OF TRUSTEES WILL BE SUMMARIZED BY THE CCO AND REPORTED TO THE AUDIT COMMITTEE OF THE BOARD. THIS COMMITTEE WILL THEN SHARE THIS INFORMATION WITH THE BOARD CHAIRPERSON. WHEN A POTENTIAL OR ACTUAL CONFLICT EXISTS, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OR AT A COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE UPON, THE TRANSACTION OR ARRANGEMENT THAT COULD CONSTITUTE THE CONFLICT OF INTEREST. THE BOARD OR COMMITTEE MEMBERS SHALL DETERMINE BY A MAJORITY VOTE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL'S BEST INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE CURRENT EXECUTIVE COMPENSATION PLAN IS IN FULL COMPLIANCE WITH ALL EXISTING RULES AND REGULATIONS APPLICABLE TO A 501(C) CORPORATION. THE FOLLOWING IS A SUMMARY OF EACH PLAN: EXECUTIVE COMPENSATION PLAN-THE PRESIDENT, AND ALL OTHER SENIOR EXECUTIVIES ARE GOVERNED BY OUR EXECUTIVE COMPENSATION PROGRAM ESTABLISHED BY THE BOARD OF TRUSTEES. THE EXECUTIVE COMPENSATION PLAN IS ADMINISTERED ALSO BY THE EXECUTIVE COMPENSATION COMMITTEE UNDER THE DIRECTION OF THE BOARD OF TRUSTEES. ALL PAYMENTS FROM THIS PROGRAM ARE BASED ON AUDITED RESULTS AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO ANY PAYMENTS BEING MADE. THE REVIEW OF THE COMPENSATION AGREEMENTS AND GATHERING OF COMPARABILITY DATA IN DETERMINING THE REASONABLENESS OF COMPENSATION FOLLOW THE PROCEDURES DESCRIBED IN TREASURY REGULATION SECTION 53.4958-6. FORM 990, PART VI, SECTION C, LINE 19 CORPORATE COMPLIANCE POLICIES (INCLUDING CONFLICTS OF INTEREST POLICY) AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC VIA POSTING ON THE ELLIS HOSPITAL WEBSITE: WWW.ELLISMEDICINE.ORG. IN ADDITION, THESE DOCUMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN FOUNDATION -3,297,229. PENSION AND POSTRETIREMENT RELATED CHANGES -4,517,575. YANKEE ALLIANCE TAX INCOME -364,508. ALLIANCE FOR BETTER HEALTH CARE -242. VISITING NURSE SERVICE ASSOCIATION OF SCHENECTADY -375,023. INCOME TAX BENEFIT 17,290. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST -2,606,472. HEALTHY ALLIANCE IPA 728,547. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CONTINUATION OF SCHEDULE H, PART VI, LINE 4 SCHENECTADY COUNTY WAS DIRECTLY SERVED BY ONE NEW YORK STATE-DESIGNATED DSRIP PERFORMING PROVIDER SYSTEM (PPS), THE ALLIANCE FOR BETTER HEALTH (AFBH), AND IS ADJACENT TO THE SERVICE AREA OF THE ALBANY MEDICAL CENTER PPS. SCHENECTADY COUNTY POPULATION 160,093 (2022) PERSONS PER SQUARE MILE 772.6 (2020) PERSONS UNDER 18 YEARS 21.1% (2022) PERSONS 65 YEARS AND OVER 18.1% (2022) WHITE ALONE (NOT HISPANIC OR LATINO) 75.3% (2022) HISPANIC OR LATINO 8.0% (2022) BLACK OR AFRICAN AMERICAN ALONE 13.9% (2020) BACHELOR'S DEGREE OR + (AGE 25+) 33.3% (2017-21) MEDIAN VALUE, OWNER-OCCUPIED HOUSING $178,000 (2017-21) MEDIAN HOUSEHOLD INCOME $69,891(2017-21) PERSONS IN POVERTY 12.9% (2022) CITY OF SCHENECTADY POPULATION 68,809 (2022) PERSONS PER SQUARE MILE 6,212.7 (2020) PERSONS UNDER 18 YEARS 20.1% (2022) PERSONS 65 YEARS AND OVER 14.2% (2022) WHITE ALONE (NOT HISPANIC OR LATINO) 55.6% (2022) HISPANIC OR LATINO 11.8% (2022) BLACK OR AFRICAN AMERICAN ALONE 18.7% (2022) BACHELOR'S DEGREE OR + (AGE 25+) 22.8% (2017-21) MEDIAN VALUE, OWNER-OCCUPIED HOUSING $118,300 (2017-21) MEDIAN HOUSEHOLD INCOME $50,237 (2017-21) PERSONS IN POVERTY 21.3% (2022) NEW YORK STATE POPULATION 19,677,151 (2022) PERSONS PER SQUARE MILE 428.7 (2020) PERSONS UNDER 18 YEARS 20.3% (2022) PERSONS 65 YEARS AND OVER 18.1% (2022) WHITE ALONE (NOT HISPANIC OR LATINO) 68.6% (2022) HISPANIC OR LATINO 19.7% (2022) BLACK OR AFRICAN AMERICAN ALONE 17.7% (2022) BACHELOR'S DEGREE OR + (AGE 25+) 38.1% (2017-21) MEDIAN VALUE, OWNER-OCCUPIED HOUSING $340,600 (2017-21) MEDIAN HOUSEHOLD INCOME $75,157 (2017-21) PERSONS IN POVERTY 13.9% (2022) FIGURE 1: SCHENECTADY COUNTY, CITY, AND STATE DEMOGRAPHICS (SOURCE: US CENSUS BUREAU, STATE AND COUNTY QUICKFACTS, AS ACCESSED JULY 20, 2023) RESIDENTS OF THE CITY OF SCHENECTADY ARE GENERALLY LESS AFFLUENT AND LESS HEALTHY THAN RESIDENTS OF THE SURROUNDING TOWNS, WHILE RESIDENTS OF THE COUNTY AS A WHOLE ARE LESS AFFLUENT THAN THE STATE AS A WHOLE; HOWEVER THE COUNTY'S POVERTY RATE IS BELOW THAT OF THE STATE (SEE FIGURE 1). FOR EXAMPLE, THE MEDIAN HOUSEHOLD INCOME FOR THE CITY IS ONLY ABOUT TWO-THIRDS THAT OF THE COUNTY AS A WHOLE WHICH, IN TURN, IS BELOW THAT OF THE STATE. THE POVERTY RATE IN THE CITY IS NEARLY 85% HIGHER THAN THAT OF THE COUNTY AS A WHOLE. FIGURE 2: SCHENECTADY COUNTY INSURANCE, PROVIDER, AND DIAGNOSIS INFORMATION (SOURCE: HCD, 2023 COMMUNITY HEALTH PROFILE) SCHENECTADY COUNTY ADULTS 18-64 WITH HEALTH INSURANCE (2021) 94.6% ADULTS WITH REGULAR HEALTH CARE PROVIDER (AGE-ADJUSTED, 2021) 87% ADULTS WHO VISITED DENTIST W/IN 1 YEAR (AGE-ADJUSTED, 2018) 75.5% NEW YORK STATE ADULTS 18-64 WITH HEALTH INSURANCE (2021) 92.6% ADULTS WITH REGULAR HEALTH CARE PROVIDER (AGE-ADJUSTED, 2021) 85% ADULTS WHO VISITED DENTIST W/IN 1 YEAR (AGE-ADJUSTED, 2018) 69.6% SCHENECTADY COUNTY AND STATE HEALTH INSURANCE AND HEALTH ACCESS MEASURES SOURCE: HCD, 2022 CAPITAL REGION COMMUNITY HEALTH NEEDS ASSESSMENT STATE HEALTH DEPARTMENT DATA (2016-2019) SHOW THAT HOSPITALIZATIONS FOR CONDITIONS WHICH COULD HAVE BEEN TREATED IN THE COMMUNITY ("PREVENTION QUALITY INDICATORS") RANGE AS HIGH AS 205% OF THE EXPECTED RATE IN CERTAIN CITY NEIGHBORHOODS, BUT ARE AS LOW AS 60% OF THE EXPECTED RATE IN THE RURAL TOWNS. IN ONE DRAMATIC DISPARITY CONFIRMED BY MORE RECENT (2016-2019) SPARCS HOSPITAL DISCHARGE DATA, EMERGENCY DEPARTMENT VISITS FOR ASTHMA RANGE FROM 143.2 /10,000 IN THE CITY'S HAMILTON HILL NEIGHBORHOOD (12307) TO 24.2 /10,000 IN THE NEARBY SUBURB OF NISKAYUNA (12309). A SIGNIFICANT MINORITY POPULATION IN THE CITY OF SCHENECTADY IS COMPRISED OF GUYANESE OF WEST INDIAN DESCENT. THE RESULT OF SECONDARY MIGRATION FROM NEW YORK CITY PROMOTED BY A PREVIOUS MAYOR ALONG WITH PRIMARY MIGRATION FROM GUYANA, THE INFLUX IS CREDITED WITH REVERSING YEARS OF POPULATION DECLINE IN THE CITY. SCHENECTADY COUNTY PUBLIC HEALTH SERVICES LED MULTIPLE INITIATIVES TO IDENTIFY AND ADDRESS HEALTH DISPARITIES RELATING TO THE WEST INDIAN POPULATION. RESEARCH CONDUCTED BY PHYSICIANS AT ELLIS MEDICINE REVEALED SPECIFIC HEALTH ISSUES REGARDING THE WEST INDIAN POPULATION. IN PARTICULAR, THE UNEXPECTED PREVALENCE OF DIABETES AMONG NON-OBESE GUYANESE MALES IS THE SUBJECT OF JOURNAL ARTICLES (SEE FOR EXAMPLE: HOSLER, PRATT, SEN, BUCKENMEYER, SIMAO, BACK, SAVADATTI, KAHN, HUNT, "HIGH PREVALENCE OF DIABETES AMONG INDO-GUYANESE ADULTS, SCHENECTADY, NEW YORK," PREVENTING CHRONIC DISEASE 2013; 10:120211) AND HELPED LEAD TO AWARDING OF A FEDERAL RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH (REACH) GRANT TO SCPHS IN 2010. THE INITIAL PLANNING STAGE OF THE REACH GRANT FUNDED AN EXTENSIVE COMMUNITY SURVEY OF DIABETES PREVALENCE, PILOT TRAINING OF A DOZEN INDIGENOUS DIABETES HEALTH PROMOTERS, AN ELEMENTARY SCHOOL DIABETES PREVENTION EDUCATION PROGRAM, AND A DIABETES HEALTH SCREENING PROGRAM FOR AT-RISK WEST INDIAN RESIDENTS. THE WEST INDIAN DIABETES ACTION COALITION UTILIZED A MAPP PROCESS TO DEVELOP A COMMUNITY ACTION PLAN (CAP). UNFORTUNATELY, SHIFTING PRIORITIES AT THE CENTERS FOR DISEASE CONTROL (CDC) ENDED FUNDING FOR THE PROJECT BEFORE ITS IMPLEMENTATION PHASE. IN 2014, SCPHS WAS AWARDED A "PARTNERSHIPS TO IMPROVE COMMUNITY HEALTH" (PICH) GRANT, FUNDED BY THE CDC. ONE OF THE GOALS OF THIS GRANT IS TO INCREASE SCREENING RATES FOR TYPE-2 DIABETES IN THE WEST INDIAN POPULATION THAT ARE SEEN AT ELLIS FAMILY HEALTH CENTER, AN ELLIS MEDICINE PRIMARY CARE SITE. OVERALL, SCHENECTADY COUNTY RESIDENTS ARE SLIGHTLY MORE LIKELY THAN THE AVERAGE NEW YORK STATE RESIDENT TO HAVE HEALTH INSURANCE, TO SEE A DOCTOR, AND TO SEE A DENTIST; AND SIGNIFICANTLY MORE LIKELY TO VISIT AN EMERGENCY DEPARTMENT FOR MENTAL HEALTH CARE (SEE FIGURE 2). THE VAST MAJORITY OF PRIMARY MEDICAL CARE AND DENTAL CARE FOR LOW-INCOME RESIDENTS IS PROVIDED