Woodland Memorial HospitalCommunity Benefit 2020 Report and 2021 PlanAdopted October 2020

A message fromEdmundo Castañeda, President and CEO of Woodland Memorial Hospital and Roger Clarkson,Chair of the Dignity Health Woodland Healthcare Community Board.Dignity Health’s approach to community health improvement aims to address significant healthneeds identified in the Community Health Needs Assessments that we conduct with communityinput, including from the local public health department. Our initiatives to deliver community benefitinclude financial assistance for those unable to afford medically necessary care, a range of preventionand health improvement programs conducted by the hospital and with community partners, andinvesting in efforts that address social determinants of health.Woodland Memorial Hospital (Woodland Memorial) shares a commitment with others to improvethe health of our community, and delivers programs and services to help achieve that goal. TheCommunity Benefit 2020 Report and 2021 Plan describes much of this work. This report meetsrequirements in California state law (Senate Bill 697) that not-for-profit hospitals produce an annualcommunity benefit report and plan. Dignity Health hospitals in Arizona and Nevada voluntaryproduce these reports and plans, as well. We are proud of the outstanding programs, services andother community benefits our hospital delivers, and are pleased to report to our community.In fiscal year 2020 (FY20), Woodland Memorial provided 24,866,821 in patient financialassistance, unreimbursed costs of Medicaid, community health improvement services and othercommunity benefits. The hospital also incurred 25,730,670 in unreimbursed costs of caring forpatients covered by Medicare.The hospital’s Community Board reviewed, approved and adopted the Community Benefit 2020Report and 2021 Plan at its October 27, 2020 meeting.Thank you for taking the time to review our report and plan. We welcome any questions or ideas forcollaborating that you may have, by reaching to out to us at (916) 851-2005.Sincerely,Edmundo CastañedaPresident/CEOCommunity Benefit FY 2020 Report and FY 2021 PlanRoger ClarksonChairperson, Community BoardWoodland Memorial Hospital 2

Table of ContentsAt-a-Glance Summary4Our Hospital and the Community Served6About Woodland Memorial HospitalOur MissionFinancial Assistance for Medically Necessary CareDescription of the Community ServedCommunity Need Index66678Community Assessment and Significant Needs8Community Health Needs AssessmentSignificant Health Needs992020 Report and 2021 Plan10Creating the Community Benefit PlanImpact of the Coronavirus PandemicReport and Plan by Health NeedCommunity Grants ProgramProgram DigestsOther Programs and Non-Quantifiable Benefits101113192028Economic Value of Community Benefit30Hospital Board and Committee Rosters31Financial Assistance Policy Summary32Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 3

At-a-Glance SummaryCommunityServedWoodland Memorial is situated in Yolo County, located at 1325 Cottonwood Streetin Woodland, CA. The general acute care hospital is a part of Dignity Health andhas 720 employees, 108 licensed acute care beds, 17 emergency department bedsand 31 inpatient mental health beds. The hospital provides compassionate, highquality health care and services to the residents of Woodland, Davis and thesurrounding communities. Less than a quarter of the region’s population resides inunincorporated communities.EconomicValue ofCommunityBenefit 24,866,821 in patient financial assistance, unreimbursed costs of Medicaid,community health improvement services, community grants and other communitybenefits 25,730,670 in unreimbursed costs of caring for patients covered by MedicareSignificantCommunityHealth NeedsBeingAddressedThe significant community health needs the hospital is helping to address and thatform the basis of this document were identified in the hospital’s most recentCommunity Health Needs Assessment (CHNA). Needs being addressed bystrategies and programs are:1. Access to Mental, Behavioral,and Substance Abuse Services2. Injury and Disease Preventionand Management3. Access to Basic Needs, Such asHousing, Jobs, and Food4. Active Living and HealthyEatingFY20Programs andServices5. Access to Quality Primary CareHealth Services6. Access to Specialty and ExtendedCare7. Safe and Violence-FreeEnvironmentThe hospital delivered several programs and services to help address identifiedsignificant community health needs. These included: Enhanced Mental Health Crisis & Follow-Up: This strategic partnershipaddresses the limited access to behavioral health services by improvingcommunication and collaboration abilities of the nonprofit agencies involvedthrough direct referrals to lower levels of care which increases the number ofindividuals served and decrease delays in service.Congestive Heart Active Management Program (CHAMP ): Establishes arelationship with patients who have heart disease after discharge from thehospital through regular phone interaction to support and education to helpmanage this disease and monitoring of symptoms or complications.Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 4

