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Otherwise, they’re more likely to default to ER care, which is expensive. Better to find out early that you have a cholesterol problem that can be solved with a healthy diet and exercise than to end up in the ER for an angioplasty because you developed heart disease.” “Through the hospital’s foundation, we are connecting community supporters to the needs of community healthcare providers. For example, bringing more primary care providers to the South County market to provide adult and pediatric care and obstetrics services. Also, supporting Foothills Community Health Center, Gardner South County Health Center, and Rotocare, which provide entry-level care out in the community. They are always busy, which speaks volumes about the need.” De Paul Health Center How Santa Clara County Assesses Our Healthcare Under the Affordable Care Act, non- profit hospital organizations are required to prepare and publish a Community Healthcare Needs Assessment (CHNA) once every three years. Santa Clara County’s most recent CHNA was pub- lished in 2016 by a Community Benefit Coalition of representatives from seven nonprofit hospitals; the Hospital Council of Northern & Central California; and the county’s Public Health Department. The purpose of the assessment is to gather data on county health trends and needs, and to use this data in policy making and program planning. For Saint Louise and other nonprofit hospitals in the coalition, it serves as a tool in meet- ing state requirements for dev elopment of Community Benefit Plans, and IRS requirements for CHNA implementation strategies. The CHNA takes somewhat of a holistic approach. In addition to the physical and mental health of county residents, it looks at “quality of life” indicators such as access to healthcare, affordable housing, childcare, education, and employment, as well as physical, environmental, and social factors that impact community health. 30 Why bring up the CHNA? Because it’s a detailed and comprehensive yet highly readable assessment of county health needs, and a useful way to gauge the effectiveness of Saint Louise and other participating hospitals (Stanford, El Camino, Sutter Health, Kaiser Per- manente and Lucile Packard Children’s Hospitals) at implementing their own Community Benefit Plans to meet the needs in their hospital communities. County Health Priorities: • • • • • • • • • • • • • • • • Obesity and Diabetes Behavioral Health Access to Healthcare and Healthcare Delivery Violence Birth Outcomes Alzheimer’s Disease and Dementia Cerebrovascular Diseases Communicable Diseases Economic Security Housing Learning Disabilities Oral and Dental Health Respiratory Conditions Sexual Health Tobacco Use Unintentional Injuries GILROY • MORGAN HILL • SAN MARTIN NOVEMBER/DECEMBER 2017 What’s Next So far, Congressional attempts to pro- pose a healthcare replacement bill fa- vor middle and upper-middle-income earners, and punish the elderly—who have been paying into the healthcare system for decades—as well as the poor and people with pre-existing health conditions. If Congress has its way, by the year 2026, a 64-year-old earning $26,500 a year will be forced to pay $14,500 for insurance. That’s about eight times more than what would be required under the Afford- able Care Act, and it wouldn’t leave enough to cover room and board in Santa Clara County. As Roger Knopf said, “It’s time to have a good discussion about health- care, and the discussion doesn’t belong in Congress. It belongs with the pay- ors, providers, physicians and patient advocates.” Sources: The Commonwealth Fund, common- Santa Clara County Community Health Needs Assessment, 2016, stlouise.ver- Health Affairs, blog/2016/07/06 Saint Louise Hospital, Kaiser Permanente,