2013 Community Benefit Report: The University of Chicago Medicine

AT THE FOREFRONT OF OUR COMMUNITY The University of Chicago Medicine’s 2013 Report to the Community

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LETTER TO THE COMMUNITY

We are proud to call the South Side of Chicago our home. We value its collection of culturally rich neighborhoods. We are grounded by its history and lifted by its people. At the same time, we are reminded on a daily basis of the complicated public health challenges faced by the more than 800,000 people who live on the South Side.

Rates of diabetes, obesity, heart disease, asthma and cancer rank poorly compared to the rest of the nation. These are conditions that can be prevented or treated with appropriate interventions. Unfortunately, access to medical care is a challenge for people on the South Side.

Since 1988, seven area hospitals have closed, reducing the number of available beds by about 60 percent.

This challenging environment has led the University of Chicago Medicine to strategically choose the areas on which to focus its efforts to best meet the needs of the community. Thus, we have performed a rigorous Community Health Needs Assessment to obtain input on top health issues. We were told the biggest concern is access to high-quality medical care. Additionally, UChicago Medicine has prioritized diabetes, childhood obesity and asthma, as well as cancer —particularly breast and colorectal cancer.

But we cannot address these serious issues alone. To improve the health outcomes of a group of individuals, we must act collectively and intentionally. We must help assemble and organize resources by collaborating with community groups, residents and other health care providers to expand our reach.

We hope this report will provide interesting and important insights into our programs that benefit the health and well-being of our community.

Kenneth S. Polonsky, MD Dean and Executive Vice President for Medical Affairs, University of Chicago

Sharon O’K O’Keefe Sh f President, University of Chicago Medical Center

UChicago Medicine, a national leader in each of these fields, is deeply committed to providing services to address these concerns.

Kenneth Polonsky, MD, left, helps to make way for a children’s garden at Bright Star Church in Bronzeville during the 12th annual Day of Service and Reflection. Sharon O’Keefe, right, meets with young pageant winners at the 2014 Bud Billiken Parade.

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COMMUNITY BENEFITS AND SERVICES

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$283 million

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IN FISCAL 2013

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22.5% of $1.26 billion in total operating expenses, an 11% increase from 2012

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$153.6 Million Total Uncompensated Care 1

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$65.52 Million Medicare Program Losses: Support to make up for Medicare and Medicaid reimbursement rates, which do not cover the cost of care. Medicare is a federal health insurance program for people 65 and older and those with certain disabilities. $50.1 Million Medicaid Program Losses:* Medicaid is a federal-state program for those requiring financial assistance.

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$78.9 Million Medical Education: Cost to teach and train future health care professionals not covered by tuition, grants or scholarships.

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$48.3 Million Medical Research: Funding to investigate ways to better prevent, detect and treat disease, as well as advance patient care.

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$1.24 Million Uncategorized Community Benefits: Includes support for health improvement services, community activities, volunteers and language assistance.

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$968,000 Cash and In-Kind Contributions/Donations:* Gifts to community groups for health-related activities.

$25.7 Million Charity Care:* Cost of providing free or discounted services to qualified individuals. $12.3 Million Unrecoverable Patient Debt: Amount absorbed when a hospital cannot collect expected payment for services.

THE UNIVERSITY OF CHICAGO CONTRIBUTES TO THE ECONOMIC VITALITY OF THE REGION EMPLOYMENT IMPACT 1 The University of Chicago, including the University of Chicago Medicine, is the largest employer on Chicago’s South Side. Combined with its vendor network, the university significantly impacts the community and regional economy through the employment and personal income of employees.

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11,884 Total staff employed by the University who reside within the city of Chicago

$579,658,912 Total wages paid out to staff who reside within the city of Chicago

1 IN 3 University staff members who reside within the South Side

$230,085,725 Total wages paid out to staff who reside within the South Side

*An IRS-defined category of community benefit. Components of community benefit for fiscal 2013 (measured at cost). Data prepared based on the Illinois Attorney General’s and IRS guidelines for fiscal year ending June 30, 2013.

