Strateic Alliance Q Introduction T O B A C O F R E LIVING...

In many ways, healthcare is a local practice — much of the most important care occurs close to home in the communities where we live and work. As the region’s largest healthcare provider, North Shore-LIJ touches many lives, and as an emerging national healthcare leader, we’re able to work with our state and national partners to apply best practices and to provide the highest quality care.

Our mission is to improve the health of the more than eight million people who live and work in the communities we serve throughout the New York metropolitan area, regardless of the ability to pay. In addition, we engage with people and organizations across

our service area through a range of programs to promote health and wellness, prevent and control disease and illness and enable people to live a healthier life.

This outreach ranges from multilingual, prenatal care for non-English-speaking expectant mothers, to behavioral support for troubled veterans and their families, CPR, smoking cessation, diabetes management and weight reduction programs. Outreach also means helping elderly individuals live safely and securely in their homes, and even providing emergency preparedness training programs for civilians and first responders. All together, we call these vital initiatives community benefit.

We’re proud of the steps the health system has already made toward building healthier communities, and we have been recognized for some of those accomplishments. North Shore-LIJ was selected as a finalist for the American Hospital Association 2013 Foster G. McGaw Prize for Excellence in Community Service, demonstrating our commitment to improving the health and well-being of the communities we serve. The health system was also featured in the “Partners in Prevention” section of the U.S. Surgeon General’s National Prevention Council 2014 Annual Status Report to the President of the United States and Congress for our ongoing efforts to advance the National Prevention Strategy. But there is much work left to do.

The nation’s healthcare landscape is in the midst of significant change, requiring us to do more than provide acute, inpatient care. We continue to align our organization with the future of healthcare, educating the next generation of medical professionals at the innovative Hofstra North Shore-LIJ School of Medicine, and investing in the most advanced medical research at the Feinstein Institute.

I’m proud that North Shore-LIJ is at the forefront of this important cultural change, and that we have always sought to provide the highest quality care to every person and family who entrusts us with their care. You’ll see in the following pages how far we’ve come and how excited we are to achieve even greater benefits for our communities in the years ahead.

HEALTHY & SAFECOMMUNITY

ENVIRONMENTS

INCREASE THE HEALTH AND

WELLNESS OF THE EIGHT MILLION

PEOPLE SERVED BY NORTH SHORE-LIJ

ELIMINATION OFHEALTH DISPARITIES

EMPOWEREDPEOPLE

CLINICAL &COMMUNITYPREVENTIVE

SERVICES

TOBACCO FREE LIVING

PREVENTING DRUG AND

EXCESSIVE ALCOHOL ABUSE

ND VIO

REPROD

UCTIVE A

MENTAL AND EMOTIONAL

WELL-BEINGACTIVE LIVING

Dear Friends,

IntroductionAligning with the National Prevention Strategy to Prevent Disease and Manage IllnessNorth Shore-LIJ is committed to improving the health and wellness of the more than eight million people who live in the communities we serve. Preventing disease and managing illness is critical to helping people live longer, healthier lives and managing rising healthcare costs.

Further, many of the strongest predictors of health and well-being fall outside of the healthcare setting. Where we live, learn and work have a significant impact on our physical and mental health. To continue to improve the health of our communities, it is vital to move from a system of episodic sick care to one based on wellness and prevention.

This principle of prevention is the foundation of the National Prevention Strategy (NPS) from the Surgeon General’s National Prevention Council. With the ultimate goal of “increasing the number of Americans who are healthy at every stage of life,” the strategy is composed of four strategic directions:

• Healthy and Safe Community Environments: Create, sustain and recognize communities that promote health and wellness through prevention.

• Clinical and Community Preventive Services: Ensure that prevention-focused healthcare and community prevention efforts are available, integrated and mutually reinforcing.

• Empowered People: Support people in making healthy choices.

• Elimination of Health Disparities: Eliminate disparities, improving the quality of life for all Americans.

Based on this strategic direction and the similar recommendations of New York State’s own Prevention Agenda, North Shore-LIJ underwent a comprehensive Community Health Needs Assessment (CHNA), engaging stakeholders to examine and reaffirm the health needs of their own communities.

