EASTERN LONG ISLAND HOSPITAL

Community Service Plan – 2012 Update

ELIH Mission/Vision Statement

Mission: Eastern Long Island Hospital provides essential healthcare services to the communities of the North Fork and Shelter Island and critical access to specialized services.

 Vision: To be a regional leader in healthcare, committed to an East End healthcare system that ensures excellence, compassion, education, and the improved health of the community.

Community Partners:

• Emergency Medical Squads
• Greenport and Southold Rotary Clubs
• Long Island Blood Services
• Malecare
• Mattituck Chamber of Commerce
• Mattituck Community Fund
• Mattituck High School Business Advisory
• Mattituck Lyons Club
• Nassau Suffolk Hospital Council
• New York Organ Donor Network
• North Fork Breast Coalition
• North Fork Chamber of Commerce
• North Fork Promotion Council
• Peconic Landing
• Southold High School Business Advisory
• Southold Mother’s Club
• Southold Town Senior Services
• Suffolk County Department of Health
• Suffolk County Office for the Aging
• Sunshine Society of Southold
• United Way of Long Island

Working with Partners: 

Eastern Long Island Hospital has a comprehensive community outreach program that is complimented by the efforts of the East End Health Alliance and several community partners. The goals of the community service plan are assessed on an annual basis by the Board of Trustees, Medical Staff, Hospital Management, Clinical Staff, Auxiliary and Volunteers in conjunction with leaders of local not-for-profit organizations and governmental agencies. 

In concert with the Suffolk County Department of Health and the East End Health Alliance, Eastern Long Island Hospital holds and participates in community Fall Prevention programs and Smoking Cessation classes.  In addition, several support groups and task forces have been formed to address independent living and chronic health issues, including cancer prevention and awareness, suicide prevention, heart disease, diabetes, nutrition and safe medication practices. 

GOALS and Achievements - Update on priorities in collaboration with Suffolk County Department of Health—

 

Tobacco Use

Need:  As noted by the Suffolk County Department of Health, tobacco use remains the leading preventable cause of death in the United States resulting in a cost of more than $89 billion in medical costs annually.  Eastern Long Island Hospital recognizes the need to take a proactive stance on the issue of tobacco use in the community and educate patients on reducing the risk of tobacco related illnesses and premature death.  

Program Description: ELIH is commited to providing a healthy environment for its patients, visitors and employees and adopted a smoke-free campus policy that began on July 6, 2011. Nursing assessments and admission protocols are in place to counsel each patient regarding tobacco use and health history.  ELIH utilizes “ExitCare” an electronic software system to assist clinical staff with medical record documentation. Peer-reviewed patient discharge instructions and prescription writing solutions are inherent in the program to assist with treatment plans and follow-up.  Patient information is provided to help smokers quit.

In addition to offering patient education for patients, ELIH provides nicotine replacement medications, nicotine addiction counseling and tobacco relapse interventions to employees.  ELIH continues to partner with Suffolk County to provide Smoking Cessation programs at ELIH and promote programs at other facilities.

Secondhand smoke booklets provided by the Kiwanis Clubs of Eastern Suffolk County and the Suffolk County Department of Health are distributed to parents whose children present with respiratory illness in the Emergency Department. 

Partners

Kiwanis Clubs of Eastern Suffolk County

Suffolk County Department of Health

Suffolk County Office of Health Education  

Goal:  ELIH is committed to meeting short term goals-- i.e. 100% compliance in completing clinical history profiles regarding smoking habits on every patient and continues working toward long term goals-- i.e. the improved health of Suffolk County residents; reducing the prevalence of tobacco use in Suffolk County; creating a culture of safety and reducing health risk and cost by eliminating exposure to environmental tobacco smoke and maintaining a smoke-free campus.

 

 

Measures used to track progress:  

Reduce Tobacco Use:  A patient education module “Exit Care” is used hospital wide to track tobacco use upon admission and provide follow-up and referrals upon discharge.  This electronic documentation system provides peer-reviewed, evidence-based discharge instructions and patient education information.

 

Unintentional injuries

Need:  Falling is the leading cause of unintentional injury at home among Americans 65 and older. Older people sustain such injuries by stumbling on stairs; slipping in bathtubs; falling off ladders and step stools; and tripping over garden hoses, dog leashes, and household appliance cords.