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Figures based on 2014 University of Chicago Employment Impact Report. www.uchicago.edu/community/economic_impact/uchicago_local/

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HEALTH PRIORITY: ACCESS TO CARE

South Shore native Alpha Shaw considered herself fairly familiar with her community’s many offerings. But during a recent visit to Komed Holman Health Center her doctor, Doriane Miller, MD, handed her a list of health-related services near her home. Two programs she hadn’t been aware of caught her interest.

HEALTHERX’S REACH*

95,000 HealtheRx “prescriptions” generated

43,000+ South Side residents served

20 Clinical sites, including 15 federally qualified health centers

*April 2013 – June 2014.

Grant Number 1C1CMS330997-03-0000 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services.

South Siders are learning more than ever about accessible health care allies that, unbeknownst to them, are right around the corner—from fitness programs to wellness support groups to nearby sources of fresh produce.

These lists, or “prescriptions,” for neighborhood resources are part of an innovative program called CommunityRx, which was developed under the South Side Health and Vitality Studies (SSHVS) at the University of Chicago Medicine.

The effort is also funded by the U.S. Department of Health and Human Services.

Doriane Miller, MD, speaks with Alpha Shaw at the Komed Holman Health Center. After her visit, Shaw left with a list of health-related services near her South Shore home.

“I think there’s a few things here I might try for nutrition and exercise,” she said.

Shaw is one of more than 43,000 residents to leave a South Side health center, clinic or emergency department since last spring who have been provided with a personalized printout called HealtheRx. The program connects patients with communitybased health and wellness resources that are aligned with their individual needs.

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The program, which launched in March 2013, is is aimed at creating critical links between health care and social resources in communities, so people can better manage their health between medical appointments. The backbone of the initiative is a continuously updated electronic database of community assets that’s merged with electronic health records. Together, they generate custom referrals for social services, community businesses and local organizations that are most relevant to a patient’s health status.

“Research shows that the vast majority of physicians view patients’ social service needs as important to address as health needs,” said Stacy Lindau, MD, MA, CommunityRx director and SSHVS principal investigator.

“CommunityRx makes it exceedingly easy for physicians and other health care providers to identify relevant community resources and inform their patients. People then use these referrals to be well, manage disease and live independently.”

HEALTH PRIORITY: ACCESS TO CARE CommunityRx is one of several UChicago Medicine programs primed to boost access to health and wellness services by lowering structural, social or cultural barriers. Inventive collaborations and outreach initiatives bridge traditional and unconventional health care settings to offer more people an entry to high quality care. Here are some of the other ways UChicago Medicine is working to improve health care access for residents of the South Side:

SUPPORT FOR FREE CLINICS

The Chicago Center for HIV Elimination (CCHE) seeks to eliminate new HIV transmission events by 2041 using network science to target and integrate prevention while creating structural, community-specific interventions.

The Repayment for Education to Alumni in Community Health (REACH) Program provides a stipend to graduates of the Pritzker School of Medicine who complete a residency and return to practice medicine at a Federally Qualified Health Center (FQHC) or a community hospital on Chicago’s South Side.

PEDIATRIC MOBILE MEDICAL UNIT The University of Chicago Medicine resident Nikhil Narang, MD, treats a patient at a CommunityHealth clinic in Englewood.

CommunityHealth West Town 2611 W. Chicago Ave. | 773.395.9900 Faculty and medical students support a weekly clinic at this facility.

CommunityHealth Englewood 641 W. 63rd St. | 773.994.1515 Volunteer physicians and residents from UChicago Medicine provide much of the care at this clinic.

Washington Park Children’s Free Clinic 5350 S. Prairie Ave. | 773.924.0220 ext. 110 From 5:30 to 7:30 p.m. each Tuesday, medical students and faculty provide acute medical care, social services and referrals for children.

Maria Shelter Clinic 7320 S. Yale Ave. | 773.994.5350 Medical students and an attending physician provide care at this facility for homeless women and their children.

UChicago Medicine’s Pediatric Mobile Medical Unit provides a safety net of primary medical services to Chicago students, elementary through high school, many of whom face challenges obtaining health care from other providers.