As a result of the CHNA, North Shore-LIJ and its community partners have selected the following priorities and focus areas for its service area:

Preventing Chronic Disease: The health system is committed to preventing chronic disease, with a specific focus on reducing obesity and increasing access to high-quality chronic disease preventive care in both clinical and community settings.

Promoting Mental Health & Preventing Substance Abuse: To address the mental health needs identified by the CHNA process, North Shore-LIJ will promote mental, emotional and behavioral health, and strengthen related infrastructure across systems.

Using these directives as a guide, the following pages detail the health system’s approach to providing community benefit and some examples of our programs and services. To learn more about our programs, visit northshorelij.com.

Michael J. DowlingPresident and CEO North Shore-LIJ Health System

Healthy People, Healthier Communities

North Shore-LIJ Community Benefit Update

Contributed

$750.4 million in community benefit

contributions

Offered more than3,250 community benefit programs

serving 2.0 million people

Provided more than

33,000 freehealth screenings

and immunizations to community members

Trained

27,995health professionals

Community Benefit Contributions*

TOTAL 2013 COMMUNITY BENEFIT $750,470,000

Representing 11.54% of Operating Expenses

*Includes The Feinstein Institute for Medical Research. Does not include Northern Westchester or Phelps Memorial hospitals.

CASAColumbia(Strategic Alliance)

Lenox HillHealthPlexBarnabas

Health(Strategic Alliance)

Phelps MemorialHospital Center

Northern WestchesterHospital

Yale New HavenHealth

(Strategic Alliance)

19 hospitals

Over 400 ambulatory & physician practices

Home Care

Long Term Care

Hospice Care

Insurance provider

5 tertiary hospitals

9 community hospitals

3 specialty care hospitals

2 affiliate hospitals

Manhattan Eye, Ear & Throat Hospital

KarolinskaInstitute

Sweden

Florida

Boca RatonRegional Hospital

Key Facts■ 19 hospitals (More than 6,400 hospital and long-term care beds)* • 5 tertiary • 9 community • 3 specialty • 2 affiliates■ Owner/operator of North Shore-LIJ CareConnect Insurance Company, Inc.■ 3 skilled nursing facilities■ Over 400 ambulatory and physician practices■ 34 nursing home/senior living affiliates■ The Feinstein Institute for Medical Research■ Comprehensive continuum of care■ Strategic alliances • Barnabas Health • CASAColumbia • Cleveland Clinic ■ 7 million people in service area■ Over 4 million patient contacts■ 141,345 ambulatory surgeries■ 282,044 hospital discharges■ 27,368 births■ 664,915 emergency visits■ 688,660 home care visits■ 102,277 ambulance transports■ $7 billion annual operating budget■ 14th largest healthcare system in the US■ More than 50,000 employees • More than 9,440 physicians* • More than 10,000 nurses* • More than 1,500 medical residents and fellows■ More than $686.4 million in community benefit (10.9 percent of operating expenses) by participating in 1,966 unique programs, serving more than 1.9 million community members and training 24,862 health professionals.■ Recipient of the National Quality Forum’s 2010 National Quality Healthcare Award■ Hofstra North Shore-LIJ School of Medicine

*Does not include affiliate organizations

• Karolinska Institute• Montefiore Medical Center• Yale New Haven Health

ASIAN BLACK HISPANIC MULTIRACE OTHER WHITE

STATEN ISLAND NEW YORK QUEENS NASSAU SUFFOLK WESTCHESTER

Community Benefit (CB) Categories Actual $ MM

Unreimbursed Medicaid $324.48

Health Professions Education $235.64

Charity Care $89.99

Research $65.14

Community Health ImprovementServices and CB Operations $21.50

Subsidized Health Services $9.28

Cash and In-Kind Contributions $4.44

TOTAL 2013 COMMUNITY BENEFIT $750.47

Serving A Diverse Population

Source: NYS Office of the State Comptroller; U.S. Census, 2010 - Race/Ethnicity Demographics. Report prepared by North Shore-LIJ Health System Office of Strategic Planning and Program Development

