2019 Community Health Needs Assessment Kaiser Foundation Hospital: Downey Medical Center License number: 930000078 Approved by Kaiser Foundation Hospitals Board of Director’s Community Health Committee September 16, 2019 Kaiser Permanente Southern California Region Community Benefit CHNA Report for KFH-Downey Contents I. Introduction/background A. About Kaiser Permanente (KP) B. About Kaiser Permanente Community Health C. Purpose of the Community Health Needs Assessment (CHNA) Report D. Kaiser Permanente’s approach to Community Health Needs Assessment 4 4 4 5 5 II. Community served A. Kaiser Permanente’s definition of community served B. Map and description of community served i. Map ii. Geographic description of the community served iii. Demographic profile of the community served iv. Severely under-resourced communities 6 6 7 7 7 8 8 III. Who was involved in the assessment? 9 A. Identity of hospitals and other partner organizations that collaborated on the assessment 9 B. Identity and qualifications of consultants used to conduct the assessment 10 IV. Process and methods used to conduct the CHNA A. Secondary data i. Sources and dates of secondary data used in the assessment ii. Methodology for collection, interpretation, and analysis of secondary data B. Community input i. Description of who was consulted ii. Methodology for collection and interpretation C. Written comments D. Data limitations and information gaps 10 10 10 11 14 15 16 16 16 V. Identification and prioritization of the community’s health needs A. Identifying community health needs i. Definition of “health need” ii. Criteria and analytical methods used to identify the community health needs B. Process and criteria used for prioritization of health needs C. Prioritized description of all the community needs identified through the CHNA D. Community resources potentially available to respond to the identified health needs 17 17 17 17 17 18 19 VI. KFH-Downey 2016 Implementation Strategy evaluation of impact A. Purpose of 2016 Implementation Strategy evaluation of impact B. 2016 Implementation Strategy evaluation of impact overview C. 2016 Implementation Strategy evaluation of impact by health need 19 19 20 22 VII. Appendices Appendix A. Secondary data sources and dates i. Secondary sources from the KP CHNA Data Platform ii. Additional sources Appendix B. Community input tracking form Appendix C. Health Need Profiles Appendix D. Community resources Appendix E. Strategic Lines of Inquiry for Community Engagement 27 28 28 29 30 31 42 44 I. Introduction/background A. About Kaiser Permanente (KP) Founded in 1942 to serve employees of Kaiser Industries and opened to the public in 1945, Kaiser Permanente is recognized as one of America’s leading health care providers and nonprofit health plans. We were created to meet the challenge of providing American workers with medical care during the Great Depression and World War II, when most people could not afford to go to a doctor. Since our beginnings, we have been committed to helping shape the future of healthcare. Among the innovations Kaiser Permanente has brought to U.S. health care are: ● ● ● Prepaid health plans, which spread the cost to make it more affordable A focus on preventing illness and disease as much as on caring for the sick An organized, coordinated system that puts as many services as possible under one roof—all connected by an electronic medical record Kaiser Permanente is an integrated health care delivery system comprised of Kaiser Foundation Hospitals (KFH), Kaiser Foundation Health Plan (KFHP), and physicians in the Permanente Medical Groups. Today we serve more than 12 million members in nine states and the District of Columbia. Our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. Care for members and patients is focused on their Total Health and guided by their personal physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health. B. About Kaiser Permanente Community Health For more than 70 years, Kaiser Permanente has been dedicated to providing high-quality, affordable health care services and to improving the health of our members and the communities we serve. We believe good health is a fundamental right shared by all and we recognize that good health extends beyond the doctor’s office and the hospital. It begins with healthy environments: fresh fruits and vegetables in neighborhood stores, successful schools, clean air, accessible parks, and safe playgrounds. Good health for the entire community requires equity and social and economic well-being. These are the vital signs of healthy communities. Better health outcomes begin where health starts, in our communities. Like our approach to medicine, our work in the community takes a prevention-focused, evidence-based approach. We go beyond traditional corporate philanthropy or grantmaking to pair financial resources with medical research, physician expertise, and clinical practices. Our community health strategy focuses on three areas: ● Ensuring health access by providing individuals served at KP or by our safety net partners with integrated clinical and social services; 4 ● ● Improving conditions for health and equity by engaging members, communities, and Kaiser Permanente’s workforce and assets; and Advancing the future of community health by innovating with technology and social solutions. For many years, we’ve worked side-by-side with other organizations to address serious public health issues such as obesity, access to care, and violence. And we’ve conducted Community Health Needs Assessments to better