Pediatric Mobile Medical Unit Stats *2012/2013 school year

123 VISITS

950

to 28 schools and 9 health fairs

medical service encounters

706 SCHOOL PHYSICAL EXAMS

101 STUDENTS received care for obesity-related health issues

ASTHMA CARE FOR 66 STUDENTS

759 VACCINATIONS ADMINISTERED

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HEALTH PRIORITY: ACCESS TO CARE The University of Chicago Medicine is committed to caring for our neighbors who live on the South Side of Chicago.

Through the South Side Healthcare Collaborative, we support more than 30 community and free clinics, many of which offer primary care services. This network helps improve the health and well-being of residents across the city.

W Peterson Ave

13 Chicago Family Health Center - South Chicago 9119 S. Exchange Ave. 773.768.5000 14 Christian Community Health Center 9718 S. Halsted St. 773.233.4100

W Bryn Mawr Ave Foster Ave

15 Christian Community Health Center 1701 W. Monterey Ave., Suite 2 773.233.4100 16 Community Health 641 W. 63rd St. 773.994.1515

Western Ave.

17 Friend Family Health Center - Ashland 4802 S. Ashland Ave. 773.376.9400

28 Cottage View Health Center of Near North Health Services Corp.

4829 S. Cottage Grove Ave. 773.548.1170 29 Komed Holman Health Center of Near North Health Services Corp.

4259 S. Berkeley Ave. 773.268.7600 30 Reavis School-Based Health Center of Near North Health Services Corp.

834 E. 50th St. 773.358.6767 31 TCA Health, Inc. 1029 E. 130th St. 773.995.6300

FREE CLINICS 18 Friend Family Health Center - Beethoven 25 W. 47th St. 773.536.4879 S Halsted St

University of Chicago Medicine Campus

19 Friend Family Health Center - Cottage Grove 800 E. 55th St. 773.702.0660 20 Friend Family Health Center - Pulaski 5635 S. Pulaski Rd. 773.585.3900 21 Friend Family Health Center - Western 5843 S. Western Ave. 773.434.8600

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1 ACCESS Ashland Family Health Center 5159 S. Ashland Ave. 773.434.9216

7 ACCESS located at Holy Cross 2701 W. 68th St., 3-South 773.434.4040

2 ACCESS Auburn-Gresham Family Health Center 8234 S. Ashland Ave. 773.874.1400

8 Beloved Community Family Wellness Center 6821 S. Halsted St. 773.651.3629

3 ACCESS Booker Family Health Center 654 E. 47th St. 773.624.4800

9 Chicago Family Health Center - Chicago Lawn 3223 W. 63rd St. 773.768.5000

4 ACCESS Brandon Family Health Center 8300 S. Brandon Ave. 773.721.7600

10 Chicago Family Health Center - East Side 10536 S. Ewing Ave. 773.768.5000

5 ACCESS Grand Boulevard Health and Specialty Center 5401 S. Wentworth Ave. 773.288.6900

11 Chicago Family Health Center - Pullman 570 E. 115th St. 773.768.5000

6 ACCESS at the Illinois Eye Institute 3241 S. Michigan Ave., 2nd Floor 312.949.7770

12 Chicago Family Health Center - Roseland 120 W. 111th St. 773.768.5000

22 IMAN Health Clinic 2744 W. 63rd St. 773.434.4626 23 Mercy Family Health Center at Lower West 1713 S. Ashland Ave. 312.746.4025 24 Mercy Family Health Center at Oakwood Shores 3755 S. Cottage Grove Ave. 773.451.0460 25 Mile Square Health Center at Bishop Plaza 4630 S. Bishop Plaza 312.996.2000 26 Mile Square Health Center at Englewood 641 W. 63rd St. 312.996.2000 27 Mile Square Health Center at South Shore 7131 S. Jeffery Blvd.

312.996.2000

32 CommunityHealth: West Town 2611 W. Chicago Ave. 773.395.9900 Faculty and medical students support a weekly clinic at this facility.

33 CommunityHealth: Englewood 641 W. 63rd St. 773.994.1515 Volunteer physicians and residents from UChicago Medicine provide much of the care at this facility.

34 Washington Park Children’s Free Clinics 5350 S. Prairie Ave. 773.924.0220 x 110 Medical students and faculty provide care, social services and referrals for children during a weekly evening clinic.

35 Maria Shelter Medical Clinic 7320 S. Yale Ave. 773.994.5350 Medical students and an attending physician provide care for homeless women and their children.