Program Description:  The ELIH Senior Options & Solutions program focuses on assessing the needs of residents 65+ in the community and linking them with services.  While tracking out of hospital falls remains a challenge, falls leading to hospital admissions are tracked and in home assessments are made with suggestions for improvement.

Patient education materials are distributed on assessment and discharge and include a Staying Independent for Life brochure – prepared by a hospital county coalition. An 8-wk education series in cooperation with a senior care community and local libraries entitled, “Independent for LIFE” contained a fall prevention component.  ELIH continues to partner with Suffolk County Department of Health in establishing a comprehensive falls prevention strategy.   A coordinated presentation of the Suffolk County program--Stepping On Program took place at the Southold Human Resource Center in Mattituck on three consecutive Tuesdays.  For each session, ELIH provided a physical therapist to present balance and muscle strengthening exercises in accordance with the program manual.    

ELIH provides professional staff to participate in fall prevention programs targeted at seniors, including a physical therapist to conduct annual balance screenings.  The Director of Senior Options and Solutions is part of an advisory team that will work over the next five years to implement three evidence-based fall prevention programs: Tai Chi: Moving for Better Balance, Stepping On, and Otago Exercise Program. A major goal is to integrate community-based programming with clinical care settings. The CDC is developing a toolkit called STEADI, which will help in making these connections. 

Partners:

AARP

Dominican Sisters Family Health Service

John T. Mather Memorial Hospital

North Shore-LIJ Health System

Peconic Landing

St. Catherine’s Hospital

St. Charles Rehabilitation Hospital

St. John’s University

St. Joseph’s College

Suffolk County Department of Health

Suffolk County Office for the Aging

Southold Human Resource Center

 

Goal:   Keeping seniors safe and limiting the incidence of falls and injury.  

Measures used to track progress:  

Fall Prevention:  Fall prevention calls are tracked through the Senior Options and Solutions (SOS) program with in home assessments provided.  Of note, ELIH appointed a staff person from SOS to the Suffolk County Fall Prevention for Older Adults Advisory Team.  

ADDITIONAL Prevention Priorities

Access to Quality Health Care

Need: Residents need a continuum of care in their community to maintain optimum health and wellness. In addition to maintaining these services for all residents, ELIH has a significant number of senior residents who tend to access care more than other segments of the population.  There are also residents who are underinsured, have no insurance or have a low income. This underserved population needs help in applying for financial aid, accessing care and taking a proactive approach to health and wellness.  

Program Description:

ELIH recognizes the need for quality care and local access to medical and emergency services for all residents. Mandated by the Burger Commission to maintain these services locally, ELIH provides essential healthcare services and critical access to specialized services.  ELIH has been recognized by HealthgradesTM for the Outstanding Patient Experience Award, three years consecutively, 2010, 2011 and 2012.

ELIH is the primary hospital for the North Fork and Shelter Island residents.  A referral system is in place for inpatient and outpatient medical care that includes emergency treatment, diagnostic testing, ambulatory surgery and behavioral health services. 

ELIH also works closely with Hudson River Healthcare in Greenport to ensure local access to hospital services for all populations regardless of their ability to pay.  The chief physician in this primary care practice is bilingual and is a member of the medical staff at ELIH. 

 

Partners:

San Simeon Nursing Facility

Peconic Landing

Stony Brook University Medical Center

CAST (Community Action Southold Town)

Dominican Sisters Family Health Service

East End Churches

Hudson River Healthcare

Goal:   Ensure access to quality care for all residents and educate individuals on issues that may be of concern to the community including those who need translation services.

Community Preparedness

Need:   ELIH recognizes the role it plays in the community to keep patients safe in the event of a community-wide disaster due to extreme weather conditions, environmental hazards or terrorist activity.

Program Description:  ELIH is a member of an Emergency Preparedness Task Force for Southold Town and actively participates in evacuation plans for the area and the designation of community shelters.  ELIH has a comprehensive emergency management plan (CEMP) in place to create the safest and most efficient operations for patients, visitors and staff.  ELIH participates in several drills each year county wide.  These drills have included a simulated Marine Disaster Drill in cooperation with Cornell Cooperative Extension and Plum Island Animal Disease Center, among others.