FY21 PlannedPrograms andServicesResource Connection & Patient Navigator Program: Serves as an access pointfor vulnerable individuals and families to be connected to primarycare/community health and social services, receive case management, education,and enrollment supportHaven House Interim Care Program: Medical respite transitional program thatutilizes a four bed house and offers respite for homeless individuals upondischarge from the hospitalOncology Nurse Navigator: Offers one-to-one support and guidance to patientsdiagnosed with cancer from the day of diagnosis onwards includingpatient’s immediate concerns and barriers to care such as difficulties withinsurance, financial burden, lack of transportation and addressing the knowledgedeficit of around their diagnosis and treatment options.Yolo Adult Day Health Center: Addresses specialty health care and supportneeds of the elderly and disabled populations by offering a high touchinterdisciplinary program of medical, psycho-social and rehabilitation servicesfor adults at high risk of needing a higher level of care due to health, functionaland cognitive losses.Community Based Violence Prevention Program: Focuses on educating staff toidentify and respond to victims within the hospital; provide victim-centered,trauma-informed care; and collaborate with community agencies to improvequality of care.For FY21, the hospital plans to build upon many of the FY20 initiatives and explorenew partnership opportunities with Yolo County, health plans and communityorganizations. Efforts to enhance patient navigation services in partnership withEmpower Yolo will continue while adding additional organizations including healthplans, community clinics, and other community resources. Hospital ED staff willwork in collaboration with Empower Yolo to identify individuals that needassistance with establishing a medical home and understanding their health coverageand benefits.In FY20, Woodland Memorial will played an active role in developing innovativestrategies to address the growing number of individuals experiencing homelessnesswhich will continue into FY21, including: a medical respite program in partnershipwith Yolo Community Care Continuum and Sutter Health called Haven House; anda Street Medicine Program in partnership with Yolo County HHSA and SutterHealth. The hospital will continue to focus on access to behavioral health servicesthrough the Mental Health Continuum of Care Partnership and in partnership withYolo County and other community partners.This document is publicly available online at nt.Written comments on this report can be submitted to the Woodland Memorial Community Health andOutreach Department at 3400 Data Drive, Rancho Cordova, CA 95670 or by e-mail toDignityHealthGSSA [email protected] Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 5

Our Hospital and the Community ServedAbout Woodland MemorialWoodland Memorial is a member of Dignity Community Care, which is a part of CommonSpirit Health.Woodland Memorial is situated in Yolo County, located at 1325 Cottonwood Street in Woodland, CA.The general acute care hospital is a part of Dignity Health and has 720 employees, 108 licensed acute carebeds, 17 emergency department beds and 31 inpatient mental health beds. A wide range of the hospital’smedical services have received numerous local and national recognitions and accreditations. WoodlandMemorial holds Quality Oncology Practice Initiative certification, is recognized as a Certified PrimaryStroke Center by the Joint Commission, as well as The Joint Commission’s Gold Seal of Approval forChest Pain Certification, and received a Get with the Guidelines Stroke Gold Plus Quality Achievementaward by the American Heart Association/American Stroke Association. The hospital was alsorecognized as a “Baby Friendly Hospital” by the World Health Organization and the United NationsChildren’s Fund.Our MissionAs CommonSpirit Health, we make the healing presence of God known in our world by improving thehealth of the people we serve, especially those who are vulnerable, while we advance social justice for all.Our VisionA healthier future for all – inspired by faith, driven by innovation, and powered by our humanity.Financial Assistance for Medically Necessary CareWoodland Memorial delivers compassionate, high quality, affordable health care and advocates formembers of our community who are poor and disenfranchised. In furtherance of this mission, the hospitalprovides financial assistance to eligible patients who do not have the capacity to pay for medicallynecessary health care services, and who otherwise may not be able to receive these services.A plain language summary of the policy is at the end of this report. The financial assistance policy andplain language summary are on the hospital’s web site.Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 6

