Highlights and Outcomes of Key Community Benefits Activities
Supporting Health Care Reform:
Despite the success of health reform in Massachusetts, there are still residents that do not have health insurance for a variety of reasons. Virtually all elders are covered by the Medicare Program, but there are still adults and children that are uninsured, and many residents forego health care services due to high co-payments and deductibles. Based on a March 2013 study published by the Urban Institute and The Blue Cross Blue Shield Foundation of Massachusetts, many of the uninsured are living in families with income below 400% of the Federal Poverty Level. Most will be eligible for Medicaid or subsidized coverage under changes associated with the Patient Protection and Affordable Care Act (ACA) of 2010. These uninsured individuals are younger adults, males, Hispanics, and those with language and perhaps literacy issues. Another important group is low-income uninsured workers that are not currently eligible for Commonwealth Care because of the offer of coverage through their employer; but also not able to realistically afford the coverage offered through their workplace. In our service area it is estimated that there over 12,000 adults and 900 children without coverage.
In 2012, Hallmark Health Financial Counselors completed 2,251 applications for individuals in the state health programs; such as Mass Health programs, Commonwealth Care, Children’s Medical Security Plan, Healthy Start and the Health Safety Net. This does not include interactions that did not result in an application. Hallmark Health System Financial Navigators also helped patients to enroll in SNAP (formerly Food Stamps) and other social service programs. In addition, these Navigators attended more than twenty (20) community outreach events to assist participants and provide enrollment information. Other services provided to residents include advocating for residents, making appointments, and procuring other services such as providing information about the Mobile Food Market. Billing and collections practices are also posted on the system web site.
Another important component of supporting health reform was the need to educate and train high quality professionals to deliver health care. In 2012, Hallmark Health System continued to operate the Lawrence Memorial/Regis College School of Nursing and Radiography Programs. Continuing medical education was offered to physicians, nurses and other health professions, and community members; many of these sessions focused on topics related to the target populations.
Mentoring opportunities were made available for high school students, nursing students and other health professionals from a variety of colleges and high schools, offering the chance for young adults to explore health care as a career option, or to train as nurses, dieticians, pharmacists, physical therapists and in other health professions.
Reducing Health Disparities:
Massachusetts residents of color face disproportionately higher rates of morbidity and mortality than residents of the state as a whole. Health disparities exist in racial and ethnic groups, in the gay, lesbian and transgender populations, for the chronically mentally ill, for the developmentally and physically handicapped, and through the impact of poverty; especially for children and the elderly.
Over that past few years, Hallmark Health System has made a concerted effort to reach out to organizations that have had success in reaching residents impacted by health disparities. Hallmark Health System has strengthened its role at the Community Health Network Areas (CHNA 15 and 16), acting both in leader and member roles. In CHNA 16, the North Suburban Health Alliance, serving most of the region surrounding our hospitals, Hallmark Health System continues to share the lead role with Cambridge Health Alliance. HHS is also represented at the regional CHNA meetings which also include CHNA 13 and 14.
Hallmark Health System has increased its connections to agencies that work with underserved populations such as the Chinese Culture Connection, the YWCA of Malden, and the Tri-city Community Action Program (Tri-Cap). Hallmark Health System is also fully committed to expanding the cultural congruency of our health system. Since our initial work with the Harvard Pilgrim Health Care Foundation Culture InSight Team, through a Blue Cross/Blue Shield Foundation grant in 2007, HHS has instituted a Diversity Committee which continues to meet quarterly and is led by the System Vice President of Human Resources. New hire orientation continues to include an introduction to the HHS Diversity Program and the Interpreter Services Program. Annual competency is maintained through a mandatory online training session.
Hallmark Health programs that support the needs of the diverse communities in our service area include programs such as “Meet.Mingle.Mammogram”, a multi-part educational, support, and screening program designed to serve diverse women in Burlington, Everett, Malden, Medford, Melrose, North Reading, Reading, Stoneham, Wakefield, Wilmington, Winchester and Woburn. This program, formerly funded by the Massachusetts affiliate of Susan G. Komen for the Cure, allows the staff of Hallmark Health to educate young women, aged 20 to 39 years about the importance of breast health and breast cancer prevention strategies, offers navigation services to any woman in the community needing support in scheduling her annual mammogram, and provides special screening events for diverse women. The program is offered in partnership with other local agencies such as the Malden YWCA Encore Plus program.
In Malden, HHS received funding from the Marshall Foundation for The Malden Elder Asian Diabetes Health Project. For the Hallmark Health System catchment area, not including childbirth, the top three causes of hospitalization are related to diabetes, chronic obstructive pulmonary disease, and circulatory system disorders. The data also shows that Asian-Americans have a higher risk of having diabetes when compared to Asians who remained in their country of origin.