understand each community’s unique needs and resources. The CHNA process informs our community investments and helps us develop strategies aimed at making long-term, sustainable change—and it allows us to deepen the strong relationships we have with other organizations that are working to improve community health. C. Purpose of the Community Health Needs Assessment (CHNA) Report The Patient Protection and Affordable Care Act (ACA), enacted on March 23, 2010, included new requirements for nonprofit hospitals in order to maintain their tax-exempt status. The provision was the subject of final regulations providing guidance on the requirements of section 501(r) of the Internal Revenue Code. Included in the new regulations is a requirement that all nonprofit hospitals must conduct a community health needs assessment (CHNA) and develop an implementation strategy (IS) every three years (http://www.gpo.gov/fdsys/pkg/FR-2014-1231/pdf/2014-30525.pdf). The required written IS plan is set forth in a separate written document. Both the CHNA Report and the IS for each Kaiser Foundation Hospital facility are available publicly at https://www.kp.org/chna. D. Kaiser Permanente’s approach to Community Health Needs Assessment Kaiser Permanente has conducted CHNAs for many years, often as part of long standing community collaboratives. The new federal CHNA requirements have provided an opportunity to revisit our needs assessment and strategic planning processes with an eye toward enhanced compliance and transparency and leveraging emerging technologies. Our intention is to develop and implement a transparent, rigorous, and whenever possible, collaborative approach to understanding the needs and assets in our communities. From data collection and analysis to the identification of prioritized needs and the development of an implementation strategy, the intent was to develop a rigorous process that would yield meaningful results. Kaiser Permanente’s innovative approach to CHNAs includes the development of a free, webbased CHNA data platform that is available to the public. The data platform provides access to a core set of approximately 120 publicly available indicators to understand health through a framework that includes social and economic factors, health behaviors, physical environment, clinical care, and health outcomes. In addition, hospitals operating in the Southern California Region utilized the Southern California Public Health Alliance’s Healthy Places Index Platform, which includes approximately 80 publicly available community health indicators with resolution at the census tract level. In addition to reviewing and analyzing secondary data, each KFH facility, individually or with a collaborative, collected primary data through key informant interviews, focus groups, and surveys. Primary data collection consisted of reaching out to local public health experts, community leaders, and residents to identify issues that most impacted the health of the 5 community. The CHNA process also included an identification of existing community assets and resources to address the health needs. Each hospital/collaborative developed a set of criteria to determine what constitutes a health need in their community. Once all the community health needs were identified, they were prioritized, based on identified criteria. This process resulted in a complete list of prioritized community health needs. The process and the outcome of the CHNA are described in this report. In conjunction with this report, KFH-Downey will develop an implementation strategy for the priority health needs the hospital will address. These strategies will build on Kaiser Permanente’s assets and resources, as well as evidence-based strategies, wherever possible. The Implementation Strategy will be filed with the Internal Revenue Service using Form 990 Schedule H. Both the CHNA and the Implementation Strategy, once they are finalized, will be posted publicly on our website, https://www.kp.org/chna II. Community served A. Kaiser Permanente’s definition of community served Kaiser Permanente defines the community served by a hospital as those individuals residing within its hospital service area. A hospital service area includes all residents in a defined geographic area surrounding the hospital and does not exclude low-income or underserved populations. 6 B. Map and description of community served i. Map Figure A – KFH-Downey Service Area ii. Geographic description of the community served The KFH-Downey service area includes Artesia, Bell, Bell Gardens, Bellflower, Cerritos, Commerce, Compton, Cudahy, Downey, Florence-Graham, Hawaiian Gardens, Huntington Park, Lakewood, Lynwood, Maywood, North Long Beach, Norwalk, Paramount, Pico Rivera, Santa Fe Springs, South Gate, portions of South Los Angeles, Vernon, Watts, Whittier, and Willowbrook. The service area consists of portions of Service Planning Area’s (SPA’s) 6 and 7 in Los Angeles County. 7 iii. Demographic profile of the community served The following table includes race, ethnicity, and additional socioeconomic data for the KFHDowney service area. Please note that ‘race’ categories indicate ‘non-Hispanic’ population percentage for Asian, Black, Native American/Alaska Native, Pacific Islander/Native Hawaiian, Some Other race, Multiple Races, and White. ‘Hispanic/Latino’ indicates total population percentage reporting as Hispanic/Latino. Table 1. Demographic profile: KFH-Downey1 Race/Ethnicity Total Population Socioeconomic 1,512,831 Living in Poverty (
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