BY THE HOMETOWN HEALTH FQHC AND THE COMMUNITY PRACTICES OF THE ELLIS MEDICAL GROUP. BOTH HAVE ACHIEVED RECOGNITION BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) AS PATIENT-CENTERED MEDICAL HOMES (PCMH). CONTINUATION OF SCHEDULE H, PART V, LINE 5 3. ENGAGEMENT OF COMMUNITY ORGANIZATIONS AND CONSUMERS THROUGH WRITTEN COMMENTS RECEIVED ON 2013, 2016, 2019, AND 2022 CHNAS AND IMPLEMENTATION STRATEGIES: AS REQUIRED, ELLIS HOSPITAL POSTED THE 2013, 2016, 2019, AND 2022 CHNAS AND IMPLEMENTATION STRATEGIES ON ITS PUBLIC WEBSITE. (SEE HTTP://WWW.ELLISMEDICINE.ORG/PAGES/COMMUNITY-REPORT.ASPX). IN ADDITION, THE IMPLEMENTATION STRATEGIES WERE INCLUDED IN THE IRS FORMS 990 SCHEDULE H AND ALSO POSTED ON THE HOSPITAL'S WEBSITE. ELLIS HOSPITAL SOLICITED PUBLIC COMMENT VIA A "CONTACT US" FORM ON ITS WEBSITE (HTTPS://WWW.ELLISMEDICINE.ORG/PAGES/CONTACT.ASPX), THROUGH ITS FACEBOOK PRESENCE (HTTPS://WWW.FACEBOOK.COM/ELLISMEDICINENY) AND ON TWITTER (HTTPS://TWITTER.COM/ELLISMEDICINE) WITH ALL ACCOUNTS ACTIVELY MONITORED BY STAFF FROM THE COMMUNICATIONS AND MARKETING OFFICE. THE HOSPITAL ALSO SOLICITED PUBLIC COMMENTS THROUGH THE REGULAR MEETINGS OF THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY (SCHC). NO WRITTEN COMMENTS WERE RECEIVED REGARDING THE 2013, 2016, AND 2022 CHNAS AND IMPLEMENTATION STRATEGIES. VERBAL COMMENTS WERE RECEIVED, HOWEVER, DURING MEETINGS OF SCHC AND WERE USED TO MODIFY AND MAKE MID-COURSE CORRECTIONS TO THE OVERALL IDENTIFICATION, EVALUATION, AND PRIORITIZATION OF HEALTH NEEDS. THE MOST SIGNIFICANT COMMENTS RELATED TO PRIORITY MODIFICATIONS SO AS TO BE ABLE TO TAKE ADVANTAGE OF OPPORTUNITIES WHICH OCCURRED BETWEEN ADOPTION OF THE 2013 AND 2016 DOCUMENTS. THIS PARTICULARLY INVOLVED ELEVATION OF THE PRIORITY OF FOOD INSECURITY (INITIALLY LISTED AS TIER B) AS SEVERAL FUNDING OPPORTUNITIES BECAME AVAILABLE. GREATER KNOWLEDGE OF THE IMPACT OF FOOD INSECURITY ON THE OVERALL WELL-BEING OF INDIVIDUALS AND FAMILIES IN SCHENECTADY THEN LED TO IT INCLUSION AS A COMPONENT IN THE OBESITY/DIABETES INITIATIVE FOR 2016. GIVEN THIS EXPERIENCE, THE PARTNERS UNDERTOOK A COLLABORATIVE REGIONAL EFFORT TO MORE AGGRESSIVELY ENCOURAGE WRITTEN COMMENTS ON THE 2019 REGIONAL CHNA EARLY IN ITS DEVELOPMENT PROCESS. HCD PROVIDED A LINK TO THE NEAR-FINAL DRAFT AND AN ACCOMPANYING ON-LINE QUESTIONNAIRE, WHILE ALL OF THE REGIONAL HOSPITALS AND PUBLIC HEALTH DEPARTMENTS (INCLUDING ELLIS) PROMINENTLY POSTED THE LINK ON QUESTIONNAIRE ON THEIR PUBLIC WEBSITES DURING MAY AND JUNE 2019. THIS POSTING THROUGHOUT THE ENTIRE SIX-COUNTY REGION RESULTED IN 30 WRITTEN COMMENTS. THE WRITTEN COMMENTS INDICATE THAT COMMENTERS FOUND THE DRAFT CHNA EASY TO UNDERSTAND (67% = EASY OR VERY EASY VS. 3% DIFFICULT) AND GENERALLY INFORMATIVE (33% = EXTREMELY INFORMATIVE, 53% = INFORMATIVE, 13% = SOMEWHAT INFORMATIVE). SOME COMMENTERS IDENTIFIED APPARENT ERRORS AND MADE SUGGESTIONS FOR IMPROVEMENT WHICH WERE INCORPORATED IN THE FINAL REGIONAL CHNA. CONTINUATION OF SCHEDULE H, SECTION B, LINE 11 ELLIS WILL CONTINUE TO PROVIDE EDUCATIONAL OPPORTUNITIES FOR COMMUNITY PROVIDERS TO KEEP THEM UP TO DATE ON THE LATEST MEDICAL ADVANCES FOR COVID-19. PURSUANT TO GUIDANCE FROM THE NEW YORK STATE DEPARTMENT OF HEALTH, SCHENECTADY'S 2019 AND 2016 CHNAS FOCUSED SPECIFICALLY ON THE TWO MOST SIGNIFICANT COMMUNITY HEALTH NEEDS: 1) CHRONIC DISEASE (OBESITY AND DIABETES FOR 2016, AND TOBACCO PREVENTION FOR 2019) AND 2) MENTAL HEALTH. IN 2022, THE TWO MOST SIGNIFICANT HEALTH NEEDS IDENTIFIED WERE 1) VACCINE PREVENTABLE DISEASES (COVID-19) AND 2) MENTAL HEALTH AND SUBSTANCE USE DISORDERS. THE INITIAL 2013 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED FIFTEEN HEALTH NEEDS, AND, CONSISTENT WITH FEDERAL REQUIREMENTS, THE 2019 AND 2016 CHNAS CONTINUE TO IDENTIFY ALL FIFTEEN (CONSOLIDATED TO FOURTEEN THROUGH COMBINATION OF THE INTERCONNECTED OBESITY/DIABETES AND FOOD INSECURITY TOPICS) HEALTH NEEDS AS REMAINING IN NEED OF ATTENTION BY THE HOSPITAL. THIS NUMBER WAS REDUCED TO 9 TOPICS FOR THE 2022 CHNA, AND INCLUDED: DIABETES, OBESITY, SEXUALLY TRANSMITTED INFECTIONS, TICK-BORNE ILLNESSES, BREAST CANCER, TOBACCO USE, AND CHILDHOOD LEAD EXPOSURE. DURING 2022 AND DATING BACK TO THE INITIAL PPACA REQUIREMENTS FOR 2013, ELLIS HOSPITAL AND ITS PARTNERS INCLUDING OTHER HOSPITALS, COUNTY PUBLIC HEALTH AGENCIES, AND COMMUNITY-BASED ORGANIZATIONS TOOK ACTIONS TO ADDRESS SUCH NEEDS, COMMENSURATE WITH THE PRIORITY OF EACH NEED AND THE AVAILABILITY OF RESOURCES. ACTIONS ADDRESSING THE SIGNIFICANT NEEDS INCLUDED THE FOLLOWING: CHRONIC DISEASE OBESITY AND DIABETES: -ELLIS EMBARKED ON A TWO-PRONGED APPROACH TO ISSUES OF DIABETES AND OBESITY: 1) SPECIFIC DIABETES EDUCATION PROGRAMS WERE DEVELOPED AND DELIVERED IN THE COMMUNITY AND 2) WEIGHT LOSS AND PHYSICAL EXERCISE PROGRAMS WERE IMPLEMENTED FOR VARYING TARGET GROUPS. -ELLIS AND PARTNERS PILOTED THE "LEARN TO LIVE WELL" DIABETES PROGRAM FOR PARISHIONERS AND COMMUNITY MEMBERS AT THE ZION LUTHERAN CHURCH; THE FOUR-SESSION CURRICULUM INCLUDED A PRESENTATION BY ELLIS CERTIFIED DIABETES EDUCATORS. -ELLIS STAFF MET WITH REPRESENTATIVES FROM THE CITY MISSION AND THE LOCAL HINDU TEMPLE TO EXPLORE DIABETES PROGRAMMING THROUGH THEIR ORGANIZATIONS. -IN 2014, SCHENECTADY COUNTY PUBLIC HEALTH SERVICES RECEIVED A "PARTNERSHIPS TO IMPROVE COMMUNITY HEALTH" (PICH) GRANT WHICH SUPPORTED INCREASED SCREENING FOR DIABETES IN HIGH-RISK POPULATIONS. ELLIS WAS A SUBCONTRACTOR UNDER THE GRANT. -THE PICH GRANT ALSO SUPPORTED TRAINING OF ELLIS DIABETES CARE STAFF AS LIFESTYLE COACHES FOR THE NATIONAL DIABETES PREVENTION PROGRAM (DPP), WHICH IS OFFERED AT ELLIS MEDICINE LOCATIONS STARTING IN OCTOBER 2016. IN LATE 2018, THE ELLIS DDP PROGRAM RECEIVED RECOGNITION FROM THE CENTERS FOR DISEASE CONTROL (CDC). -AN EMBEDDED DIABETES CARE MANAGER WAS PLACED AT ELLIS FAMILY HEALTH CENTER AS PART OF THE PICH GRANT TO WORK ON POLICIES AND SYSTEMS RELATED TO DIABETES MANAGEMENT IN A PRIMARY CARE SETTING, INCLUDING REFERRALS TO THE DIABETES SELF-MANAGEMENT EDUCATION PROGRAM. -WITH ASSISTANCE FROM ELLIS MEDICINE IT STAFF, A REGISTRY OF PATIENTS WITH DIABETES WAS DEVELOPED FOR ELLIS FAMILY HEALTH CENTER TO FACILITATE IMPROVED CARE. -ELLIS STAFF AND LOCAL COLLEGE STUDENTS MET WITH NEIGHBORHOOD ASSOCIATIONS TO CONDUCT A COMMUNITY ASSET MAPPING; THIS INVENTORY IS TO BE USED TO ASSESS THE VIABILITY OF A CITY-WIDE PHYSICAL ACTIVITY PROGRAM. -ELLIS HELD A PHYSICAL ACTIVITY FIELD DAY FOR LOCAL YOUTH IN PARTNERSHIP WITH UNION COLLEGE. -ELLIS ENGAGED ITS OWN EMPLOYEES IN COMPETITIVE WALKING EVENTS AND OTHER WEIGHT-LOSS ACTIVITY; PARTICIPATION COUNTS TOWARD REDUCTIONS IN HEALTH INSURANCE PREMIUMS. -THE HEALTHY FOOD ACCESS WORKGROUP, RENAMED THE DIABETES/OBESITY WORKGROUP, MET THREE TIMES DURING 2017. AVERAGE ATTENDANCE FOR THE MEETINGS WAS 13 PEOPLE. THIS GROUP'S FOCUS DURING THE YEAR WAS TO STEER THE FOOD ACCESS FOCUSED WORK OF THE "PARTNERSHIPS TO IMPROVE COMMUNITY HEALTH" (PICH) GRANT WHICH HAD BEEN AWARDED TO SCHENECTADY COUNTY PUBLIC HEALTH SERVICES. THIS GROUP WORKED WITH SIX FOOD PANTRIES IN SCHENECTADY COUNTY TO INCREASE THE AVAILABILITY OF HEALTHY OPTIONS DISTRIBUTED TO CLIENTS. THIS INCLUDES INCREASING OPTIONS FOR FRUITS AND VEGETABLES AS WELL AS WHOLE GRAINS AND LOW-FAT DAIRY. IMPLEMENTATION EFFORTS AT FOOD PANTRIES INCLUDE "POLICY, SYSTEMS AND ENVIRONMENTAL" (PSE) IMPROVEMENTS. EXAMPLES OF THESE PSE STRATEGIES INCLUDE SIGNAGE TO PROMOTE THE FOOD GROUPS WITH A NUTRITION MESSAGE, MOVING ITEMS ON SHELVES TO HIGHLIGHT FRUITS AND VEGETABLES AT EYE LEVEL, AND IMPROVING THE DISPLAYS FOR FRESH PRODUCE TO MAKE THE FOOD PANTRIES LOOK MORE LIKE A MARKET. RECIPES AND COOKING DEMONSTRATIONS WERE ALSO DONE AT FOOD PANTRIES TO INCREASE THE LIKELIHOOD OF CLIENTS CHOOSING THE HEALTHIER OPTIONS. EACH PANTRY THAT IS ENGAGED IN THIS WORK IN SCHENECTADY COUNTY IS DOING A DIFFERENT COMBINATION OF INTERVENTIONS TO INCREASE THE AVAILABILITY OF HEALTHY