Description of the Community ServedWoodland Memorial serves the residents of Woodland,Davis, West Sacramento and the surrounding communities.The community or hospital service area (HSA) is defined asthe geographic area (by ZIP code) in which the hospitalreceives 80% of discharges. The hospital’s primary servicearea is comprised of 21 zip codes (95605, 95606, 95607,95616, 95618, 95620, 95627, 95637, 95645, 95653, 95679,95691, 95694, 95695, 95697, 95698, 95776, 95912, 95932,95937 and 95987). A summary description of thecommunity is below. Additional details can be found in theCHNA report online.The City of Woodland has a strong historic heritage andserves as the primary support community for agriculturalservices. Davis is a unique university communityinternationally known for its commitment to environmentalawareness and progressive and socially innovativeprograms. Winters is a small city located on Putah Creek in the western Yolo County, and is home toa thriving agricultural industry. West Sacramento sits on the Sacramento River, on the east side ofYolo County, and is home to the Port of Sacramento, which ships over a million tons of agriculturalproducts to worldwide markets. Less than a quarter of the region’s population resides inunincorporated communities, including Esparto, the gateway to Capay Valley, Madison, Yolo,Dunnigan, Clarksburg, Guida, Knights Landing, Monument Hills, Capay, Plainfield, Brooks, Rumsey,El Macero and Zamora. Arbuckle and portions of Dixon are designated as Health ProfessionalShortage Areas by the U.S. government’s Health Resources and Services Administration. WoodlandMemorial’s service area also includes the University of California, Davis one of the world's leadingcross-disciplinary research and teaching institutions located near Davis, California and the YochaDehe Wintun Nation, an independent, sovereign, self-governed nation that supports its people, theCapay Valley community and the region by strengthening culture, stewarding the land and creatingeconomic independence for future generations.Demographics within Woodland Memorial’s hospital service area are as follows, derived from 2020estimates provided by Strategy’s SG2 Analytics Platform (Source: Claritas Pop-Facts 2020): Total Population: 284,159Race/Ethnicity: Hispanic or Latino: 35.5%; White: 44.9%, Black/African American: 2.3%Asian/Pacific Islander: 12.6%, All Other: 4.7%.% Below Poverty: 8.7%Unemployment: 6.8%No High School Diploma: 15.9%Medicaid (household): 8.2%Uninsured (household): 5.1%Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 7

Community Need IndexOne tool used to assess health need is the Community Need Index (CNI) created and made publiclyavailable by Dignity Health and IBM Watson Health. The CNI analyzes data at the zip code level on fivefactors known to contribute or be barriers to health care access: income, culture/language, education,housing status, and insurance coverage.Scores from 1.0 (lowest barriers) to 5.0 (highest barriers) for each factor are averaged to calculate a CNIscore for each zip code in the community. Research has shown that communities with the highest CNIscores experience twice the rate of hospital admissions for ambulatory care sensitive conditions as thosewith the lowest scores.Community Assessment and Significant NeedsThe hospital engages in multiple activities to conduct its community health improvement planningprocess. These include, but are not limited, to conducting a Community Health Needs Assessment withcommunity input at least every three years, identifying collaborating community stakeholderorganizations, describing anticipated impacts of program activities and measuring program indicators.Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 8