Source: Adapted from National Prevention Council, National Prevention Strategy, Washington, DC: U.S. Department of Health and

Human Services, Office of the Surgeon General, 2011

North Shore-LIJ Service Area

ENVIRONMENTS

EMPOWEREDPEOPLE

SERVICES

TOBACCO FREE LIVING

PREVENTING DRUG AND

ND VIO

REPROD

UCTIVE A

Dear Friends,

Contributed

contributions

Provided more than

Trained

19 hospitals

Home Care

Long Term Care

Hospice Care

Insurance provider

KarolinskaInstitute

Sweden

Florida

Charity Care $89.99

Research $65.14

ENVIRONMENTS

EMPOWEREDPEOPLE

SERVICES

TOBACCO FREE LIVING

PREVENTING DRUG AND

ND VIO

REPROD

UCTIVE A

Dear Friends,

Contributed

contributions

Provided more than

Trained

19 hospitals

Home Care

Long Term Care

Hospice Care

Insurance provider

KarolinskaInstitute

Sweden

Florida

Charity Care $89.99

Research $65.14

Eliminating Health Disparities

The North Shore-LIJ Health System serves a wide geographic area, representing many different communities. The health system is one of the largest and most diverse organizations in the metropolitan New York area, employing 54,000 people.

To achieve health equity and eliminate disparity, North Shore-LIJ adheres to the tenets of diversity, inclusion, health literacy and

cultural and linguistic competency in a cross-cultural approach to delivering quality patient centered care.

In alignment with the National Prevention’s Strategy’s “Elimination of Health Disparities” strategic direction, initiatives focusing on improved healthcare access and the provision of in-house financial assistance programs and public insurance options that make healthcare more affordable have been integrated into healthcare delivery. North Shore-LIJ also incorporates the National Prevention Strategy’s directive of “Empowered People” by establishing programs and initiatives to eliminate other barriers to health and wellness, including programs that address cultural and language diversity, gender differences and social determinants of health.

Improving Access to CareThe North Shore-LIJ Healthcare Access Center (866-381-1931), staffed by bilingual employees, helps to enroll uninsured community members into free or low-cost public insurance programs. For those individuals ineligible for public health insurance programs, the Health Access Center can arrange low-cost access to routine medical care through the Financial Assistance Program (800-995-5727), which assists patients whose household incomes are less than 500% of the federal poverty level.

Responding to Language and Cultural DiversityIn the borough of Queens alone, more than 170 different languages are spoken. This is one reason why the health system recognizes diversity, inclusion and health literacy as core characteristics of quality patient care. Our goal is to advance cultural and linguistic competence and promote effective communication to eliminate health disparities and improve patient outcomes and satisfaction. For example, our partnership with the Long Island Regional Adult Education Network offers health literacy courses to adults who speak English as a second language.

Focusing on the Unique Health Needs of WomenWomen’s health needs and risk factors are unique, requiring specialized diagnoses, treatment and follow-up. North Shore-LIJ established the Katz Institute for Women’s Health (KIWH) to improve the health of women across their life span through exemplary clinical practice, advancement in research, education, community engagement and commitment to healthcare equality. The Katz Institute coordinates access to all of North Shore-LIJ’s clinical programs and services through one entry portal, the KIWH Resource Center, open Monday through Friday from 9AM to 5PM (855-850-KIWH). The Katz Women’s Hospitals on the North Shore University Hospital and LIJ Medical Center campuses further reflect our commitment to women’s health and family-centered care. Each location helps women take full advantage of North Shore-LIJ’s broad spectrum of services, and provides women and their families with the highest levels of support and care.

Our Family Planning Program provides comprehensive reproductive healthcare, including routine gynecology, pregnancy testing, preconception counseling, HPV vaccinations, as well as testing and treatment for sexually transmitted infections, including HIV. Access to comprehensive prenatal care is available to uninsured pregnant women (including those without proof of citizenship) through the Prenatal Program, which provides medical and social work services throughout pregnancy, delivery and postpartum, as well as free breastfeeding, sibling preparation, and labor and delivery classes. The Women, Infants and Children (WIC) Program provides nutrition education, counseling and guidance for pregnant women and new mothers, as well as nutrition and health services for children from birth to age five. The program also provides referrals to food assistance programs and other needed services, including dental care.