To build community awareness about the impact of diabetes, our Program Coordinator wrote diabetes articles for a multi-part series “Managing Your Diabetes” which the Sampan newspaper published. The paper also advertised our events to an even wider audience. The Chinese Culture Connection helped with the translation of a phone message in Chinese, and provided information about the programs during community outreach activities. Screening and education was also offered through the multi-session programs.
Improving Chronic Disease Management:
Many factors contribute to the rapidly rising rates of chronic disease, both locally and across the country. These include such diverse factors as poor nutrition, lack of physical activity, inherited conditions, and exposure to tobacco. In addition, the nationwide obesity epidemic has also led to a marked increase in many chronic diseases. The impact of these illnesses is on the individual, their family and friends, and on the community. As well as affecting an individual’s quality of life, these diseases also have a long term financial impact on the community.
In the Hallmark Health service area cardiovascular disease, diabetes, long-term cancers, bone and joint diseases, such as osteoporosis and arthritis, and substance abuse and mental illnesses, such as depression bring health challenges for area residents to cope with every day. To assist residents in identifying and coping with these diseases, Hallmark Health offers a variety of services and programs such as support groups for elder caregivers, residents with diabetes and those faced with respiratory illnesses such as asthma and chronic bronchitis. In addition the hospital provides education and screening, including self-management programs for diabetics through the American Diabetes Association (ADA) and other self-management programs for chronic diseases through the evidenced-based “My Life, My Health” program, developed by Stanford University. In the Hallmark Health service area, Cambridge Health Alliance, Mystic Valley Elder Services, and Hallmark Health have collaborated to offer the My Life, My Health programs in a strategic way to residents.
One of Hallmark Health System’s signature programs, the Senior Citizen’s Outreach Program offers nursing services such as nursing assessments and referrals, blood pressure screenings, individual health conferences, and multi-session classes to area residents. Education programs are provided on topics ranging from healthy aging, blood pressure and diabetes management to coping with stress. The program is staffed by a registered nurse specializing in the chronic diseases facing older adults.
Promoting Wellness in Vulnerable Populations:
For Hallmark Health, three (3) populations have been identified as especially vulnerable. These include low to moderate income elders; families with children/adolescents at risk due to poverty, isolation, language or cultural barriers, domestic violence, lack of knowledge or skills to navigate the health care system, or those in need of developing parenting skills; and the un-served and underserved community members suffering from behavior health issues. These populations are at risk for abuse and neglect, lack of preventative care leading to poor health outcomes, and are often the segment of society living at or below the poverty level.
For the past fifteen years, Hallmark Health System has provided the Healthy Families home-visiting program for first-time parents age 20 and under living in Everett, Malden, Medford, Melrose, North Reading, Reading, Stoneham, and Wakefield. Funded by the Children’s Trust Fund and supported by Hallmark Health, Healthy Families offers free services for participants and their families during pregnancy and until the child turns three. Services include home visiting, mentoring, role modeling, prenatal and parenting education, parenting activities and groups for young parents, and connecting families with community services and resources. In addition, educational classes such as prenatal classes, infant care, CPR, and First Aid are also provided.
In 2012, Hallmark Health System received additional funding from the Massachusetts Department of Public Health to expand these important services in Everett, considered one of the seventeen most high risk cities in Massachusetts. In Everett, the model serves first time young parents age 22 and under. In the first five months of operations, the program has hired four new staff members, fully served 10 families and had 12 referrals.
Another successful Hallmark Health long-term prevention program is the North Suburban Child and Family Resource Network (NSCFRN), a community-based parenting education and support program that serves families living or working in Melrose, Stoneham, and Wakefield as well as other local communities. In 2012, the Network, funded by a grant through the Massachusetts Department of Early Education and Care, offered parent/child play and learn groups focused on improving literacy, parenting education programs, support groups, family fun activities, as well as information on resources and referrals. Specific programs were also offered for grandparents and fathers. The Network is administered through a partnership between Melrose, Stoneham, and Wakefield Public Schools and Hallmark Health. The program also provides support for childcare providers. Parents and community representatives assist with fundraising, community outreach, and program development. In 2012, the program served over 750 unduplicated families.
In 2012, Hallmark Health System was chosen by the Everett Public Schools to mentor them in their Coordinated Family and Community Engagement (CFCE) program funded by the Massachusetts Department of Early Education and Care. Hallmark Health System donates space for programs, has a lead role on the Everett Early Child Committee, and provides “play and learn” groups and support programs for families with young children.
Community Benefits Program Stories or linkages:
Healthy Families and MA
Hallmark Health System Regional Substance Use Coalition