OPTIONS BECAUSE EACH PANTRY USES A SLIGHTLY DIFFERENT MODEL TO DELIVER FOODS TO CLIENTS. SOME PANTRIES ARE A CHOICE MODEL, WHERE CLIENTS GET TO CHOOSE ALL THE FOOD THEY TAKE WITH THEM. SOME PROVIDE PRE-PACKED FOOD BOXES AND SOME ARE A MIX OF BOTH MODELS. THE DIFFERENT PANTRY MODELS LEND THEMSELVES TO DIFFERENT INTERVENTIONS WORKING BETTER THAN OTHERS. THE DIABETES/OBESITY WORKGROUP ASSISTED PANTRIES IN DECIDING WHAT INTERVENTIONS WOULD WORK BEST FOR THEIR MODEL. GIVEN THE COMPLETION OF THE GRANT PERIOD, AND THE ABILITY OF MEMBER ORGANIZATIONS TO PURSUE EVIDENCE-BASED FOOD POLICIES, THE WORKGROUP DISCONTINUED MEETING AFTER 2017. -DURING 2018, SIX FOOD PANTRIES CONTINUED TO SUSTAIN POLICY, SYSTEMS AND ENVIRONMENTAL CHANGES TO OFFER HEALTHIER FOOD OPTIONS TO FOOD PANTRY CLIENTS. THESE INTERVENTIONS WERE A CONTINUATION OF THOSE IMPLEMENTED DURING THE PICH GRANT INCLUDING SIGNAGE TO INDICATE HEALTHY OPTIONS WITH A NUTRITION MESSAGE, MOVING HEALTHY ITEMS TO EYE LEVEL ON SHELVING, AND IMPROVING DISPLAYS OF FRESH PRODUCE TO MAKE THEM LOOK MORE APPEALING. RECIPES AND FOOD DEMONSTRATIONS CONTINUED TO TAKE PLACE, AND EACH PANTRY FURTHER ADAPTED THE INTERVENTION TO THE PARTICULAR DISTRIBUTION MODEL BEING USED. IN 2018, NEW WORK BEGAN WITH FOUR (THREE OVERLAPPING WITH PREVIOUS WORK) FOOD PANTRIES IN SCHENECTADY COUNTY TO OFFER CHRONIC DISEASE-SPECIFIC FOOD PACKAGES. FOOD PACKAGES FOR DIABETES AND HYPERTENSION ARE GIVEN OUT TO CLIENTS INDICATING THEY HAVE SOMEONE IN THEIR FAMILY WITH EITHER CONDITION OR SOMEONE AT RISK FOR THE CONDITIONS. THE FOOD PACKAGES INCLUDE HEALTHIER OPTIONS TO ASSIST IN THE MANAGEMENT OR PREVENTION OF DIABETES AND HYPERTENSION THROUGH NUTRITION. EXAMPLES OF FOODS IN THE DIABETES/HYPERTENSION PACKAGES INCLUDE WHOLE WHEAT PASTA, BROWN RICE, NO SUGAR ADDED CANNED FRUIT AND NO SALT ADDED CANNED VEGETABLES. INFORMATION ABOUT THE CONDITIONS AND MANAGEMENT OF THEM IS ALSO INCLUDED IN THE FOOD PACKAGES. CLIENTS CAN GET THE FOOD PACKAGES EACH TIME THEY COME TO THE FOOD PANTRY BY INDICATING THEIR INTEREST IN THE PROGRAM WHEN ASKED. IN ADDITION TO THE FOOD, A REGISTERED DIETICIAN FROM CORNELL COOPERATIVE EXTENSION, SCHENECTADY COUNTY PROVIDED TECHNICAL ASSISTANCE TO THE FOOD PANTRIES TO MODIFY THE FOOD PACKAGES AND PROVIDES NUTRITION EDUCATION AT EACH OF THE FOOD PANTRIES ONE TIME A MONTH. INDIVIDUALS WHO ARE EXPERIENCING FOOD INSECURITY ARE BEING IDENTIFIED THROUGH THIS WORK BY SCREENING INDIVIDUALS AT COMMUNITY-BASED ORGANIZATIONS AND HEALTH INSURERS AND REFERRING THEM TO FOOD PANTRIES THAT ARE OFFERING HEALTHY OPTIONS AND CHRONIC DISEASE SPECIFIC FOOD PACKAGES IF THEY HAVE THAT NEED. -IN OCTOBER 2016, ELLIS DIABETES CARE STARTED THE FIRST DIABETES PREVENTION PROGRAM (DPP) IN THE COMMUNITY IN A NUMBER OF YEARS. THE DPP IS A LIFESTYLE CHANGE PROGRAM TO PREVENT DIABETES. IT RAN 16 CONSECUTIVE WEEKS AND THEN MONTHLY MAINTENANCE SESSIONS FOR THE REMAINDER OF A YEAR. IN 2018, THERE WERE 2 CLASSES STARTED. THE FIRST CLASS STARTED IN APRIL 2018 AND HAD AN AVERAGE ATTENDANCE OF 14 PARTICIPANTS; THIS GROUP WAS IN THE MAINTENANCE PHASE AT THE END OF THE YEAR. A SECOND CLASS STARTED IN SEPTEMBER 2018 AND HAS AN AVERAGE ATTENDANCE OF 12 PARTICIPANTS. AS OF DECEMBER 31, 2018, THIS CLASS IS IN THE INITIAL 16 WEEKS, MEETING ONCE A WEEK. IN JULY 2018, SCHENECTADY'S DPP WAS GRANTED PRELIMINARY RECOGNITION FROM THE CDC AND CONTINUED TO SUBMIT DATA EVERY SIX MONTHS TO THE CDC TO REACH FULL RECOGNITION, WHICH WAS GRANTED AT THE END OF 2018. CDC-RECOGNIZED PROGRAMS CAN APPLY FOR REIMBURSEMENT THROUGH MEDICARE. THE PROGRAM CLOSED IN 2020 DUE TO THE COVID-19 PANDEMIC AND ONGOING STAFFING ISSUES. CONTINUATION OF SCHEDULE H, SECTION B, LINE 11 -ELLIS DIABETES CARE ALSO OFFERS DIABETES SELF-MANAGEMENT EDUCATION (DSME) PROGRAMS FOR INDIVIDUALS ALREADY DIAGNOSED WITH DIABETES. EDUCATION TOPICS INCLUDE; BEING ACTIVE, HEALTHY COPING, HEALTHY EATING, MONITORING, PROBLEM SOLVING, REDUCING RISKS AND TAKING MEDICATION. THEY RECEIVE REFERRALS FROM ELLIS PRACTICES BUT ALSO COMMUNITY-BASED ORGANIZATIONS AND OTHER MEDICAL PROVIDERS IN THE COMMUNITY. ONE OF OUR GOALS IS INCREASE REFERRALS TO DSME AND INCREASE THE NUMBER OF INDIVIDUALS WHO FOLLOW THROUGH ON THEIR REFERRAL AND ATTEND AT LEAST ONE SESSION OF DSME. BETWEEN AUGUST 2019 AND JULY 2021, 368 PATIENTS WERE ESTABLISHED IN THE ELLIS DIABETES SELF-MANAGEMENT EDUCATION PROGRAM. THE PROGRAM HAS ACHIEVED RECOGNITION BY THE AMERICAN DIABETES RECOGNITION, MOST RECENTLY IN OCTOBER 2021, WHICH ALLOWS ELLIS TO BILL FOR DSME SERVICES THROUGH MEDICAID, MEDICARE AND PRIVATE INSURERS. IN 2022, THE OUTPATIENT DIABETES EDUCATOR MET WITH 351 DIABETIC PATIENTS. -ELLIS ALSO EMPLOYS A CERTIFIED DIABETES EDUCATOR IN THE INPATIENT SETTING. THE EDUCATOR'S TIME IS DIVIDED BETWEEN PATIENT EDUCATION, STAFF DEVELOPMENT, AND QUALITY IMPROVEMENT INITIATIVES. IN 2022, THE EDUCATOR CONDUCTED 590 PATIENT CONSULTS TO PROVIDE EDUCATION TO NEWLY DIAGNOSED DIABETICS IN THE INPATIENT SETTING. THE 2022-2025 GOAL IS TO MAINTAIN THE NUMBER OF DIABETES EDUCATION PATIENT CONSULTS THAT THE CERTIFIED DIABETES EDUCATOR PROVIDES. IN 2022, THE DIABETES EDUCATOR IS WORKING ON A PROJECT TO START ELIGIBLE PATIENTS ON FREESTYLE LIBRE 2 AND DEXCOM CONTINUOUS GLUCOSE MONITORS WHILE IN THE HOSPITAL FOR TRANSITIONING THE PATIENTS TO HOME MONITORING. -THE INPATIENT DIABETES EDUCATOR PROVIDES EDUCATION TO HEALTH CARE WORKERS AT ELLIS MEDICINE THROUGH REGISTERED NURSE ORIENTATIONS, MONTHLY GRADUATE NURSE MEETINGS, QUARTERLY HOSPITALIST EDUCATION MEETINGS, MEDICAL GRAND ROUNDS PRESENTATIONS, RESIDENT ORIENTATION, AND PHARMACY/NURSING IN-SERVICE EDUCATION HUDDLES FOR INSULIN PUMP USE. ADDITIONALLY, THE EDUCATOR ALSO WORKS WITH THE BELANGER SCHOOL OF NURSING TO OFFER GUEST LECTURES ON DIABETES, AND WITH SAGE COLLEGE TO PROVIDE ORIENTATION FOR INTERNS AND SHADOWING OPPORTUNITIES FOR NUTRITION STUDENTS IN THE HOSPITAL SETTING. FOR 2022-2025, THE GOAL IS TO BEGIN PROVIDING CME CREDIT FOR EDUCATIONAL PROGRAMS PROVIDED TO THE HOSPITALISTS. -SCPHS PROVIDED FUNDING THROUGH THE PARTNERSHIPS TO IMPROVE COMMUNITY HEALTH GRANT TO TRAIN ELLIS MEDICINE STAFF AS "LIFESTYLE COACHES" TO DELIVER THE DPP. SCPHS ALSO SUPPORTED THE PROMOTION OF THE CLASSES THROUGH ADVERTISEMENTS IN THE LOCAL NEWSPAPER AND SHARING FLYERS WITH LOCAL PARTNERS. THE PICH GRANT WAS ABLE TO PURCHASE INCENTIVES FOR THE PROGRAM TO HELP PEOPLE TO CONTINUE COMING TO THE PROGRAM. -ELLIS MEDICINE PROVIDES STAFF FOR RUNNING THE DSME PROGRAMS, WHICH IS HOUSED IN ELLIS DIABETES CARE. THEY ALSO PROVIDE RESOURCES TO PROMOTE THE PROGRAM IN THE COMMUNITY AND TO THEIR EMPLOYEES. ELLIS DIABETES CARE COLLECTS ALL THE DATA THAT IS NEEDED FOR THIS PROGRAM AND MONITORS PROGRESS WITH REFERRALS. SUNNYVIEW HOSPITAL ALSO PROVIDES REFERRALS TO THE DSME PROGRAM. -FUNDING FROM THE COMMUNITY FOUNDATION FOR THE GREATER CAPITAL REGION TO SUPPORT THE CONTINUED WORK WITH FOOD PANTRIES IS HELPFUL IN MAINTAINING FORWARD MOMENTUM. FUNDED ACTIVITIES INCLUDE EDUCATION FOR FOOD PANTRY CLIENTS, THE PURCHASE OF HEALTHIER FOOD OPTIONS, AND SUPPORT FROM CORNELL COOPERATIVE EXTENSION, SCHENECTADY COUNTY. ELLIS MEDICINE'S MULTIPLE PRIMARY CARE OFFICES AND OUTPATIENT EDUCATION SERVICES INTERFACE DIRECTLY WITH COMMUNITY MEMBERS EXPERIENCING FOOD INSECURITY WHO COULD BENEFIT FROM ACCESS TO HEALTHY FOODS AT LOCAL FOOD PANTRIES. ELLIS CARE MANAGERS ALSO PROVIDE THEIR CLIENTS WITH REFERRALS TO COMMUNITY-BASED ORGANIZATIONS INCLUDING FOOD PANTRIES. CDPHP RECENTLY BEGAN UTILIZING THEIR CARE MANAGERS TO SCREEN FOR FOOD INSECURITY AND MAKE APPROPRIATE REFERRALS BASED ON THE OUTCOME. UTILIZING THE MEDICAL COMMUNITY AS A POINT OF ENTRY FOR HAS ENSURED COMMUNITY MEMBERS ARE CONNECTED WITH THE SERVICES THAT THEY NEED. CITY MISSION'S EMPOWER HEALTH PROGRAM HAS ALSO BEEN INSTRUMENTAL IN SCREENING FOR FOOD INSECURITY IN THE COMMUNITY AND PROVIDING REFERRALS TO FOOD PANTRIES AS NEEDED. THE FOOD PANTRIES ARE VERY