36 New Life Volunteering Society 2645 W. Peterson Ave. 773.275.8630 Medical students and faculty provide care once a week at this facility.

37 IMAN Health Clinic 2744 W. 63rd St. 773.434.4626 Special Services: Family Medicine, Pediatrics, TB Testing, Women’s Health.

HEALTH PRIORITY: CANCER CARE

The University of Chicago Medicine Comprehensive Cancer Center Office of Community Engagement and Cancer Disparities held a multiethnic fashion show for cancer survivors in November 2013 to show minority communities that cancer is a beatable disease. Local personality and TV show host Jacinda Lockett emceed the event, while translators were on hand to tell survivors’ stories in Chinese and Spanish.

African-Americans carry a heavy cancer burden, with a death rate for all cancers that’s nearly 25 percent higher than that of their white counterparts.

Meanwhile, the Hispanic population has a high rate for liver, stomach and cervical cancers, and Asians/Pacific Islanders are twice as likely as whites to die from liver and stomach cancers.

The University of Chicago Medicine is in a strong position to reduce these inequities thanks to its world-class cancer research and proximity to underserved neighborhoods. The University of Chicago Comprehensive Cancer Center Office of Community Engagement and Cancer Disparities (OCECD) was formed to address disparities and understand the needs of the community.

Linking Patients to Care The OCECD works to remove barriers to getting care. In 2012, it began a two-year partnership with the American Cancer Society to participate in a statewide initiative to increase colorectal cancer screenings. In 2010, only 60 percent of Illinoisans 50 and older were screened for colorectal cancer, which is among the most preventable, yet deadly, cancers. Rates were even lower in minority populations. Since then, UChicago Medicine has provided almost 200 colonoscopies to uninsured South Side residents.

Engaging the Community The Walk Though Program is one of the OCECD’s culturally tailored educational efforts aimed at reducing cancer disparities. This experiential learning effort familiarizes community members with diagnostic, treatment and survivorship services at UChicago Medicine by bringing participants from the Asian-American, Hispanic and African-American communities to UChicago Medicine. During a walking tour of breast cancer care, participants learn first-hand what it’s like to be in the procedural rooms for mammography, radiation therapy and chemotherapy.

Emphasis on Education One of OCECD’s major initiatives has been increasing the number of underrepresented minorities from South Side communities in the health care workforce. The Mentored Education Now Taking on Research (MENTOR) program provides local public health graduate students with hands-on experience in health disparities research.

MENTOR scholars work under the guidance of UChicago faculty to plan, implement and evaluate community-based research projects addressing cancer disparities. These projects entail working side-by-side with community members to transform knowledge into action.

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HEALTH PRIORITY: DIABETES

Two programs supported by the University of Chicago Medicine are helping South Side residents manage diabetes while learning more about their own communities.

Diabetes has a disproportionate impact on African-Americans and Hispanics in Chicago, compared to the general population.

The South Side Diabetes Project helps African-Americans manage this chronic condition, while the bilingual Picture Good Health/Imagínate una Buena Salud assists Mexican-Americans in the Little Village and South Lawndale neighborhoods.

THE SOUTH SIDE DIABETES PROJECT Led by Assistant Professor of Medicine Monica Peek, MD, MPH, and Professor Marshall Chin, MD, MPH, the South Side Diabetes Project collaborates with health centers to deliver innovative and evidence-based diabetes care at six locations. Patients attend diabetes empowerment classes and take part in programs and activities emphasizing healthy eating and exercise. Project partners include the 61st Street Farmers Market, Walgreens, Save-A-Lot Grocery Stores, the K.L.E.O Community Family Life Center and the Greater Chicago Food Depository.

The project’s Food Rx initiative provides coupons for fruits, vegetables and other healthy groceries. The Community Fitness Passport Program awards fitness bags and pedometers for physical activity at certain South Side exercise locations.

The South Side Diabetes Project hosts tours of the 61st Street Farmers Market to help people learn about quick, healthy and affordable fresh food choices. Okra and tomatoes are just some of the vegetables available at local markets.

“Several participants told us they continue coming because of the friendships they develop and the social support they receive,” said Nora Geary, one of the project managers. “It’s an amazing program.”