Partners:

Cornell Cooperative Extension

Local EMS Squads

Plum Island Animal Disease Center

Southold Town

Suffolk County Office of Emergency Management

Goal:  Fulfill the roles of the emergency incident command system by providing continuous training for ELIH personnel.  Maintain open dialogue with community partners to ensure the best used of pooled resources and keep the public informed. 

Healthy and Safe Environment

Need:  Patient education and screenings to ensure wellness for all residents and promote healthy living is needed in order to maintain a healthy and safe environment for all. 

Program Description:  ELIH offers several community outreach programs throughout the year, including: 

• Sharps collection and disposal program
• Safe medication disposal program
• Senior Wellness Education Series
• Senior Health Fair
• Community Blood Drives – 3 times a year with an average of 50 pints of blood collected at each drive. 
•  Skin Cancer screening – Screens an average of 60 local residents annually. 
• Community Blood Pressure screening and education.
• Flu Shot and Pneumonia vaccine clinic
• Prostate Cancer Support Group
• Caregiver’s Support Group
• North Fork Cancer Support Group
• Advanced Care Planning   
• Vial of Life - provides lifesaving information and helps the local emergency response teams treat patients without delay. Over 3,000 Vial of Life kits are distributed each year to discharged patients and community groups.  Information can be easily updated by downloading a Vial of Life information form from the hospital’s website at www.elih.org
• GI Health - Acid reflux seminar held at a local venue provided timely information on the causes of acid reflux and the importance of timely screenings and interventions.  Panelists included a gastroenterologist and a nutritionist.
• Patient Education - ELIH continues to update its website with timely health advice and contributes to health columns in the local press and distributes a health publication three times a year to over 18,000 residents. 

 

Partners:

Emergency Medical Squads

Greenport and Southold Rotary Clubs

Long Island Blood Services

Malecare

Mattituck Chamber of Commerce

Mattituck Community Fund

Mattituck Lyons Club

Nassau Suffolk Hospital Council

New York Organ Donor Network

North Fork Breast Coalition

North Fork Chamber of Commerce

North Fork Promotion Council

Peconic Landing

Southold Town Senior Services

Sunshine Society of Southold

Goal:   Ensure access to quality care for all residents and educate individuals on health issues that may be of concern to all segments of the community.

Healthy Mothers, Healthy Babies, Healthy Children

Pre-Natal Care

Need:   Expectant women with no insurance and low income tend to delay medical care during pregnancy. Those who receive prenatal care during pregnancy have healthier babies, are less likely to deliver prematurely, and are less likely to develop complications related to pregnancy.  This underserved population needs help in applying for financial aid and accessing care.   

Program Description:  ELIH provides medical office space for the Center for Prenatal Care affiliated with Southampton Hospital at the Medical Village located in Greenport.  The services provided include pregnancy care, gyn care, pap smears, nutrition counseling, family planning and HIV counseling for women in need of social service assistance.  The Center has successfully worked with the local town government to obtain the agreement of local grocers to accept WIC vouchers.  Translation services are offered to the significant number of Hispanic women seeking care at the Center.

Partners:

Community Action Southold Town (CAST)

Local Churches

Perinatal Coalition

Southampton Hospital

Goal:  The Prenatal Program’s goals are to ensure pregnant women have early access to prenatal care, decrease pregnancy related diseases, and reduce the number of infant deaths and the number of infants born prematurely.  

Parenting Education:

Need:   Parenting is a learning experience in which parents use multiple sources to develop their skills, from trial and error to discussion with other parents to external sources such as research and parenting classes. Eastern Long Island Hospital recognizes the need to take an active role in keeping children well by educating the primary caregivers in the community.     

Program Description:  ELIH continues to support families and their children by providing pediatric advice to parents, grandparents and child care providers.  Free seminars addressing nutrition and wellness for children as well as emergency pediatric concerns are held in the community.  Handmade calico bears teddy bears are given to comfort young patients in the Emergency Room.  Minor consent form brochures are provided in advance of care to ensure timely medical treatment for children when a parent cannot be reached for consent.  “W.H.A.L.E” (We Have A Little Emergency) is a child car seat identification program in place to help EMS teams identify car seat passengers and expedite rescue efforts.  ID kits and minor consent forms may be requested through the Community Relations office.

Partners:

Cutchogue Homemakers

Southold Mother’s Club

ELIH Auxiliary

Local Emergency Medical Squads

Goal:   Ensure health, wellness and safety for all children in the community, parental guidance and timely access to care.