INTERESTED IN THIS WORK AND SEE THE IMPORTANCE OF OFFERING HEALTHY OPTIONS FOR THEIR CLIENTS. THE NUTRITION EXPERTISE THAT CORNELL COOPERATIVE EXTENSION, SCHENECTADY COUNTY BRINGS WAS VERY IMPORTANT IN MOVING THE WORK WITH THE FOOD PANTRIES FORWARD. -THE ELLIS BARIATRIC CARE CENTER PROVIDES A COMPREHENSIVE BARIATRICS PROGRAM WITH SERVICES TO HELP IMPROVE THE HEALTH OF OBESE PATIENTS IN THE COMMUNITY, INCLUDING WEIGHT-LOSS SURGERY, NUTRITION SERVICES, HEALTHY LIFESTYLE EDUCATION, AND PATIENT SUPPORT GROUPS. DUE TO THE ONGOING COVID-19 PANDEMIC, THE MONTHLY PATIENT SUPPORT GROUPS WILL TRANSITION TO AN ONLINE FORMAT TO ENSURE CONTINUED, SAFE ACCESS FOR PATIENTS. THE ELLIS BARIATRIC CARE CENTER EMPLOYS A FULL-TIME DIETICIAN WHO SEES PATIENTS EVERY MONTH UNTIL THEY REACH THEIR WEIGHT LOSS GOAL, AND FOR ONE YEAR AFTER SURGERY. THE PRACTICE PROVIDES FOLLOW-UP CARE FOR EVERY PATIENT FOR A LIFETIME. THEY RECEIVE PATIENT REFERRALS FROM ELLIS PRIMARY CARE PRACTICES AND OTHER PROVIDERS IN THE COMMUNITY. IN 2022, SURGEONS AT ELLIS PROVIDED WEIGHT-LOSS SURGERIES FOR 119 PATIENTS. ELLIS MEDICINE ALSO EMPLOYS TWO OUTPATIENT DIETICIANS IN ITS DINING AND NUTRITION DEPARTMENT WHO PROVIDE MEDICAL NUTRITION SERVICES FOR A VARIETY OF MEDICAL CONDITIONS, INCLUDING OBESITY. THEY RECEIVE PATIENT REFERRALS FROM ELLIS PRIMARY CARE PRACTICES. MENTAL HEALTH AND SUBSTANCE USE - SUICIDE AND MENTAL / EMOTIONAL / BEHAVIORAL INFRASTRUCTURE: -THE SCHENECTADY COUNTY OFFICE OF COMMUNITY SERVICES (THE LOCAL GOVERNMENT'S MENTAL HEALTH AND SUBSTANCE USE DISORDERS UNIT) AND ELLIS UNDERTOOK A COLLABORATION TO FORM WORK GROUPS EVALUATING MENTAL HEALTH NEEDS. -IN COLLABORATION WITH RESEARCHERS FROM THE SCHENECTADY COUNTY PUBLIC HEALTH SERVICES AND STUDENTS AT UNION COLLEGE, A PROJECT TO FOCUS ON THE CHNA-IDENTIFIED EXCESS NUMBER OF NEWBORNS BORN PHYSICALLY DEPENDENT ON SUBSTANCES IN SCHENECTADY RECEIVED ELLIS INSTITUTIONAL REVIEW BOARD (IRB) APPROVAL TO CONDUCT CHART REVIEWS OF NEWBORNS WITH A POSITIVE DRUG SCREEN. -THE STUDY EVALUATED THE MOST USED DRUGS AND THE DEMOGRAPHICS OF THE NEWBORNS' MOTHERS. BECAUSE OF THE SMALL SAMPLE SIZE, NO FINAL CONCLUSIONS WERE REACHED. -IN 2015, ELLIS AND SCPHS WORKED WITH HCD WHICH WAS COMPILING MENTAL HEALTH AND SUBSTANCE USE DATA FROM SUCH STANDARDIZED SURVEY TOOLS AS BRFSS AND SCHOOL CLIMATE SURVEY TO ANALYZE AMONG THE CAPITAL REGION COUNTIES. THE SURVEY INFORMATION FLAGGED THE NEWBORN DRUG-RELATED DIAGNOSIS RATE IN SCHENECTADY COUNTY AS A CRITICAL ISSUE COMPARED WITH THE REGION, ALTHOUGH THE SINGLE YEAR RATE DID DIP SLIGHTLY (6.3%) BETWEEN 2012 AND 2013. OTHER INDICATORS FOR WHICH SCHENECTADY COUNTY EXCEEDS THE REGIONAL RATE ARE POST TRAUMATIC STRESS DISORDER (3.8% VS. 3.1%) AND SUBSTANCE USE DISORDER-OTHER (9.3% VS. 7.7%). SPECIFIC SCHENECTADY NEIGHBORHOODS, HOWEVER, GREATLY EXCEED REGIONAL RATES ON MULTIPLE INDICATORS; FOR EXAMPLE, THE SCHENECTADY STOCKADE RATES EXCEED REGIONAL RATES ON 14 OF 18 INDICATORS, WHILE THE DEMENTIA RATE IN SCOTIA/GLENVILLE IS 83% ABOVE THE REGIONAL RATE. -DURING 2016, THE ELLIS OUTPATIENT MENTAL HEALTH CLINIC APPLIED FOR AND RECEIVED DESIGNATION AS A NATIONAL HEALTH SERVICE CORPS (NHSC) PRACTICE SITE. -THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY (SCHC) INITIATED A MENTAL/EMOTIONAL/BEHAVIORAL (MEB) WORKGROUP IN THE FALL OF 2016 TO DISCUSS SUICIDE PREVENTION EFFORTS IN THE COMMUNITY. THIS GROUP MET TWICE DURING LATE 2016 AND EARLY 2017. IN MARCH 2017, SCHC AND SCHENECTADY COUNTY OFFICE OF COMMUNITY SERVICES HELD A SUICIDE PREVENTION DAY OF DIALOGUE THAT BROUGHT TOGETHER COALITION PARTNERS, STATE LEADERS, COMMUNITY-BASED ORGANIZATIONS, MEMBERS OF THE COMMUNITY TO DISCUSS THE ISSUE OF SUICIDE IN THE COMMUNITY AND WHAT CAN BE DONE TO PREVENT IT. ABOUT 30 INDIVIDUALS ATTENDED THE FORUM. THE SECOND HALF OF THE DAY WAS SPENT ON TRAINING THE GROUP IN THE EVIDENCE-BASED SUICIDE PREVENTION TRAINING CALL "QUESTION, PERSUADE, REFER." IT WAS IMPORTANT TO GIVE PARTICIPANTS PRACTICAL SKILLS TO TAKE BACK TO USE IN THEIR ORGANIZATIONS OR LIVES AS WELL AS START THE BROADER CONVERSATION ABOUT SUICIDE PREVENTION IN THE COMMUNITY. FROM THIS DAY OF DIALOGUE, SCHENECTADY COUNTY OFFICE OF COMMUNITY SERVICES HAS DECIDED TO RE-ENGAGE A PREVIOUSLY FORMED SUICIDE PREVENTION COALITION. THIS GROUP WILL LOOK AT COUNTY LEVEL DATA AND DEVELOP STRATEGIES TO IMPROVE SUICIDE PREVENTION EFFORTS INCLUDING TRAINING IN THE COMMUNITY. THIS GROUP MET FOR THE FIRST-TIME DURING JANUARY 2018. CONTINUATION OF SCHEDULE H, SECTION B, LINE 11 DURING 2018, THERE WERE FOUR MEETINGS OF THE SUICIDE PREVENTION COALITION. THE DATES AND ATTENDANCE ARE AS FOLLOWS: JUNE 5 (40 ATTENDEES), AUGUST 20 (25 ATTENDEES), OCTOBER 15 (15 ATTENDEES), AND NOVEMBER 13, (15 ATTENDEES). THE SUICIDE PREVENTION COALITION ESTABLISHED FOUR PRIORITY AREAS TO WORK ON AS A GROUP. THESE INCLUDE: 1) CHANGE AND ELIMINATE STIGMA, 2) INCREASE COMMUNITY INVOLVEMENT, 3) ENCOURAGE NETWORKING BETWEEN PROVIDERS OF SERVICE AND THE COMMUNITY, AND 4) INCREASE PEER SERVICES. THE COALITION SHORTLY THEREAFTER WENT ON A HIATUS 2019 DUE TO LOW MEMBERSHIP INVOLVEMENT. IN 2022/2023 THE OFFICE OF COMMUNITY SERVICES WILL EXPLORE THE CURRENT COMMUNITY NEEDS AND POTENTIAL BENEFITS OF RE-INSTITUTING THE COALITION. -THE ELLIS PEDIATRIC HEALTH CENTER RECEIVED A GRANT FROM THE NEW YORK STATE OFFICE OF MENTAL HEALTH TO IMPLEMENT THE HEALTHY STEPS PROGRAM SUPPORTING AT-RISK FAMILIES WITH CHILDREN FROM BIRTH TO THREE YEARS OLD. THE GRANT ENABLED HIRING A HEALTHY STEPS SPECIALIST WHO IS ENGAGED IN EXPANDING AWARENESS OF THE ADVERSE CHILDHOOD EXPERIENCES (ACES) CONCEPT THROUGHOUT THE COMMUNITY. -THE OFFICE OF COMMUNITY SERVICES PROVIDED TRAUMA-INFORMED CARE TRAINING TWO TIMES FOR SCHENECTADY COUNTY FOSTER PARENTS, ONE ON MARCH 26, 2018 (15 PARTICIPANTS) AND ONE ON OCTOBER 30, 2018 (ALSO 15 PARTICIPANTS). ADDITIONALLY, OCS TRAINED ELLIS MEDICINE'S OUTPATIENT ADULT MENTAL HEALTH CLINIC STAFF ON TRAUMA-INFORMED CARE AND SUICIDE PREVENTION ON AUGUST 8, 2018; 45 PARTICIPANTS ATTENDED THAT TRAINING. A TRAUMA-INFORMED CARE TRAINING CLASS WAS HOSTED BY THE UNIVERSITY AT ALBANY SCHOOL OF SOCIAL WELFARE ON MARCH 12, 2018; 10 PEOPLE FROM SCHENECTADY COUNTY ATTENDED. THE TITLE WAS "TRAUMA PAST TRAUMA PRESENT: UNDERSTANDING AND APPLYING IMPORTANT SKILLS IN TRAUMA INFORMED PHASE ORIENTED TREATMENT." THE TRAINER WAS DR. ALLISON JACKSON. -SCHENECTADY CITY SCHOOL DISTRICT IS ALSO ENGAGED IN WORK AROUND TRAUMA, CREATING TRAUMA-SENSITIVE SCHOOLS. IN MAY 2018, SCHENECTADY HIGH SCHOOL HELD A MENTAL HEALTH FAIR IN THE EVENING FOR BOTH STUDENTS AND PARENTS. NUMEROUS COMMUNITY RESOURCES WERE SHARED AND THEN A SCREENING OF THE FILM "RESILIENCE" WAS HELD WITH A DISCUSSION PANEL AFTER. OVER 100 PEOPLE ATTENDED THE EVENT. -THE DUAL RECOVERY TASK FORCE, LED BY THE OFFICE OF COMMUNITY SERVICES, MET A TOTAL OF NINE TIMES DURING 2018 WITH AN AVERAGE ATTENDANCE OF 16 INDIVIDUALS. THE DUAL RECOVERY TASK FORCE INCLUDES PROVIDERS FROM BOTH MENTAL HEALTH AND SUBSTANCE USE DISORDER SYSTEMS, MAKING AN IMPORTANT CONNECTION FOR TREATING THOSE WITH DUAL DIAGNOSES. THE GROUP HAD 13 DIFFERENT PRESENTATIONS AT THEIR MEETINGS REGARDING COMMUNITY RESOURCES FOR THOSE WITH A DUAL DIAGNOSIS. PROGRAMS THAT WERE PRESENTED RANGED FROM OUTPATIENT MENTAL HEALTH CLINICS TO HARM REDUCTION SERVICES AND HOUSING. THESE PRESENTATIONS BY COMMUNITY PROVIDERS ARE AN IMPORTANT STEP IN PROMOTING THEIR PROGRAMS AND MAKING SURE THE COMMUNITY IS AWARE OF ALL AVAILABLE RESOURCES. -IN 2018, THE TRAUMA INFORMED CARE WORKGROUPS THAT WERE ESTABLISHED IN 2017 MERGED INTO ONE GROUP UNDER THE NEW TITLE OF "TRAUMA-INFORMED COMMUNITY WORKGROUP." THIS GROUP MET A TOTAL OF EIGHT TIMES: FEBRUARY 21 (14 ATTENDEES), FEBRUARY 27 (7 ATTENDEES), JUNE 22 (5 ATTENDEES), JUNE 26 (14 ATTENDEES), JULY 31 (10 ATTENDEES), AUGUST 28 (15 ATTENDEES), OCTOBER 30 (18 ATTENDEES) AND NOVEMBER 26 (12 ATTENDEES). THIS GROUP HELD A BRAINSTORMING SESSION