Community Health Needs AssessmentThe health issues that form the basis of the hospital’s community benefit plan and programs wereidentified in the most recent CHNA report, which was adopted in June 2019.The CHNA contains several key elements, including: Description of the assessed community served by the hospital; Description of assessment processes and methods; Presentation of data, information and findings, including significant community health needs; Community resources potentially available to help address identified needs; and Discussion of impacts of actions taken by the hospital since the preceding CHNA.Additional detail about the needs assessment process and findings can be found in the CHNA report,which is publicly available at nt or upon request at the hospital’s Community Health office.Significant Health NeedsThe most recent community health needs assessment identified the following significant communityhealth needs:1. Access to Mental, Behavioral, and Substance Abuse Services: Includes access to preventionand treatment services.2. Injury and Disease Prevention and Management: Contains health outcomes that requiredisease prevention and/or management and treatment including: cancer, cardiovasculardisease/stroke, HIV/AIDS/STDs and asthma.3. Access to Basic Needs, Such as Housing, Jobs, and Food: Includes economic security, foodsecurity/insecurity, housing, education and homelessness.4. Active Living and Healthy Eating: Encompasses all components of active living and healthyeating including health behaviors, associated health outcomes and aspects of physicalenvironment/living conditions.5. Access to Quality Primary Care Health Services: Encompasses access to primary careresources which include community clinics, pediatricians, family practice physicians, internists,nurse practitioners, pharmacists, telephone advice nurses, and similar.6. Access and Functional Needs – Transportation and Physical Disability: Includes the need fortransportation options, transportation to health services and options for person with disabilities.7. Access to Specialty and Extended Care: Encompasses access to specialty care and extendedservices including skilled nursing facilities, hospice care, in-home healthcare, etc.8. Safe and Violence-Free Environment: Consists of safety from violence and crime includingviolent crime, property crimes and domestic violence.9. Pollution-Free Living Environment: Contains measures of pollution such as air and waterpollution levels.10. Access to Dental Care and Prevention: Encompasses lack of providers and access, especially inrural areas.Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 9

Significant Needs the Hospital Does Not Intend to AddressWoodland Memorial does not have the capacity or resources to address all priority health issues identifiedin Yolo County, although the hospital continues to seek opportunities that respond to the needs that havenot been selected as priorities. The hospital is not addressing access and functional needs, pollution-freeliving environment and access to dental care and prevention, as these priorities are beyond the capacityand expertise of Woodland Memorial.2020 Report and 2021 PlanThis section presents strategies and program activities the hospital is delivering, funding or on which it iscollaborating with others to address significant community health needs. It summarizes actions taken inFY20 and planned activities for FY21, with statements on anticipated impacts, planned collaboration, andpatient financial assistance for medically necessary care. Program Digests provide detail on selectprograms’ goals, measurable objectives, expenses and other information.This report specifies planned activities consistent with the hospital’s mission and capabilities. Thehospital may amend the plan as circumstances warrant. For instance, changes in significant communityhealth needs or in community assetsand resources directed to those needsmay merit refocusing the hospital’slimited resources to best serve thecommunity.The anticipated impacts of thehospital’s activities on significanthealth needs are summarized below,and for select program initiatives arestated in Program Digests. Overall,the hospital anticipates that actionstaken to address significant healthneeds will: improve healthknowledge, behaviors, and status;increase access to needed andbeneficial care; and help createconditions that support good health.The hospital works to evaluateimpact and sets priorities for its community health programs in triennial Community Health NeedsAssessments.Creating the Community Benefit PlanWoodland Memorial is dedicated to improving community health and delivering community benefit withthe engagement of its management team, board, clinicians and staff, and in collaboration with communitypartners. The Community Board and Community Health Advisory Committee are composed ofcommunity members who provide stewardship and direction for the hospital as a community resource.Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 10