Reducing Barriers to Better HealthSocial determinants, or the conditions in which people are born, grow, live and age, have considerable impacts on health. North Shore-LIJ programs align with the NPS’ empowerment directive by expanding knowledge, resources, ability and access to make healthy choices.

When people are empowered, they are able to take an active role in improving their health, supporting their families and friends in making healthy choices, and leading community changes. Examples of programs which seek to reduce social barriers to good health include: Futures In Motion: A Youth Career Alliance Network (Youth CAN!), an educational and vocational training program offered in partnership with New Yorkers For Children, FEGS Health and Human Services, and Walgreens Family of Companies, that helps youth aging out of foster care find sustainable employment; and the Hofstra North Shore-LIJ School of Medicine’s Medical Scholars Pipeline Program, an intensive, four-year program for talented high school students from low-income communities who are interested in pursuing health-related careers.

For low-income children with learning disabilities, an optimal educational experience is one of the greatest tools available for breaking the cycle of poverty and affording children the opportunity to reach their fullest potential. North Shore-LIJ’s Center for Attention and Learning (CAL) is a unique educational evaluation program committed to helping these children receive the assistance they need to lead productive, meaningful and fulfilling lives. The only program of its kind within the five boroughs, CAL provides comprehensive neuropsychological evaluations, educational advocacy, follow-up, parental guidance and integrated agency involvement, devoted to underserved families.

Empowering People to Make Healthy Choices

To make good health decisions, people need accurate information. But information alone is often not enough to change behavior — community partnership is also needed. As we establish strategies to improve the health of our communities, success will depend upon our efforts in building trusted partnerships with the communities we serve. North Shore-LIJ works with

schools, government, faith-based organizations, other healthcare providers, neighborhoods and civic groups, to ensure a healthier tomorrow for our communities.

With a focus on prevention and wellness, we work with our communities to inform, enable and empower people to make effective behavior changes and take an

active role in their health — targeting people before they fall sick and improving the health status of those with chronic conditions, thereby reducing hospitalizations.

InformNorth Shore-LIJ raises awareness about healthier lifestyle choices by providing health education and prevention programs to the community on a wide range of health topics and diseases. Through partnerships with our communities, programs are offered at community sites, schools, worksites, health fairs, and through collaborative partnerships with local, state and national organizations.

EnableCreating access to healthier lifestyle options promotes good health. Many of our hospitals sell fresh fruit and vegetables from local farmers markets to promote sustainable production and consumption of local produce. The health system also established a coalition of civic, community, legislative and faith-based leaders to address health and wellness within one of its local communities, Spinney Hill. A community farmers market operates from July through October, with nearly 3,000 residents visiting and participating in “Farm to Table” programs, including cooking demonstrations, produce sampling, nutrition and education workshops.

North Shore-LIJ recognizes tobacco cessation as a top priority as well. Our Center for Tobacco Control (CTC) provides free tobacco cessation and preventive services to community members and employees, as well as comprehensive tobacco dependence treatment education to healthcare providers, using evidence-based practice. The CTC reached more than 15,000 children and adults last year by providing educational programs at health fairs, classroom presentations, expos and other events. The health system also joined the Partnership for a Healthier NYC, with a focus on Queens County, to reduce exposure to secondhand smoke in outdoor areas, reduce youth smoking by educating and advocating to reduce access to tobacco products and retail marketing, and to advocate for smoke-free housing. Since 2013, the number of smoke-free housing units in Queens increased from 200 to 1,300 and NYC legislation was signed into law restricting tobacco product access to youth under 21 years old.

EmpowerNorth Shore-LIJ offers a number of supportive programs that empower people to choose healthier lifestyles. We are a licensed provider of the Stanford University Chronic Disease Self-Management Program, which improves the health of chronically ill individuals. Participants experience a high level of mutual support and success, which builds confidence in their ability to manage their health and maintain active and fulfilling lives.

North Shore-LIJ’s free and ongoing support groups also offer people with similar medical conditions and life challenges an opportunity to discuss and share experiences and knowledge, and ask questions. Support groups cover a wide variety of health topics for patients and their families.