IN JUNE 2018 TO DETERMINE A MISSION, VISION, GOALS AND COMMON DEFINITIONS OF TRAUMA LANGUAGE (TRAUMA-INFORMED CARE, ACES, TOXIC STRESS, AND RESILIENCE). ONE OF THE GOALS OF THE GROUP WAS TO DETERMINE A BASELINE OF TRAUMA-INFORMED PRACTICES EACH PARTICIPATING ORGANIZATION IS USING. THIS BASELINE WOULD HELP DETERMINE NEXT STEPS FOR TRAINING NEEDS OF COMMUNITY BASED ORGANIZATIONS. THE GROUP DECIDED TO UTILIZE COORDINATED CARE SERVICES, INC.'S TOOL CALLED THE "TRAUMA-INFORMED CARE ORGANIZATIONAL SELF-ASSESSMENT TOOL" (TIC OSAT) FOR EACH ORGANIZATION. DURING THE FALL OF 2018, 11 ORGANIZATIONS REPRESENTED ON THE WORKGROUP COMPLETED SURVEYS USING THE TIC OSAT. THE SURVEY DIVIDES RESULTS INTO STAFF AND LEADERSHIP. LEADERSHIP AT THE 11 ORGANIZATIONS COMPLETED 36 SURVEYS AND STAFF COMPLETED 175. THE TIC OSAT SOFTWARE GENERATES REPORTS FOR EACH ORGANIZATION AND AN OVERALL REPORT COMBINING ALL ORGANIZATIONS. THE WORKGROUP ANALYZED THE RESULTS AT A MEETING IN NOVEMBER 2018 AND DETERMINED THAT WORKFORCE DEVELOPMENT AROUND TRAUMA-INFORMED CARE WAS WHERE THE WORK OF THE GROUP SHOULD START. ONE EXCITING RESOURCE THAT THE GROUP WILL USE, AND SOME HAVE USED ALREADY, IS AN ONLINE LEARNING PROGRAM CALLED "INTRODUCTION TO ADVERSE CHILDHOOD EXPERIENCES FOR HEALTHCARE PROFESSIONALS." IT WAS DEVELOPED BY THE ALLIANCE FOR BETTER HEALTH'S (THE LOCAL DSRIP PPS) MEB WORKGROUP AND IS BROKEN DOWN INTO THREE MODULES THAT CAN BE TAKEN ALL TOGETHER OR AT DIFFERENT TIMES. THE COURSE PROVIDES A PRE- AND POST-TEST TO ASSESS KNOWLEDGE. THE OFFICE OF COMMUNITY SERVICES WILL ALSO BE UTILIZED IN 2019 FOR THEIR EXPERTISE AND ABILITY TO PROVIDE ADDITIONAL TRAINING ON TRAUMA TOPICS WORKFORCE DEVELOPMENT. -A "SAFE TALK" TRAINING CLASS WAS HELD ON AUGUST 27, 2018 AT THE MAIN BRANCH OF THE SCHENECTADY COUNTY LIBRARY WHERE 30 PEOPLE WERE TRAINED. THIS TRAINING WAS HOSTED BY NORTHERN RIVERS AND THE SCHENECTADY COUNTY OFFICE OF COMMUNITY SERVICES. - THE SUBSTANCE USE DISORDER PREVENTION COALITION IS ANOTHER GROUP WORKING ON MEB AND SUBSTANCE USE PREVENTION IN THE COMMUNITY. THE COALITION IS CO-LED BY THE SCHENECTADY COUNTY OFFICE OF COMMUNITY SERVICES AND NEW CHOICES RECOVERY CENTER. THE GROUP MET FOUR TIMES IN 2018: JANUARY 5 (25 ATTENDEES), APRIL 6 (24 ATTENDEES), AUGUST 1 (35 ATTENDEES), AND OCTOBER 29 (18 ATTENDEES). THE GROUP DEVELOPED AND DISTRIBUTED A RESOURCE LIST FOR PARTNERS TO PROMOTE THE EXISTING MENTAL HEALTH AND SUBSTANCE USE DISORDER RESOURCES IN THE COMMUNITY. ADDITIONAL ACTIVITIES INCLUDE PROMOTING COMMUNITY EVENTS, SUCH AS RECOVERY NETWORKS, AND DRUG TAKE BACK DAYS, AND REVIEWING DATA TO SET PRIORITIES FOR 2019. -ON JULY 25, 2018, A MENTAL HEALTH FIRST AID TRAINING WAS HELD IN SCHENECTADY WITH 32 PARTICIPANTS. THIS TRAINING WAS OFFERED FOR FREE THROUGH MENTAL HEALTH ASSOCIATION IN NEW YORK STATE (MHANYS). IN 2018, 2021 AND 2022, THE OFFICE OF COMMUNITY SERVICES STAFF BECAME CERTIFIED TRAINERS IN BOTH YOUTH AND ADULT MENTAL HEALTH FIRST AID AND ARE WILLING TO OFFER THIS TRAINING FREE OF CHARGE FOR COMMUNITY MEMBERS THAT ARE INTERESTED IN TAKING IT. -IN 2021, ELLIS OPENED A NEW CHILD, ADOLESCENT AND FAMILY MENTAL HEALTH CENTER TO HELP WITH THE GROWING DEMAND FOR MENTAL HEALTH SERVICES ACROSS THE CAPITAL REGION. THIS OUTPATIENT MENTAL HEALTH PROGRAM SERVES PATIENTS AGES 4-18 WITH THE GOAL OF PROVIDING PATIENTS AND THEIR FAMILIES WITH COMPREHENSIVE, EFFECTIVE MENTAL HEALTH SERVICES IN A NURTURING, SAFE AND SUPPORTIVE ENVIRONMENT. AMONG THE SERVICES PROVIDED ARE INITIAL PSYCHIATRIC ASSESSMENTS WITH DIAGNOSIS, MEDICATION MANAGEMENT, PSYCHOTHERAPY/COUNSELING SERVICES, CRISIS SERVICES (FOR EXISTING PATIENTS), CONSULTATION/COLLATERAL SERVICES FOR SCHOOLS AND OTHER PROFESSIONAL AGENCIES, WELLNESS PLANNING, AND COMMUNITY EDUCATION. -IN 2022, ELLIS MEDICINE HOSTED A VIRTUAL NALOXONE TRAINING FOR EMPLOYEES. 21 ELLIS STAFF TOOK THE TRAINING, AND 10 EMPLOYEES RECEIVED NARCAN KITS. ASTHMA AND SMOKING: -SCHENECTADY COUNTY PUBLIC HEALTH SERVICES, ELLIS, AND OTHER COMMUNITY ORGANIZATIONS APPLIED FOR AND RECEIVED A GRANT FROM NEW YORK STATE HEALTH FOUNDATION TO SUPPORT A "SCHENECTADY ASTHMA SUPPORT COLLABORATIVE" (SASC). A REQUIRED LOCAL CASH MATCH WAS PROVIDED BY THE SCHENECTADY FOUNDATION, THE GE FOUNDATION, AND MVP HEALTHCARE. SERVICES OF A COLLABORATIVE MODEL COMBINING CARE MANAGEMENT, PATIENT EDUCATION, AND IN-HOME NURSING SERVICES BEGAN IN LATE 2014, WITH THE GRANT PERIOD ENDING IN DECEMBER 2015. -SASC CREATED A SEAMLESS THREE-TIERED CARE MODEL (CENTRALIZED CARE COORDINATION, HOME VISITS/ASSESSMENTS, AND ASTHMA EDUCATION). OVER THE COURSE OF THE PROJECT, 68 PATIENTS CONSENTED TO PARTICIPATE IN CARE COORDINATION. WHILE 57 (84%) OF THESE REMAINED ENGAGED AFTER TWO MONTHS, ONLY 13 (19%) COMPLETED BOTH THE HOME VISITS AND ASTHMA EDUCATION COMPONENTS. THE PROJECT'S FINAL REPORT CONCLUDED THAT CULTURAL DYNAMICS ("FATALISM") AND STRUCTURAL BARRIERS (ISSUES OF TRUST) MAY HAVE PREVENTED INDIVIDUALS FROM ACCESSING OPTIMAL CARE. -ALTHOUGH THE PROJECT CLEARLY DEMONSTRATED THE CHALLENGES OF ENGAGING PATIENTS, THE CLINICAL ASPECTS OF THE THREE-TIERED MODEL REMAIN VALID. THE DESIGN OF THE SCHENECTADY MODEL WAS USED TO INFORM DEVELOPMENT OF ASTHMA PROJECTS ACROSS THE SIX-COUNTY SERVICE AREA OF THE REGIONAL DSRIP PARTNERSHIP, THE ALLIANCE FOR BETTER HEALTH. CONTINUATION OF SCHEDULE H, SECTION B, LINE 11 -ELLIS, THE SCHENECTADY CITY SCHOOL DISTRICT (SCSD), AND PRICE CHOPPER PHARMACY PARTICIPATED IN THE "SCHOOL-BASED ASTHMA MANAGEMENT PROGRAM," WHICH ENROLLS A SMALL BUT INCREASING NUMBER OF THE 1,150 DIAGNOSED ASTHMATIC STUDENTS IN SCSD. THE PROGRAM ADMINISTERS ALBUTEROL TREATMENTS, ENABLING STUDENTS TO RETURN TO CLASS 98.7% OF THE TIME. IN ADDITION TO THE IN-SCHOOL COMPONENT, NEARLY A THIRD OF THE STUDENTS AND THEIR PARENTS COMPLETED OUTPATIENT ASTHMA SELF-MANAGEMENT TRAINING SESSIONS THROUGH ELLIS ASTHMA CARE. -THE ELLIS ASTHMA EDUCATION PROGRAM FOUND THAT "GRADUATES" ACHIEVE A 60-70% REDUCTION IN EMERGENCY DEPARTMENT VISITS OVER 12 MONTHS POST-DISCHARGE. -A CARE MANAGER FROM THE ELLIS-SPONSORED HEALTH HOME COMPLETED A TWO-DAY ASTHMA TRAINING COURSE. -ELLIS CONTINUED ITS STRONG ASTHMA EDUCATION PROGRAM AND CONTINUED TO COLLABORATE WITH THE CAPITAL DISTRICT TOBACCO FREE COALITION. INFORMAL "SUASION" WITHIN THE COMMUNITY ENCOURAGED VARIOUS SMOKE-FREE INITIATIVES; A NEWLY CONSTRUCTED AFFORDABLE HOUSING PROJECT ON ALBANY STREET IN SCHENECTADY IS SMOKE-FREE FROM THE START, AND THE ENTIRE UNION COLLEGE CAMPUS WAS SMOKE-FREE AS OF JANUARY 1, 2017. SINCE AUGUST 2016, THE LEGAL AGE FOR THE SALE OF TOBACCO PRODUCTS IN SCHENECTADY COUNTY IS SET BY LOCAL LAW AT 21. -ELLIS EMPLOYS AN EMBEDDED RESPIRATORY THERAPIST/EDUCATOR IN ITS EMERGENCY DEPARTMENT WHO PROVIDES BEDSIDE DISEASE MANAGEMENT EDUCATION AND SMOKING CESSATION COUNSELING TO PATIENTS WITH ASTHMA, COPD AND ASTHMA-COPD OVERLAP (ACO) RECEIVING TREATMENT AT THE ELLIS HOSPITAL EMERGENCY DEPARTMENT. IN 2022, THE EMBEDDED RESPIRATORY THERAPIST PROVIDED 61 PATIENTS WITH EDUCATION AND REFERRALS TO OUTPATIENT RESPIRATORY EDUCATION SERVICES. -ELLIS ALSO OFFERS OUTPATIENT ASTHMA, COPD AND ACO DISEASE SELF-MANAGEMENT EDUCATION. UTILIZING BEST PRACTICES ADAPTED FROM THE GUIDELINES OF THE NATIONAL ASTHMA EDUCATION AND PREVENTION PROGRAM AND THE GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE (GOLD), ELLIS OFFERS A SELF-MANAGEMENT EDUCATION PROGRAM THAT INCORPORATES THE EXPERTISE CERTIFIED ASTHMA EDUCATORS (AE-CS) AND CERTIFIED PULMONARY DISEASE EDUCATORS TO HELP PEDIATRIC AND ADULT PATIENTS LIVE A FULL AND PRODUCTIVE LIFE. IN 2022, ELLIS PROVIDED DISEASE SELF-MANAGEMENT EDUCATION A TOTAL OF 44 SESSIONS TO 32 PATIENTS. -ELLIS MEDICINE OFFERS "THE BUTT STOPS HERE", AN IN-PERSON TOBACCO CESSATION PROGRAM LED BY A CERTIFIED FACILITATOR. THE PROGRAM FEE IS $45, MEDICAID PARTICIPANTS PAY A $20 FEE, AND IT IS FREE FOR MVP MEMBERS, CDPHP MEMBERS, AND ELLIS MEDICINE EMPLOYEES. THE PROGRAM IS SIX WEEKS