PICTURE GOOD HEALTH/ IMAGÍNATE UNA BUENA SALUD The program gets its name from an innovative technique called photovoice. That’s where individuals use cameras to document their experiences living with diabetes. During weekly educational sessions in English and Spanish, participants use their pictures to spark discussions about problem solving and self-empowerment.

Because churches often play important roles in many cultures, Assistant Professor of Medicine Arshiya Baig, MD, MPH, and her team established partnerships with St. Agnes of Bohemia and Our Lady of Tepeyac, and held focus groups with Mexican-Americans in the two Little Village churches to learn more about the community’s needs.

“We learned that people want to know how to manage diabetes, how to change their lifestyles and how to prevent complications,” said Baig.

“There was definitely a thirst for knowledge.”

Soon after, Baig’s team established the Little Village Community Advisory Board along with the churches and other community partners.

Members include leaders from both congregations, Esperanza Health Centers, Walgreens and Taller de Josè, a social service agency that helps people connect to community resources and navigate the health care system. Both programs hope to expand.

“Health doesn’t just happen in the clinic or with the doctor,” said Geary. “It happens at home and in the community.”

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Donna Christian-Harris, RN, FNP, participates in a cycling fitness class during the African Festival of the Arts.

9.3% OF AMERICANS HAVE DIABETES (more than 29.1 million people)

“The important thing is to have fun and keep moving.”

–Zumba Instructor, Donna Christian-Harris, RN, FNP

28,000 AFRICAN-AMERICANS 18 years and older have diabetes in the area served by the South Side Diabetes Project.

Community Fitness Program Marks 25 Years For the past 25 years, determined fitness walkers have arrived at the Museum of Science and Industry three mornings a week with a single goal: stay in shape. The Community Fitness Program began in 1989 as part of the University of Chicago Medicine’s outreach to older adults. Today it involves a daily crowd of as many as 100 walkers who range in age from 45 to 90. Some use canes or walkers to lap around the museum’s 1/4-mile balcony. The walkers often supplement their workouts with aerobics classes twice a week.

Zumba Keeps the South Side Moving The sound of rhythmic, percussive dance music increasingly means a popular aerobic workout called Zumba. Donna Christian-Harris, RN, FNP, an advanced practice nurse at UChicago Medicine, teaches Zumba at locations on the South Side. In each hour-long workout, she demonstrates dance moves that can be performed by anyone, regardless of their fitness level.

“Everyone has their own style,” Christian-Harris says.

Fitness walker Hazel Colar smiles as she walks the 1/4mile loop at the Museum of Science and Industry.

“I am completely in awe and inspired by what I see.”

–Community Relations Coordinator Walidah Tureaud

Left: Fitness walker Yvonne Gregwor carries trekking poles as she walks at the Museum of Science and Industry.

Right: Arshiya Baig, MD, MPH, right, greets community members at a Picture Good Health/Imaginate una Buena Salud event in the Little Village neighborhood.

HEALTH PRIORITY: CHILDHOOD OBESITY AND ASTHMA

Childhood obesity in America has more than doubled in the past 30 years, according to the Centers for Disease Control and Prevention. Meanwhile, asthma affects more than 9 percent of U.S. children. This pattern is concentrated on the South Side of Chicago. By reaching out to our surrounding neighborhoods, the University of Chicago Medicine is hoping to reduce these numbers.

CHILDHOOD OBESITY More than 40 percent of children on the South Side are overweight or obese, compared to one-third nationally. UChicago Medicine is working with schools and the community to engage children to practice healthy eating and good exercise habits.

Chicago White Sox and Woodlawn Community School: UChicago Medicine has teamed up with these two partners to teach families how to make healthy lifestyle choices using its Power Up Program. During fiscal 2013, the White Sox visited the Woodlawn school’s pep rally about healthy nutrition and held a baseball clinic for 90 students. The team also hosted fielding and pitching practice for three hours one morning.

At U.S. Cellular Field on “Family Sundays,” families are encouraged to bring their children for an afternoon of fun activities, such as dancing, jumping rope, hopscotch and even hula-hooping. Children can also participate in an online Kids Club, and if they complete it, they are entered into a lottery to throw the first pitch at a Sox game.