For seniors, North Shore-LIJ developed the Aging in Place program, which formally established the health system as the medical partner to a number of naturally occurring retirement communities (NORCs) in Queens and Long Island. The program has allowed more than 9,000 older adults to continue to live in their own homes with greater comfort, safety and security. The Aging in Place program, along with social service, civic and philanthropic partners, provides a wide range of services that eliminate service fragmentation — from health assessments and flu immunizations to nutrition counseling, “Meals on Wheels,” and transportation services.

To reduce the risk of falls injuries for seniors, Stepping On, an evidence-based falls prevention program was developed, with support from North Shore-LIJ hospital facilities, Home Care Network, Sports Therapy and Rehabilitation Services (STARS), NORC nursing staff and other community partners. Stepping On empowers independent older adults to self-manage fall risk, and addresses balance and strength, home and environmental safety, vision, medication and quality of life issues.

Clinical and Community Preventive Services

By helping people prevent disease, we can help them live longer and happier lives. Preventive services include screenings, counseling and immunizations, as well as medications used to prevent disease and procedures to detect health problems early, or information to help people make good health decisions.

North Shore-LIJ’s Community Health Needs Assessment has determined that preventing chronic disease due to obesity is a primary area of concentration, as are mental health and substance abuse services. While preventive services are traditionally delivered in clinical settings, some can be delivered within communities when they are supported and reinforced by community-based prevention programs.

Weight Control in ChildhoodTo address the nation’s childhood obesity epidemic, North Shore-LIJ, in partnership with Kohl’s, offers the Keeping Kids Healthy Program, which promotes healthy eating and

fitness for students in grades K-12. In addition, Healthier Tomorrows, in conjunction with the Huntington YMCA, helps children ages 9-16 reverse early weight problems. As a founding member of the Nassau County Wellness Coalition, North Shore-LIJ and its partners also conduct Teens as Wellness Trainers, peer education workshops with students and faculty participating in 25 high schools.

Promoting Mental Health and Preventing Substance AbuseNorth Shore-LIJ’s specialty care hospitals, Zucker Hillside and South Oaks, provide a comprehensive continuum of behavioral health services to all age groups. Both inpatient and outpatient programs and services are available for general psychiatry, schizophrenia, affective disorders, geriatrics, children and adolescents. North Shore-LIJ’s Vocational and Career Counseling Programs provide vocational guidance and transitional services that afford psychiatrically disabled individuals the opportunity to cultivate a skill and enter or re-enter the workforce.

The Prevention Resource Center coordinates partnerships among schools, communities and prevention providers to decrease the prevalence of alcohol, drug use, and problem gambling in Suffolk County communities, through education, training and services.

In addition, North Shore-LIJ partners with the Queens Child Advocacy Center to expedite the investigation, prosecution, and immediate delivery of treatment services for children who are victims of sexual and physical abuse. The goal is to protect victimized children from further abuse, minimize ongoing trauma, and provide comprehensive rehabilitation services.

Preventing Disease Through Health Screenings and ImmunizationsNorth Shore-LIJ provides community residents with free health screenings and immunizations through programs organized by each member hospital. Screenings are held in conjunction with national campaigns (heart health, blood pressure, prostate cancer and skin cancer) and throughout the year at health awareness and educational events, all of which are open to the public. Last year, North Shore-LIJ provided more than 33,000 free health screenings and immunizations to community members.

The New York State Cancer Services Program is a joint effort with the state Department of Health to promote comprehensive screenings for breast, cervical and colorectal cancers, and to provide prostate cancer education to underserved populations.

Healthy and Safe Community Environments

Communities can be transformed to support well-being by making healthy choices easy and affordable. According to the NPS, healthy and safe community environments include those with clean air and water, affordable and secure housing, sustainable and economically vital neighborhoods — with efficient transportation and good schools — and supportive,

safe structures, including access to affordable, healthy foods and streetscapes designed to prevent injury.

We help to create healthy and safe environments by improving the physical environment, becoming engaged as an active member of the community — often through many employee volunteer programs — and providing critical support during emergencies and disasters.