AND INCLUDES A WORKBOOK, RELAXATION CD, AND TWO WEEKS OF NICOTINE PATCHES OR GUM. -IN 2019, THERE WERE 32 PARTICIPANTS ENROLLED IN THE PROGRAM, FOUR OF WHICH WERE MEDICAID PARTICIPANTS. IN 2020, PRIOR TO THE START OF THE COVID-19 PANDEMIC, THERE WERE 9 PARTICIPANTS ENROLLED IN THE PROGRAM. DUE TO RESTRICTIONS ON IN-PERSON MEETINGS, NO CLASSES WERE HELD IN 2020 AND IN 2021 CLASSES WERE HELD VIRTUALLY. FOR 2022-2025, THE GOAL IS TO RETURN PARTICIPATION IN "THE BUTT STOPS HERE" PROGRAM TO PRE-PANDEMIC LEVELS. TOWARDS THAT EFFORT, A NEW IN-PROGRAM CLASS BEGAN ENROLLING PARTICIPANTS IN MAY 2022. WITH COMPREHENSIVE REGULATORY-COMPLIANT SIGNAGE CONSISTENT WITH CURRENT STANDARDS AND IN A FORMAT CONSISTENT WITH SIGNS AT SUNNYVIEW AND OTHER LARGE CAMPUSES. -ELLIS REVISED ITS TOBACCO USE POLICY TO PROHIBIT THE USE OF TOBACCO PRODUCTS AND ELECTRONIC CIGARETTES ANYWHERE ON ELLIS PROPERTY. EMPLOYEES NOW ARE PROHIBITED FROM SMOKING DURING THE WORKDAY. ELLIS ALSO PRODUCED CARDS WITH INFORMATION ABOUT THE TOBACCO USE POLICY, INCLUDING RESOURCE TO SUPPORT QUITTING, THAT SECURITY STAFF PRESENT TO ANYONE USING TOBACCO PRODUCTS ON ELLIS MEDICINE PROPERTY. CARDIOVASCULAR DISEASE: -ELLIS MEDICINE HAS ACHIEVED THE AMERICAN HEART ASSOCIATION'S 2022 GET WITH THE GUIDELINES HEART FAILURE GOLD PLUS STATUS. THIS IS THE HIGHEST LEVEL OF ACHIEVEMENT FOR THIS PROGRAM. THE PROGRAM FOCUSES ON QUALITY METRICS THAT PERTAIN TO THE HEART FAILURE PATIENT POPULATION (I.E. PATIENTS DISCHARGED ON GUIDELINE DIRECTED MEDICAL THERAPY, CARDIAC REHABILITATION REFERRALS, PATIENT EDUCATION, AND FOLLOW-UP APPOINTMENTS POST-DISCHARGE, AMONG OTHER METRICS). -ELLIS ALSO HOLDS THE AHA 2022 GOLD PLUS MISSION: LIFELINE - STEMI RECEIVING CENTER RECOGNITION. THIS IS ANOTHER QUALITY IMPROVEMENT PROGRAM THROUGH THE AMERICAN HEART ASSOCIATION WHICH IMPROVES HEART ATTACK PATIENT OUTCOMES FOR IN THE COMMUNITY. -ELLIS'S ECHOCARDIOLOGY DEPARTMENT RECEIVED ACCREDITATION BY THE INTERNATIONAL ACCREDITATION COMMISSION IN JULY 2020. ELLIS IS THE ONLY ORGANIZATION ACCREDITED FOR ADULT TRANSESOPHAGEAL, ADULT STRESS, AND TRANSTHORACIC ECHOCARDIOGRAPHY IN SCHENECTADY COUNTY. THESE TESTS HELP SUPPORT THE DIAGNOSIS OF CARDIAC DISEASE, AS WELL AS THE STRUCTURAL HEART TREATMENT PROGRAM, WHICH INCLUDES THE PLACEMENT OF WATCHMAN DEVICES AND MITRAL CLIPS. PREVENTABLE EMERGENCY DEPARTMENT UTILIZATION: -ELLIS LED CREATION OF TWO REGION-WIDE HEALTH INNOVATIONS COLLABORATIONS A MEDICARE MSSP ACO ("INNOVATIVE HEALTH ALLIANCE OF NEW YORK" (IHANY)) AND A MEDICAID DSRIP PPS ("ALLIANCE FOR BETTER HEALTH" (AFBH)) BOTH WITH GOALS OF REDUCING INAPPROPRIATE HOSPITAL UTILIZATION. -BOTH COLLABORATIONS WERE APPROVED FOR INAUGURATION IN 2015 THE ACO ON JANUARY 1 AND THE PPS ON APRIL 1. -IHANY ADOPTED THE GOAL OF REDUCING INAPPROPRIATE HOSPITAL EMERGENCY DEPARTMENT UTILIZATION AS PART OF A COMPREHENSIVE PROGRAM INTENDING TO REDUCE COSTS AND PRODUCE SHARED SAVINGS. AFBHC IS REQUIRED BY THE STATE TO REDUCE INAPPROPRIATE HOSPITAL UTILIZATION (BOTH EMERGENCY DEPARTMENT AND INPATIENT) BY 25% OVER A FIVE-YEAR PERIOD. IHANY WAS SUCCESSFUL IN REDUCING EMERGENCY DEPARTMENT USE BY ITS ATTRIBUTED PATIENTS DURING ITS FIRST YEAR OF OPERATIONS. CONTINUATION OF SCHEDULE H, SECTION B, LINE 11 ADOLESCENT (TEEN) PREGNANCY: -ELLIS, THE SCHENECTADY CITY SCHOOL DISTRICT, PLANNED PARENTHOOD MOHAWK HUDSON, THE ALLIANCE FOR POSITIVE HEALTH, AND THE SCHENECTADY TEEN AND ADULT COALITION (STAC) WORKED TO CONSIDER CAUSES AND SOLUTIONS TO THE CONSISTENTLY HIGH RATES OF ADOLESCENT PREGNANCY IN CERTAIN NEIGHBORHOODS. -THE PROJECT ENGAGED ADOLESCENTS/TEENAGERS IN FOCUS GROUP AND MULTIPLE MEETINGS. A GAP IN HEALTH EDUCATION AT LOCAL SCHOOLS WAS IDENTIFIED. AFTER MOST HEALTH EDUCATION TEACHERS HAD BEEN LAID OFF DUE TO BUDGET CUTS, STUDENTS ARE RECEIVING NO HEALTH EDUCATION CLASSES BETWEEN 6TH GRADE AND 10TH GRADE. PLANNED PARENTHOOD ARRANGED STUDENT HEALTH EDUCATION ASSEMBLIES IN 2016 AND 2018 AND IS SEEKING TO REINTRODUCE MIDDLE SCHOOL HEALTH CLASSES. -THE SCHENECTADY FOUNDATION'S "CALL TO ACTION FOR SCHENECTADY'S YOUTH" GRANT PROGRAM PROVIDED FUNDING FOR THE "CRADLE PROJECT," A MULTIMEDIA PROJECT THAT IS FOCUSING A LENS ON SCHENECTADY'S HIGH RATE OF TEENAGE PREGNANCY THE HIGHEST IN THE CAPITAL REGION AND ITS TOLL ON THE COMMUNITY. DOZENS OF LOCAL YOUTH WERE INVOLVED IN WRITING ORIGINAL MUSIC AND DIALOG, AS WELL AS PERFORMING AND PRODUCING "CRADLE," A DOCUMENTARY FILM ABOUT TEEN PREGNANCY. THE FILM DEBUTED ON SATURDAY, JULY 13, 2019, AT PROCTORS THEATRE IN SCHENECTADY. THE CRADLE PROJECT WILL ALSO INCLUDE MUSIC VIDEOS AND FORUMS ABOUT SEXUAL HEALTH AND PROFESSIONAL DEVELOPMENT. FALLS: -THE 2013 CHNA IDENTIFIED PARTICULARLY HIGH FALLS MORTALITY IN THE COMMUNITY, AND A HIGH NUMBER OF FALLS IN ONE NEIGHBORHOOD. DATA ANALYSIS IDENTIFIED A LARGE SENIOR HOUSING FACILITY IN THIS NEIGHBORHOOD AS THE FALLS "HOT SPOT." -ELLIS STAFF MET WITH ADMINISTRATORS AT THE FACILITY ON SEVERAL OCCASIONS. UNION COLLEGE STUDENTS WERE ENGAGED TO ASSIST THE FACILITY STAFF TO TRACK INDICATORS AND TRENDS. -HAVING IDENTIFIED THE ISSUE AT ONE SENIOR HOUSING FACILITY, AMBULANCE CALL DATA WERE OBTAINED FROM THE LOCAL AMBULANCE COMPANY TO ANALYZE THE PREVALENCE OF FALLS AT OTHER SENIOR FACILITIES. -SCHENECTADY COUNTY PUBLIC HEALTH SERVICES AND SCHENECTADY COUNTY SENIOR AND LONG-TERM CARE SERVICES PARTNERED TO OFFER TAI CHI FOR ARTHRITIS CLASSES IN THE COMMUNITY TO HELP PREVENT FALLS IN OLDER ADULTS. -AS PART OF THE WORK OF THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY, THE SCHENECTADY COUNTY LEAGUE OF WOMEN VOTERS (LWV) UNDERTOOK LEAD ACTIVITIES FOR A "FALLS PREVENTION WORK GROUP." THE WORK GROUP MET REGULARLY AND ENGAGED EXPERTS FROM THE STATE DEPARTMENT OF HEALTH, SENIOR CITIZEN ORGANIZATIONS, REHABILITATION FACILITIES, AND LOCAL GOVERNMENT AGENCIES. THE LWV BECAME UNABLE TO LEAD THE GROUP AS OF EARLY 2017, AND THE GROUP CEASED TO MEET. FOOD INSECURITY: -THE FOCUS ON FOOD INSECURITY CAME FROM A 2013 UMATTER SCHENECTADY SURVEY. THE RESULTS OF THE SURVEY INDICATED THAT THE MAJORITY OF RESIDENTS AMONG THREE SCHENECTADY NEIGHBORHOODS (HAMILTON HILL, EASTERN AVENUE, AND CENTRAL STATE) HAD RUN OUT OF FOOD AT LEAST ONCE IN THE PAST YEAR. THIS FINDING CORRELATED WITH THE PREVALENCE OF SEVERE OBESITY (BMI >35) WHICH IS MORE THAN DOUBLE FOR PEOPLE WHO RUN OUT OF FOOD EVERY MONTH OR NEARLY EVERY MONTH COMPARED TO THOSE WHO DON'T REPORT RUNNING OUT OF FOOD. -A PARTNERSHIP INCLUDING SCHENECTADY COMMUNITY ACTION PROGRAM, CITY MISSION OF SCHENECTADY, ELLIS MEDICINE, AND THE SCHENECTADY FOUNDATION OBTAINED A GRANT FROM THE ROBERT WOOD JOHNSON FOUNDATION TO SUPPORT A "COMMUNITY COACH" FROM THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE. THE "COACH" CONVENED A SERIES OF TELEPHONE CONFERENCES AND AN ON-SITE VISIT TO HELP FOCUS COMMUNITY RESOURCES AND THINKING. -AS A RESULT OF THE COACHING, THE PARTNERSHIP DEVELOPED A COMMUNITY PLAN INCLUDING ASSET MAPPING AND A ROOT CAUSE ANALYSIS AND DEVELOPED COLLABORATION WITH THE SCHENECTADY COUNTY FOOD PROVIDERS GROUP. NO CLEAR, SINGLE, CAUSE WAS FOUND, ALTHOUGH THERE WAS SOME EVIDENCE THAT SOME SERVICE GAPS (E.G., FEW FOOD PANTRIES ARE OPEN ON WEEKENDS) AND INEFFICIENCIES IN THE DISTRIBUTION SYSTEM MAY BE CONTRIBUTORS. -DURING 2015, ELLIS MEDICINE, SCPHS, AND THEIR PARTNERS WORKED WITH TWO GRANTS (A ROBERT WOOD JOHNSON FOUNDATION ROADMAPS TO HEALTH ACTION AWARD AND PARTNERSHIPS TO IMPROVE COMMUNITY HEALTH) TO IMPROVE ACCESS TO HEALTHY FOODS. THESE EFFORTS RESULTED IN AN ONLINE TOOL ACCESSIBLE FROM PORTABLE DEVICES SUCH AS SMARTPHONES, WHICH SHOWS THE LOCATIONS OF SUCH RESOURCES AS SOUP KITCHENS, FOOD PANTRIES, AND STORES WHICH ACCEPT ELECTRONIC BENEFIT CARDS. THE RESOURCE MAP WAS DEVELOPED INTO A MOBILE PHONE APPLICATION, CALLED "FOOD 4 SCHDY." THE APPS AND WEBSITE HAVE NOT BEEN UPDATED IN RECENT YEARS AND THE COMMUNITY TRANSITIONED AWAY FROM PROMOTING THEIR USE. -THE PICH GRANT ALSO SUPPORTED