 

 

 

Vaccine Preventable Diseases

Need:  Influenza (flu) is a respiratory disease that can lead to serious complications. Vaccination is the single best way to protect against flu.  Flu viruses are constantly changing and need to be updated from one season to another for protection against new viruses. 

Program Description:  Eastern Long Island Hospital holds an annual flu shot and pneumonia vaccine clinic for local residents for a nominal fee and accepts Medicare for senior immunizations. ELIH employees and volunteers are encouraged to get vaccinated through employee health free of charge. ELIH promotes the importance of an influenza vaccine to the community and provides a flu referral hotline for those who need updated vaccine information. 

Partners:

Peconic Landing

Senior Options & Solutions

Southold Town Human Resources

Goal:  Ensure good health for the community and stop the spread of infection to reduce illness, hospitalization and even death. 

 

Mental Health and Substance Abuse

Need:  ELIH recognizes the need to reach out to individuals in the community who may need additional counseling services in order to refrain from behaviors that may be caused by neglect or  harm to themselves or others.

Program Description: 

Seniors and Solutions Program:  Due to a rising senior population, outreach efforts through the Geriatric Center of Excellence have provided much needed services for adults 65+ which have included extensive health education programs for seniors and their adult children.  Monthly wellness classes are held at the Southold Town Senior Services Center.  A caregiver support group has been formed to discuss topics associated with the challenges of caring for aging adults.  In addition, several support groups and task forces have been formed to address independent living and chronic health issues, including cancer prevention and awareness, suicide prevention, heart disease, diabetes, nutrition and safe medication practices. 

Screenings:  Mental health screenings are an integral component of the Senior Options and Solutions program at ELIH.  During the period of 1/1/2009-6/30/2012, 2539 mental health screens were completed, 262 assessments and 694 follow up visits performed. 

Suicide Prevention:

• Organized East End Coalition for Suicide Awareness
• Promote 24-hr County Hotline
• Distributing  educational materials by mail
• Person to person awareness call via rescue teams, community clubs and organizations, churches, etc.

Support Groups:  Alcoholics Anonymous meetings are held five days a week in the ELIH community room.  Narcotics Anonymous meeting are held two days a week in the ELIH community room.  A list of supports groups can be accessed at www.ELIH.org or by calling the Community Relations Office. 

Substance Abuse Education:  Appointed LCSW staff representative to serve on the Suffolk County Heroin Opiate Advisory Panel.

STIs and HIV Prevention Education:  ELIH provides counseling services and education for patients who are in the early stages of controlled substance withdrawal or who are in the early stage of abstinence in the recovery process as these patients are considered to be at higher risk for infection and may not use necessary precautions to prevent STIs or HIV. 

Partners:

CAST (Community Action Southold Town)

Local EMS Squads

Senior Options & Solutions

Southold Town Human Resources

Goal:  Ensure wellness for the health and safety of the community and prevent illness, hospitalization and even death. 

Summary of the implementation status of 3-year plan

Changes Impacting Community Health, Provision of Charity Care, and Access to Services

• Rising unemployment also increased number of uninsured
• Continued reductions of State and Federal reimbursement rates
• Increase in costs of providing care (experiencing double digit expense increases)
• Expect more applicants due to current economic climate

Challenges to Financial Aid Program

• Non-compliance in completing the application
• Lack of documentation
• Failure to fulfill agreement of reduced fee once financial aid has been granted

Successes

• Implementation of Onsite Enrollment Coordinators
• Medicaid, Family Health Plus & Child Health Plus insurance counseling

Summary of Applications Processed with Hospital Bills

Of the applications processed with bills:

• 75% were approved for Medicaid
• 25% were denied for excess income between 150% - 300% of the federal poverty level (FPL)

Summary of Site Analysis

From January 1 thru December 31, 2011, a total of 35 people attended an enrollment session. 74% of those who attended started an application for either the Medicaid, FHP, or CHP program (or a combination of the programs).  Of the applications started, 15% had at least one unpaid bill that was either incurred within the month of application or three months before the month of application.  26% of those who attended received information regarding the application process (i.e., how the process worked, documents needed to apply, immigration requirements, etc.), but they did not start an application due to not having enough of the required documentation needed to apply.  11% of those receiving only information on the application process had a pending hospital bill.