These parties review community benefit plans and program updates prepared by the hospital’s communityhealth director and other staff.As a matter of Dignity Health policy, the hospital’s community health and community benefit programsare guided by five core principles. All of our initiatives relate to one or more of these principles: Focus on Disproportionate Unmet Health-Related Needs Emphasize Prevention Contribute to a Seamless Continuum of Care Build Community Capacity Demonstrate CollaborationA general approach is taken when planning and developing initiatives to address priority health issues. Atthe onset, Community Health and Outreach staff engages a core internal team that may include clinicalstaff, care coordinators and social workers, members of the Woodland Memorial leadership team, andDignity Health leaders at the regional and local levels from Mission Integration, IT, Legal,Administration, and Finance. These core teams help shape initiatives, provide internal perspective onissues (i.e. utilization trends relative to the issue, gaps experienced in available follow-up or wraparoundcare for patients, etc.) and help define appropriate processes, procedures and methodologies for measuringoutcomes.The planning and development of each initiative also involves research on best practices to identifyexisting evidence-based programs and interventions, and relationship strengthening with communitybased providers that serve target populations for intended initiatives. Once identified, community-basedpartners become part of the hospital’s core project team. Core project teams for all initiatives meetquarterly, or as needed, to evaluate program progress and outcomes, and to make program changes and/orimprovements. When target populations and priority health issues are shared by other Dignity Healthhospitals in the Greater Sacramento region, initiatives are often regionalized in order to leverageresources, extend reach and achieve greater impact.Impact of the Coronavirus PandemicThe COVID-19 pandemic has globally resulted in millions of confirmed cases and deaths numberinghundreds of thousands. It has also sparked fears of an impending economic crisis and recession. Socialdistancing, self-isolation and travel restrictions have led to a reduced workforce across all economicsectors and caused many jobs to be lost. Schools have closed down, and the need for commodities andmanufactured products has decreased. The food sector is also facing increased demand due to panicbuying and stockpiling of food products.Moreover, the COVID-19 pandemic has caused an unprecedented challenge for our Greater SacramentoDivision Hospitals and health care systems worldwide. In particular, the risk to health care; consideringmost health care workers are unable to work remotely, strategies had to be developed around earlydeployment of viral testing for asymptomatic and/or frontline health care staff. High health care costs,shortages of protective equipment, and low numbers of ICU beds and ventilators have been majorchallenges for our hospitals in the delivery of patient care. In communities across our Division there isconcern regarding uninsured individuals, who may work in jobs predisposing them to viral infectionwhich may lead to significant financial consequences in the event of illness.Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 11

In response to this pandemic, our Division hospitals have had to implement immediate relief measuresand engage in short, medium and longer term planning to re-balance and re-energize our communities inthe midst of this crisis. Many of our hospitals have been engaging in collaborative efforts focusing ondevelopment of a broad clinical and socioeconomic plans with multi-disciplinary partners from healthcare, business, social services, government, community based organizations and wider society.In FY20, Woodland Memorial took the following actions to respond to the needs created or exacerbatedby COVID-19: The Community Health team partnered with our FY20 grant partners on adapting programs,where needed, to respond to COVID-19 or divert grant funding to support urgent needs arisingdue to the pandemic. Partnered with Yolo County on Project Room Key referring in homeless patients to thedesignated quarantine motels for shelter and follow-up care. Partnered with Woodland Clinic Medical Group, Yolo County and Sutter Hospital to launch aStreet Medicine Program in partnership with CommuniCare, to specifically respond to COVID19 and provide medical care to homeless patients quarantining in the Project RoomKey motels. County-wide Skilled Nursing Facilities COVID-19 prevention support: Staff at WoodlandMemorial, led by the CNO/COO Gena Bravo, travelled around to most SNFs in Yolo County toprovide COVID-19 infection prevention and PPE training to employees. Nobody Dies Alone Program: Staff at Woodland Memorial stepped in to provide additionalsupport a local Skilled Nursing Facility – Stollwood – which had significant COVID-19infections among both residents and staff. In addition to providing PPE and Infection Preventiontraining as described above, the program included: hospital staff performing COVID-19 testingfor residents and staff; cooking and delivery meals to staff and residents; and Clinical Leaderssitting and spending time with residents who were infected with COVID-19, so that they were notalone. Woodland Memorial Hospital partnered with Yolo County, Migrant Center leadership, anddirectly with migrant center residents to ensure these individuals and families are aware of localresources. Due to COVID-19 our team pivoted and enhanced our traditional programing toinclude: specialized infection prevention education, ensuring the residents knew it came from ourlocal health educator who is a trusted resource for returning families; delivered face masks tovarious migrant centers (Madison, Davis, and Dixon); coordinated and delivered sanitation andhygiene items; on site education, mask, and sanitizer distribution to laborers; provided one-onone support to migrant center residents as needed for diabetes management and education;partnered with local farmers throughout the region, including rural areas, to ensure educationresources are available for their seasonal and year-round workers; and Puentes de Yolo,Promotoras coalition partnerships were maintained and, with our leadership, provided services toour migrant center workers and families. Partners included CommuniCare, UC Davis Departmentof Agricultural Health and Safety, Empower Yolo, Health Education Council, UC DavisCalAgrAbility Biological and Agricultural Engineering, Yolo County Children Alliance, aresome of Puentes de Yolo members lead by Woodland Healthcare Education Services Department. Mobilized division leadership, physicians, and clinical experts within the Dignity Health systemthrough media and social media to answer questions and assuage concerns of our communityaround COVID-19. Dignity Health’s Chief Medical Officer (CMO) coordinated weekly COVID-19 calls for otherCMOs in the community to collaborate on providing the most up to date education andstrategizing for how to best provide care for the community. Implemented pre-procedure testing at all Division hospitals.Community Benefit FY 2020 Report and FY 2021 PlanWoodland Memorial Hospital 12