POLICY, SYSTEMS, AND ENVIRONMENTAL IMPROVEMENTS AT FOOD PANTRIES WITHIN THE COUNTY TO INCREASE ACCESS TO HEALTHY FOODS. THIS GRANT SUPPORTED THE OPENING OF A NEW FOOD PANTRY IN THE 12308 ZIP CODE (NORTHSIDE NEIGHBORHOOD), WHICH IS AN UNDERSERVED AREA OF THE COUNTY. -AS PART OF THE PICH GRANT, A COMMUNITY WIDE FOOD PLAN WAS DEVELOPED WITH GOALS, STRATEGIES AND EVIDENCE-BASED ACTIVITIES TO ADDRESS FOOD INSECURITY IN THE COMMUNITY. -PHYSICIANS AT THE ELLIS FAMILY HEALTH CENTER CONTINUE TO PROMOTE FRESH FRUIT AND VEGETABLE CONSUMPTION AMONG PATIENTS. -IN JANUARY 2019, ELLIS HOSPITAL, THE ALLIANCE FOR BETTER HEALTH AND CATHOLIC CHARITIES OPENED AN INNOVATIVE NEW FOOD PANTRY, THE FOOD FARMACY, ON ELLIS' MCCLELLAN STREET CAMPUS. THE FOOD FARMACY SERVES MEDICAID-ELIGIBLE PATIENTS REFERRED BY ELLIS FOR REASONS SUCH AS LIMITED ACCESS TO NUTRITIOUS FOOD AND LIMITED UNDERSTAND OF WHAT GOOD NUTRITION ENTAILS. IT PROVIDES UP TO THREE DAYS' WORTH OF FRESH PRODUCE AND OTHER NUTRITIOUS FOOD TO PEOPLE WHO NEED IT. -IN 2021, A GROUP OF COMMUNITY-BASED ORGANIZATIONS WERE BROUGHT TOGETHER BY THE SCHENECTADY FOUNDATION TO WORK TOWARD BUILDING A FOOD POLICY COUNCIL FOR SCHENECTADY COUNTY. THE GROUP CONTINUES TO MEET IN 2022 AND IS UTILIZING THE SCHENECTADY COUNTY HEALTHY AND EQUITABLE FOOD ACTION PLAN DEVELOPED UNDER THE PICH GRANT AS A GUIDING DOCUMENT. SEXUALLY TRANSMITTED INFECTIONS: -AT THE ELLIS FAMILY HEALTH CENTER AND IN ELLIS PRIMARY CARE PRACTICES, EXTENSIVE SCREENINGS FOR SEXUALLY TRANSMITTED INFECTIONS (STIS) ARE PROVIDED TO PATIENTS. ALL PATIENTS ARE SCREENED FOR HIV AND HEPATITIS C AT LEAST ONCE IN ADULTHOOD. ALL SEXUALLY ACTIVE WOMEN UNDER THE AGE OF 25 ARE SCREENED ANNUALLY FOR GONORRHEA AND CHLAMYDIA. ANY WOMAN 25 AND OLDER WHO IS AT INCREASED RISK (DETERMINED THROUGH SHARED DECISION-MAKING WITH PHYSICIAN) IS SCREENED FOR GONORRHEA, CHLAMYDIA, AND HIV. ALL PREGNANT WOMEN ARE SCREENED FOR GONORRHEA, CHLAMYDIA, HIV, SYPHILIS, AND HEPATITIS C AT THEIR INITIAL VISIT AND THEN RETESTED IN THE THIRD TRIMESTER FOR ALL, WITH THE EXCEPTION HEPATITIS C. ALL WOMEN 30 AND OVER ARE SCREENED FOR HPV AT THE TIME OF THEIR CERVICAL CANCER SCREENING EVERY 5 YEARS. ALL WOMEN AGES 21-29 YEARS ARE SCREENED FOR HPV IF THEY HAVE AN ABNORMAL PAP SMEAR. ALL WOMEN WITH A COMPLAINT OF VAGINAL DISCHARGE ARE SCREENED FOR GONORRHEA, CHLAMYDIA, AND TRICHOMONAS. ALL PATIENTS WITH A POSITIVE STI TEST ARE SCREENED FOR THE OTHER STIS, INCLUDING GONORRHEA, CHLAMYDIA, SYPHILIS, AND HIV. MEN WHO SELF-IDENTIFY AS HAVING SEX WITH MEN (MSM) ARE SCREENED AT LEAST ANNUALLY FOR GONORRHEA, CHLAMYDIA, HIV, AND SYPHILIS. ALL PATIENTS THAT IDENTIFY AS TRANSGENDER ARE SCREENED BASED ON ANATOMY. ALL PATIENTS WITH HIV ARE SCREENED ANNUALLY FOR GONORRHEA, CHLAMYDIA, AND SYPHILIS. ALL MSM WITH HIV ARE SCREENED ANNUALLY FOR HEPATITIS C. STI AND SAFER SEX EDUCATION IS PROVIDED TO ALL PATIENTS. THE DECISION TO TEST IS ALWAYS REACHED COLLABORATIVELY BETWEEN PHYSICIAN AND PATIENT. -ELLIS MEDICINE PROVIDES TREATMENT FOR PATIENTS WHO TEST POSITIVE FOR SEXUALLY TRANSMITTED INFECTIONS, INCLUDING CHRONIC CARE OF HIV AND TREATMENT OF HEPATITIS C (WHICH ARE SPECIALIZED TREATMENTS, AND ARE NOT DONE BY MOST PRIMARY CARE PHYSICIANS IN THE AREA). UNINTENDED PREGNANCY: -THE AMERICAN ACADEMY OF PEDIATRICIANS (AAP) AND THE AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS (ACOG) BOTH RECOMMEND THE USE OF LONG-ACTING REVERSIBLE CONTRACEPTION (LARCS) AS FIRST LINE PREVENTION OF UNPLANNED PREGNANCY. AS MANY BARRIERS EXISTS TO PATIENTS OBTAINING LARCS, INCLUDING EXPENSE, TIME CONSTRAINTS, LACK OF ACCESS TO PROVIDER, BOTH ORGANIZATIONS ENCOURAGE IMPLEMENTING METHODS TO INCREASE AVAILABILITY TO LARCS. ELLIS FAMILY HEALTH CENTER REGULARLY OFFERS IN-OFFICE PLACEMENT OF LARCS TO PATIENTS IN THEIR PRACTICE. CONTINUATION OF SCHEDULE H, SECTION B, LINE 11 -IN JANUARY 2019, A TASK FORCE AT BELLEVUE WOMAN'S CENTER IMPLEMENTED A PILOT PROGRAM TO INCORPORATE IMMEDIATE POST-PARTUM IUD PLACEMENT. THE PILOT PROGRAM INCLUDES PATIENTS FROM THE ELLIS FAMILY HEALTH CENTER. THESE PATIENTS ARE INFORMED OF THE AVAILABILITY OF THIS CONTRACEPTION OPTION AS PART OF THE ROUTINE PRENATAL DISCUSSION OF POSTPARTUM CONTRACEPTION. THOSE WOMEN DESIRING THIS METHOD AND WHO HAVE NO CONTRAINDICATIONS AT THE TIME OF DELIVERY, WILL BE ABLE TO HAVE IUD PLACED IMMEDIATELY FOLLOWING DELIVERY. ANECDOTALLY, THE PATIENTS AT THE ELLIS FAMILY HEALTH CENTER HAVE SHORTER INTERCONCEPTION SPACING AND HIGH PROPORTION OF UNPLANNED PREGNANCIES. THIS PROGRAM AIMS TO DECREASE THE SHORT INTERCONCEPTION SPACING OF SUBSEQUENT PREGNANCIES AND REDUCE UNINTENDED PREGNANCIES FOR THIS PATIENT POPULATION. PRENATAL CARE, PERINATAL AND INFANT HEALTH: -ELLIS' BELLEVUE WOMAN'S CENTER PARTNERS WITH OTHER MATERNITY PROVIDERS INCLUDING HOMETOWN HEALTH AND PLANNED PARENTHOOD MOHAWK HUDSON TO OFFER SEAMLESS CARE FROM INITIAL PRENATAL CARE TO BIRTH AND THEN FOLLOW-UP. THE ELLIS FAMILY HEALTH CENTER AND THE ELLIS PEDIATRIC CARE CENTER ARE IN THE SAME BUILDING, ALLOWING WARM HANDOFFS FROM THE MOTHER'S PRENATAL CARE TO THE BABY'S WELL CARE. IN ADDITION TO DIRECT CLINICAL CARE FOR PREGNANT MEDICAID BENEFICIARIES AND THEIR BABIES, THE HEALTH HOME PROVIDES CARE MANAGEMENT AND COORDINATES WITH THE SCHENECTADY COUNTY PUBLIC HEALTH SERVICE'S HOME VISITING PROGRAM. RESOURCES EXPENDED BY ELLIS INCLUDE THE NET UNREIMBURSED COST OF THE VARIOUS MATERNITY CARE SERVICES; METRICS INCLUDE MATERNITY OUTCOMES DATA. NEIGHBORHOOD SAFETY: -ELLIS AND THE CITY OF SCHENECTADY PARTICIPATED ON SEVERAL INITIATIVES TO STABILIZE THE NORTHSIDE/GOOSE HILL NEIGHBORHOOD WHERE THE NOTT STREET CAMPUS IS LOCATED. THESE INCLUDE A "WALK TO WORK" INITIATIVE AND A PROGRAM TO PROMOTE HOME OWNERSHIP ("HOME OWNERSHIP MADE EASY" (HOME)). IN ADDITION, CONSTRUCTION AT THE NOTT STREET CAMPUS INCLUDED NEW SIDEWALKS AND IMPROVED STREET LIGHTING, BOTH ISSUES OF NEIGHBORHOOD SAFETY WHICH HAD BEEN IDENTIFIED IN THE CHNA. -ELLIS WAS INVITED BY THE NEW YORK STATE HEALTH FOUNDATION TO APPLY FOR A COMMUNITY-WIDE "HEALTHY NEIGHBORHOODS FUND" GRANT. THE APPLICATION WAS SUBMITTED BUT NOT FUNDED. PROGRAMS FOR YOUTH AND ADOLESCENTS: -IN DECEMBER 2014, THE SCHENECTADY FOUNDATION HOSTED A CONFERENCE ENTITLED "BRIDGES TO YOUTHS" TO BETTER UNDERSTAND THE NEEDS OF SCHENECTADY'S YOUTH. -THE CONFERENCE LED TO THE "CALL TO ACTION FOR SCHENECTADY'S YOUTH." SINCE ITS LAUNCH, THE SCHENECTADY FOUNDATION HAS SO FAR INVESTED $770,000 IN EIGHT PROGRAMS WITH THE POTENTIAL TO BRING POWERFUL AND POSITIVE CHANGE TO SCHENECTADY'S YOUTH. CALL TO ACTION FOR YOUTH IS A THREE-YEAR, $2 MILLION COMMUNITY-WIDE EFFORT TO EMPOWER CHILDREN AND TEENS THAT FACE SIGNIFICANT BARRIERS TO SUCCESS. GRANTS INCLUDE SUPPORT OF SCHOLARSHIPS, JOB TRAINING, AND SPORTS PROGRAMS FOR YOUTH. -IN 2023, ELLIS ANNOUNCED A NEW PARTNERSHIP WITH THE SCHENECTADY CITY SCHOOL DISTRICT AND THE STATE UNIVERSITY OF NEW YORK SCHENECTADY, THE ELLIS PROMISE. THE ELLIS PROMISE TAKES A HOLISTIC APPROACH THAT INCLUDES DIVERSE RECRUITERS, SUCCESS COACHES, COMMUNITY NAVIGATORS AND FINANCIAL SUPPORT TO HELP GRADUATES OF BOTH INSTITUTIONS, ALONG WITH UNDER-RESOURCED ADULTS, OVERCOME COMMON BARRIERS AND ACHIEVE LONG-TERM SUCCESS AS ELLIS EMPLOYEES. THE GOAL IS TWOFOLD: TO HELP ELLIS ATTRACT A SUSTAINABLE AND DIVERSE WORKFORCE AND TO GIVE SCHENECTADY RESIDENTS MORE EXTENSIVE OPPORTUNITIES TO FIND AND MAINTAIN LIVING-WAGE EMPLOYMENT. BREAST CANCER: -IN 2021, ELLIS BECAME A MEMBER OF ROSWELL PARK CARE NETWORK TO ADDRESS THE UNMET NEED FOR MEDICAL ONCOLOGY SERVICES IN SCHENECTADY COUNTY. ROSWELL PARK COMPREHENSIVE CANCER CENTER IS A NATIONALLY DESIGNATED CANCER INSTITUTE (NCI); ONE OF ONLY FIVE IN NYS AND THE ONLY ONE UPSTATE. THE NEW CENTER PROVIDES ACCESS TO WORLD-CLASS CANCER CARE, WHICH PREVIOUSLY WAS ONLY AVAILABLE HOURS AWAY. ELLIS ALSO PROVIDES MAMMOGRAMS AND OTHER ADVANCED DIAGNOSTIC SERVICES AND TREATMENTS FOR OUR LOW-INCOME AND UNDERSERVED