Namaste Charter School: Founded in 2004, this Southwest Side public charter school is focused on health and wellness, as well as exceptional academics.

UChicago Medicine helps to support the school’s programs, which incorporate good nutrition and daily exercise and include yoga classes and conflict resolution—even at the elementary school level.

Eduardo Martinez, 6, eats lunch at the Namaste Charter School.

The school on Chicago’s Southwest Side gets support from the University of Chicago Medicine.

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HEALTH PRIORITY: CHILDHOOD OBESITY AND ASTHMA Namaste provides students, at no cost to their parents, healthy breakfasts and lunches that exceed the USDA gold standard.

The Comer Children’s Hospital Pediatric Mobile Unit made 123 visits to 28 schools and 9 health fairs during the 2013 fiscal year. During that time, it provided medical service encounters to nearly 1,000 children.

Chicago Run and Curtis Elementary: More than 3,500 Chicago Public School students, their families and staff took part in a one-mile fun run in Washington Park in June 2013. The celebration of health and fitness included children from Curtis Elementary School, which participated in the Chicago Run program after UChicago Medicine donated money to sponsor the school. Curtis is located in the Roseland/West Pullman neighborhood, an area that’s included in the focus of the hospital’s Urban Health Initiative.

Direct sponsorship by UChicago Medicine allowed Curtis to participate in Chicago Run, which incorporates running into elementary students’ school days. The children run, jog or engage in other physical activities for at least 15 minutes, three to five days a week. Then the young runners track their mileage and use the cumulative data to map how far they’ve traveled.

CHILDHOOD ASTHMA Nearly 17 percent of children living in neighborhoods near UChicago Medicine have asthma. This condition is among the leading causes of school absenteeism and hospitalization. In response, the Comer Children’s Hospital has made a commitment to boosting resources dedicated to improving asthma outcomes for South Side youth through individualized clinical care, research, education and community outreach.

The heart of Comer’s efforts is its Asthma Care Coordination Program, which is designed specifically for children who’ve recently been to the hospital’s emergency department, been hospitalized for asthma or generally had difficulty controlling the disease. A team helps educate children and their families about the condition, along with medications and strategies that can be used to reduce exposure to allergens or other triggers. The hospital also works to coordinate with primary care providers, school nurses and others who may be involved in a child’s asthma care.

White Sox director of conditioning Allen Thomas shows Langford Community Academy students his favorite moves during the second-year kickoff of the team’s partnership with Comer Children’s Hospital to fight childhood obesity.

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5841 S. Maryland Ave. Chicago, IL 60637

IN FISCAL 2013

MEDICAID ACUTE CARE DAYS FOR PRIVATE HOSPITALS IN METRO CHICAGO* Medicaid

26,089 ADMISSIONS

Days

Percent of Total Days

1. The University of Chicago Medicine

44,613

29% 26%

75,887

261

2. Rush University Medical Center

37,831

ER VISITS

PEDIATRIC TRAUMA ADMISSIONS

3. Advocate Christ Medical Center

34,389

19%

4. Lurie Children’s Hospital

34,316

52%

5. Northwestern Memorial Hospital

33,064

14%

6. Loyola University Medical Center

22,218

18%

10,176

7. Advocate Lutheran General Hospital

22,009

18%

EMPLOYEES

8. Mount Sinai Hospital

21,726

39%

9. Sts. Mary and Elizabeth Medical Center

18,593

36%

10. Advocate Illinois Masonic Medical Center

16,064

29%

939

914

RESIDENTS & FELLOWS

ATTENDING PHYSICIANS

*Acute care days provided to patients where Illinois Medicaid is the primary insurer, excluding normal nursery, psychiatry and rehabilitation days Source: Illinois Department of Healthcare & Family Services, Medicaid cost reports filed for the state fiscal year ending June 30, 2013

1,800 NURSES

790

582

NICU ADMISSIONS

AVERAGE BEDS IN SERVICE

22,975

120

302

INPATIENT AND OUTPATIENT SURGERIES

SOLID ORGAN TRANSPLANTS

BURN ADMISSIONS

On the cover: Children line up after recess at the Namaste Charter School. The school, on Chicago’s Southwest Side, gets support from UChicago Medicine.