In addition to continuing many of theactions identified above, WoodlandMemorial plans to take the followingactions in FY21 to continue helpingalleviate pandemic-induced needs: Adapted our FY21 CommunityGrants to allow for COVID-19specific funding. Dignity health is supporting newinitiatives focused onHomelessness in Yolo Countyincluding a Street MedicineProgram in partnership withWoodland Clinic Medical Group,Sutter Health and Yolo County; additionally the CommonSpirit Homeless Health Initiative issupporting the East Beamer Way project in Woodland. The hospital and community physicians are continuing to utilize telemedicine where appropriate,which allows us to keep patients home and safe, especially as we move into flu season. Continuing to mobilize Division leadership, physicians, and clinical experts within the DignityHealth system through media and social media to answer questions and assuage concerns of ourcommunity around COVID-19. Woodland Memorial is strongly encouraging community members to get their flu shot andeducating patients regarding the importance especially in light of COVID-19. As a broader community health and community benefit strategy, we will be looking for futureopportunities to continue to support programs and initiatives that seek to address issues related toCOVID-19.Report and Plan by Health NeedThe tables below present strategies and program activities the hospital has delivered or intends to deliverto help address significant health needs identified in the community health needs assessment.They are organized by health need and include statements of strategy and program impact, and anycollaboration with other organizations in our community.Health Need: Access to Mental/Behavioral/Substance Abuse ServicesStrategy orProgram NameSummary DescriptionInpatient MentalHealth ServicesYolo County is dependent upon Woodland Memorial asthe only source of inpatient mental health treatment inthe community. There were 637 vulnerable and at-riskindigent and Medi-Cal insured residents receiving acutepsychiatric care in FY20, who otherwise would not haveCommunity Benefit FY 2020 Report and FY 2021 PlanActiveFY20PlannedFY21 Woodland Memorial Hospital 13

had access to care. The community benefit investmentto care for these individuals was nearly 6.7 million.Mental Health CrisisPrevention and EarlyInterventionEvolving through the Community Grants Program, thispartnership was developed by the hospital and isfocused on building a continuum of care in thecommunity for mental health care working with SuicidePrevention of Yolo County and Yolo Community CareContinuum which operates the Safe Harbor crisisresidential treatment facility. PreventionWraparound and PeerParent PartnerServicesYolo Crisis Nursery in collaboration with StanfordYouth Solutions and Yolo County Children’s Alliancewill provide access to wrap-around and peer parentpartner services to families at risk of child abuse orneglect and involvement with the child welfare system.In partnership with the Birth Center at WoodlandMemorial Hospital, the community organizations willalso provide services to families in areas of highest needto keep them healthy and whole. Through CommunityGrants, this program also addresses the Active Livingand Healthy Eati

Dignity Health hospitals in Arizona and Nevada voluntary produce these reports and plans, as well. We are proud of the outstanding programs, services and other community benefits our hospital delivers, and are pleased to report to our community. In fiscal year 2020 (FY20), Woodland Memorial provided 24,866,821 in patient financial