PATIENTS. ELLIS RECENTLY BEGAN A BREAST CANCER-SPECIFIC TUMOR BOARD, AND WE HAVE VERY ENGAGED BREAST SURGEONS IN DRS. KAUH AND SANCHEZ. ELLIS IS WORKING TOWARD ENHANCING THE PROGRAM AND ACHIEVING NATIONAL ACCREDITATION FOR THE BREAST PROGRAM IN THE NEXT FEW YEARS. -IN OCTOBER 2022, ELLIS MEDICINE CELEBRATED BREAST CANCER AWARENESS MONTH BY HOLDING A BREAST CANCER SCREENING DRIVE CALLED MAMMOTHON 2022, IN PARTNERSHIP WITH ROSWELL PARK AND WTEN/CH. 10, WAS A BIG SUCCESS. WE EXCEEDED OUR GOAL FOR MAMMOGRAM SIGN-UPS BY 87.5 PERCENT, WITH 375 WOMEN MAKING APPOINTMENTS FOR THEIR ANNUAL SCREENING. CHILDHOOD LEAD EXPOSURE: -PROVIDERS AT ELLIS PEDIATRICS DO POINT-OF-CARE LEAD TESTING AT 1- YEAR-OLD AND 2-YEAR-OLD WELL CHILD VISITS. THIS IS A REQUIREMENT OF NEW YORK STATE AND A RECOMMENDATION BASED ON THE PERCENT OF CHILDREN SERVED WHO ARE ON MEDICAID. IF A CHILD HAS A KNOWN EXPOSURE (I.E., A SIBLING WITH AN ELEVATED LEAD LEVEL) OR DEVELOPMENTAL ISSUE, PROVIDERS WILL ALSO DO TESTING AT THE TIME. IF THEIR LEVEL IS ELEVATED BASED ON POC, THEY NEED A SERUM CONFIRMATION AND DEPENDING ON THE LEVEL SCHENECTADY COUNTY PUBLIC HEALTH SERVICES WILL GET INVOLVED WITH EDUCATION AND ABATEMENT. TICK-BORNE DISEASES: -ELLIS MEDICINE SEES PATIENTS AT ITS CLIFTON PARK EMERGENT CARE CENTER AND ITS MOHAWK HARBOR URGENT CARE FOR TICK REMOVAL. ELLIS HAS FIVE PRIMARY CARE LOCATIONS, WHERE PROVIDERS CAN PROVIDE TREATMENT FOR LYME DISEASE. ELLIS ALSO HAS AN INFECTIOUS DISEASE PRACTICE WHERE PATIENTS CAN BE REFERRED FOR LYME DISEASE COMPLICATIONS. ELLIS INFECTIOUS DISEASE SPECIALISTS ENDORSE THE INFECTIOUS DISEASE SOCIETY OF AMERICA SCIENTIFIC GUIDELINES FOR THE TREATMENT OF LYME DISEASE AND ITS COMPLICATIONS. COMMUNITY AND COALITION BUILDING: -ELLIS AND SCPHS CONTINUE TO CO-FACILITATE THE SCHENECTADY COALITION FOR A HEALTHY COMMUNITY. THESE MEETING ARE NOW HELD VIRTUALLY DUE TO COVID-19 PRECAUTIONS, BUT THE GROUP BEGAN HYBRID MEETINGS IN THE SPRING OF 2023. -IN 2014 ELLIS UNDERTOOK TWO MAJOR BUSINESS INITIATIVES PROMOTING BROAD COALITIONS OF HEALTHCARE PROVIDERS. A MEDICARE SHARED SAVINGS PROGRAM ACCOUNTABLE CARE ORGANIZATION (MSSP ACO) PARTNERED THREE HOSPITAL SYSTEMS, AN FQHC, AND SEVERAL COMMUNITY MEDICAL PRACTICES. A NEW YORK STATE MEDICAID DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM PERFORMING PROVIDER SYSTEM (DSRIP PPS) PARTNERED THE SAME THREE HOSPITAL SYSTEMS, TWO FQHCS, AND TWO LARGE COMMUNITY MEDICAL PRACTICES, ALONG WITH MORE THAN 50 COMMUNITY AGENCIES. BOTH WERE APPROVED BY THEIR RESPECTIVE REGULATORS TO START OPERATIONS IN 2015. -THE MSSP ACO (INNOVATIVE HEALTH ALLIANCE OF NEW YORK, OR IHANY) WAS APPROVED TO START OPERATIONS ON JANUARY 1, 2015, AND THE DSRIP PPS (ALLIANCE FOR BETTER HEALTH, OR AFBH) TO BEGIN ON APRIL 1, 2015. EACH WAS ESTABLISHED AS A SEPARATE LIMITED LIABILITY COMPANY (LLC) AND EACH UNDERTOOK TO ADOPT AN OPERATING AGREEMENT AND SEAT A BOARD OF DIRECTORS. THE DSRIP PPS RECEIVED SCHEDULED FUNDING FROM THE NEW YORK STATE DEPARTMENT OF HEALTH UNDER A FIVE-YEAR AGREEMENT. THE MSSP ACO WAS FUNDED BY CAPITAL CONTRIBUTIONS FROM THE TWO MEMBERS OF THE LLC (ELLIS HOSPITAL AND ST. PETER'S HEALTH PARTNERS) AND HAS NOT ACHIEVED "SHARED SAVINGS." IN 2017, ELLIS WITHDREW AS AN EQUITY PARTNER OF THE MSSP ACO, BUT REMAINS A CLINICAL PARTNER. IHANY WAS RECENTLY IDENTIFIED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) AS AN ACCOUNTABLE CARE ORGANIZATION (ACO) THAT HAD A POSITIVE IMPACT ON PATIENT CARE AND MEDICARE SAVINGS IN 2020. -IN NOVEMBER 2021, ELLIS MEDICINE AND ST. PETER'S HEALTH PARTNERS (SPHP) ENTERED INTO A PROVIDER TRANSITION AGREEMENT (PTA) TO PRESERVE VITAL HEALTH CARE SERVICES BY KEEPING PROVIDERS PRACTICING IN THE SCHENECTADY COMMUNITY AND IMPROVING RECRUITMENT EFFORTS THAT WILL ATTRACT NEW PROVIDERS TO THE REGION. IN ADDITION, THE AGREEMENT ALLOWS ELLIS PROVIDERS THE OPPORTUNITY TO COLLABORATE MORE CLOSELY WITH THEIR SPHP COUNTERPARTS, AND ALLOWS FOR ACCESS TO INFORMATION, DATA, AND BEST PRACTICES FROM A NATIONAL NETWORK IN TRINITY HEALTH. UNDER THE AGREEMENT, 170 PROVIDERS EMPLOYED BY ELLIS MEDICINE, ALONG WITH SELECT MANAGEMENT TEAM MEMBERS, WILL BECOME EMPLOYEES OF ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES (SPHPMA). ELLIS PATIENTS WILL SEE NO DISRUPTION IN SERVICES AND CAN CONTINUE TO SEE THEIR SAME PROVIDERS IN THE SAME LOCATIONS. THE BIGGEST THREAT TO BOTH ELLIS AND HEALTH CARE ACCESS IN SCHENECTADY IS THE DEPARTURE OF PHYSICIANS FROM OUR COMMUNITY. THE AGREEMENT GIVES ELLIS PROVIDERS ADDITIONAL INCENTIVE TO CONTINUE PRACTICING IN THE COMMUNITIES ELLIS SERVES BY CONNECTING THEM TO THE RESOURCES OF A NATIONAL HEALTH CARE NETWORK. CONTINUATION OF SCHEDULE H, SECTION B, LINE 11 -IN DECEMBER 2021, ELLIS AND ST. PETER'S HEALTH PARTNERS (SPHP) RECEIVED APPROVAL FROM THE NEW YORK STATE DEPARTMENT OF HEALTH FOR A MANAGEMENT SERVICES AGREEMENT (MSA). THE AGREEMENT ALLOWS THE TWO ORGANIZATIONS TO WORK TOGETHER ON PROJECTS DESIGNED TO PRESERVE AND EXPAND THE COMMUNITY'S ACCESS TO HEALTH CARE, WHILE ALSO STRENGTHENING ELLIS' FINANCIAL STANDING AND QUALITY METRICS. ELLIS WILL REMAIN INDEPENDENT FROM SPHP THROUGHOUT THE TWO-YEAR TERM OF THE AGREEMENT, WITH ITS BOARD OF TRUSTEES RETAINING LOCAL CONTROL. -THESE LATEST AGREEMENTS BUILD ON A LONG RELATIONSHIP BETWEEN THE TWO HEALTH CARE SYSTEMS. BOTH ELLIS AND SPHP SHARE A VISION FOR A MORE FULLY INTEGRATED, REGION-WIDE APPROACH TO CARE THAT AIMS TO IMPROVE THE HEALTH OF ITS NEIGHBORS; EMBRACES NEW MODELS SUCH AS VALUE-BASED CARE; AND LOWERS OVERALL HEALTH CARE COSTS FOR THE COMMUNITY. COMMUNITY HEALTH IMPROVEMENT: -ELLIS CONTINUED PROGRAMS OF COMMUNITY AND PATIENT EDUCATION AND SUPPORT. HEALTH PROFESSIONS EDUCATION: -ELLIS, THE ONLY HOSPITAL IN THE REGION TO SPONSOR BOTH PHYSICIAN EDUCATION AND NURSING EDUCATION, CONTINUED TO PROVIDE A BROAD VARIETY OF HEALTH PROFESSIONS EDUCATION PROGRAMS INCLUDING THE BELANGER SCHOOL OF NURSING, THE FAMILY MEDICINE RESIDENCY, GRAND ROUNDS AND OTHER CONTINUING PROFESSIONAL EDUCATION PROGRAMS. ELLIS ALSO SERVES AS A TRAINING AND PRECEPTORSHIP SITE FOR NUMEROUS COMMUNITY-BASED HEALTH PROFESSIONS EDUCATION PROGRAMS. UNREIMBURSED COSTS OF HEALTH PROFESSIONS EDUCATION ARE REPORTED ON IRS FORM 990, SCHEDULE H. SUBSIDIZED AND FREE HEALTH SERVICES: -ELLIS CONTINUED TO PARTICIPATE IN GOVERNMENT INSURANCE PROGRAMS INCLUDING MEDICARE AND MEDICAID, WHILE PROVIDING REDUCED RATES AND CHARITY CARE FOR SELF-PAY PATIENTS, AS DETAILED IN IRS FORM 990, SCHEDULE H. MEDICARE, MEDICAID, AND FINANCIAL ASSISTANCE (CHARITY CARE) COVERED OVER TWO-THIRDS OF INPATIENT DISCHARGES DURING 2022. ELLIS NOTT STREET PHARMACY LLC 1101 NOTT STREET SCHENECTADY NY 12308 815395445 RETAIL PHARMACY NY 272004 1191563 ELLIS HOSPITAL VISITING NURSE SERVICE ASSOCIATION OF SCHENECTADY 108 ERIE BOULEVARD SCHENECTADY NY 12305 141338478 HOME HEALTH CARE NY 501(C)(3) 3 ELLIS HOSPITAL 1 VOLUNTEER AIDES OF ELLIS HOSPITAL 1101 NOTT STREET SCHENECTADY NY 12308 146004058 PROVIDE VOLUNTEER SUPPORT TO THE HOSPITAL NY 501(C)(3) PF N/A 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 VISITING NURSE SERVICE ASSOCIATION E 8700245 CASH SCHEDULE R, PART V, LINE 2(1) ELLIS MANAGEMENT ANNUALLY ASSESSES THE COLLECTABILITY OF THE RECEIVABLE FROM VNS (WHOLLY OWNED SUBSIDIARY). THE RECEIVABLE IS ELIMINATED IN CONSOLIDATION, HOWEVER IS PRESENTED IN THE CONSOLIDATING SCHEDULES OF THE FINANCIAL STATEMENTS. MANAGEMENT CONSIDERS VNS' FINANCIAL RESULTS, CURRENT RATIO, LIQUIDITY, AND BUDGETED FINANCIALS FOR THE COMING CALENDAR YEAR. BASED ON THOSE FACTORS, MANAGEMENT HAS DETERMINED THAT A) THE AMOUNT DUE FROM VNS SHOULD BE CLASSIFIED AS LONG-TERM, B) THE AMOUNT DUE FROM VNS SHOULD BE FULLY RESERVED, C) MANAGEMENT HAS NOT FORGIVEN THE DEBT AND VNS WILL CONTINUE TO PRESENT A CURRENT LIABILITY IN THE CONSOLIDATING SCHEDULES AS THE AMOUNT IS CONSIDERED DUE CURRENT BY ELLIS, HOWEVER, BASED ON VNS INABILITY TO PAY, ELLIS HAS RECORDED A $8,700,245 RESERVE.