Keeping Kids Safe A million children around the world are killed by preventable injuries each year, and millions more are seriously injured. To combat this problem locally, North Shore-LIJ leads the New York State Safe Kids Coalition, bringing together health and safety experts, educators, corporations, foundations, governments and volunteers to educate and protect families. Some of the safety programs offered include motor vehicle, pedestrian, bicycle/wheeled sports, sports/recreation and falls prevention. Since the formation of the NYS Safe Kids coalitions, unintentional injury and death among children in the state have been reduced by 55 percent.

The Child Passenger Safety (CPS) program, coordinated by certified CPS Technicians, offers car seat checks, where parents and caregivers receive hands-on assistance with proper use of child restraint systems and safety belts. The program distributes complimentary child car seats to community members in need.

We are also actively involved with Bully Reduction/Anti-Violence Education (BRAVE), a consultation service available to school personnel on how to initiate bully and violence prevention programs in schools, including intervention strategies that address common bullying problems. For over 10 years, BRAVE has been implemented in more than a dozen schools, reaching more than 3,000 middle school students.

Reducing our Environmental Footprint North Shore-LIJ is committed to reducing its carbon footprint and has established far-reaching environmentally

responsible programs and business practices. To date, North Shore-LIJ has already seen a 12% reduction in its carbon footprint. We are achieving success by reducing our use of natural resources, reducing waste and encouraging recycling, seeking sustainable building materials and streamlining transportation and distribution channels to reduce motor vehicle pollution. Last year, the health system installed its first electric vehicle charging station at North Shore University Hospital for employees, with plans to expand and install additional stations across the system for use by visitors and employees.

As part of this effort, 16 North Shore-LIJ projects to date have become LEED (Leadership in Energy & Environmental Design) certified. More than 50 additional health system projects are seeking certification. In 2012 and 2013, North Shore University Hospital was awarded the Practice Greenhealth Partner for Change Award, recognizing the hospital’s efforts to “go green.” Additionally, every North Shore-LIJ hospital enrolled in the Healthy Hospitals Initiative Engaged Leadership Challenge, furthering our commitment to greening our facilities.

Helping the Community During a Disaster North Shore-LIJ’s Emergency Management Division continuously monitors weather, national and international events, as well as our own sites to ensure that the health system is prepared and can continue to offer a safe environment of care under emergency circumstances. A dedicated Emergency Operations Center also helps management deploy health system manpower and resources to where they are most needed.

A Commitment to Global Health: Bringing Resources to Countries in NeedA partnership between North Shore-LIJ and MedShare diverts surplus materials to developing countries that have a desperate need for medical supplies. For the past several years, North Shore-LIJ has provided MedShare with medical supplies that have been shipped around the world to places in need.

FOR MORE INFORMATION ABOUT OUR COMMUNITY HEALTH PROGRAMS AND SERVICES

visit: northshorelij.com

or contact:

Jennifer H. Mieres, MD, FACC, FASNC, FAHA SVP, Office of Community and Public Health

Barbara Felker, MS, MDiv VP, Diversity and Community Engagement

Christine Essig, MPA Director, Community Benefit

WELLNESS OF THE EIGHT

MILLION PEOPLE SERVED BY

NORTH SHORE-LIJ

3 4 5 6

NORTH SHORE-LIJ

or contact:

NORTH SHORE-LIJ

3 4 5 6

NORTH SHORE-LIJ

or contact:

NORTH SHORE-LIJ

3 4 5 6

NORTH SHORE-LIJ

or contact:

NORTH SHORE-LIJ

3 4 5 6

NORTH SHORE-LIJ

ENVIRONMENTS

EMPOWEREDPEOPLE

SERVICES

TOBACCO FREE LIVING

PREVENTING DRUG AND

ND VIO

REPROD

UCTIVE A

Dear Friends,

Contributed

contributions

Provided more than

Trained

19 hospitals

Home Care

Long Term Care

Hospice Care

Insurance provider

KarolinskaInstitute

Sweden

Florida

Charity Care $89.99

Research $65.14

Strateic Alliance Q Introduction T O B A C O F R E LIVING...

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