2013 UMass Memorial Community Benefits Report

We’re in Your Neighborhood!
UMassMemorial
Health Care
Community Benefits Report 2013

It has been a year and a half since I assumed the role of president and CEO of UMass Memorial
Health Care, Inc. During this time, our hospitals have completed a community health needs
assessment and are working with their respective communities to address identified needs of the
medically underserved.
Improving the health of the community requires addressing the complex social factors that
impact health and people’s ability to make healthy choices. In today’s era of health care reform,
we must incorporate population and public health strategies into our approach along with
transforming how we deliver care. Developing innovative models that link our vast clinical and
community resources are key to overcoming barriers to accessing care and addressing health
disparities. As such, all of our health care entities continue to work closely with their local public
health departments and a broad range of community partners to achieve the greatest collective
impact in improving health outcomes.
Most recently, UMass Memorial Medical Center and the Worcester Division of Public Health convened stakeholders to complete
a grant application to the Massachusetts Prevention and Wellness Trust Fund (PWTF). As a result, Worcester was selected as
one of nine communities in the state to receive PWTF funding for innovative interventions that use clinical/community links
to reduce preventable conditions and health care costs. We are thrilled that as a result of the PWTF award our Pediatric Asthma
Home Visiting Pilot project will be expanded to schools across the City of Worcester where the rate of asthma-related emergency
room visits for children ages 0 to 19 is double that of the state.
As we move forward, community health improvement and prevention efforts such as these are crucial to our mission of
addressing health care disparities in the most patient- and family-centered, cost-effective manner.
I look forward to sharing our progress with you in the coming year.
System Hospitals
UMass Memorial Medical Center
Patrick Muldoon, FACHE, President and CEO
Mónica Lowell, Vice President, Community Relations
Clinton Hospital
Sheila Daly, RN, MS, CPHQ, President and CEO
Rosa Fernandez-Peñaloza, Manager,
Community Benefits/Interpreter Services
HealthAlliance Hospital
Deborah Weymouth, FACHE, President and CEO
Kelli Rooney, Interim Director, External Affairs and Marketing
“ Developing innovative models that link our vast clinical
and community resources are key to overcoming barriers to
Marlborough Hospital
Steve Roach, President and CEO
Mary Ann Stein, Director, Volunteer Services and Community Outreach
Wing Memorial Hospital and Medical Centers
Charles Cavagnaro III, MD, President and CEO
Teresa Grove, Director of Development, Marketing and Public Relations
accessing care and addressing health disparities. ”
Inside the Report
1. UMass Memorial Community Benefits
3. Community Health Improvement Plan (CHIP)
5. In-Home Asthma Education Pilot
7. Goods for Guns
8. Cooking Matters
9. Healthy Eating and Active Living
10. Access to Healthy Food
11. Backyard Gardening
12. Youth Development
13. Worcester Youth Center
14. Improving Access
15. UMass Memorial Ronald McDonald Care Mobile
17. Elder Semi-Urgent Care
18. Focus on Public Health
19. Hepatitis Screening and Treatment
20. Community and Neighborhood Initiatives
Inside Back Cover: UMass Memorial Health Care System
dear friends and Colleagues,
Eric W. Dickson, MD, MHCM, FACEP
President and CEO
UMass Memorial Health Care, Inc.
Cover: View of Bell Hill neighborhood and UMass Memorial Hospital

UMassMemorial
Health Care
Community Benefits Mission
UMass Memorial Health Care is committed to improving the health status of
all those it serves and to addressing the health problems of the poor and other
medically underserved populations. In addition, nonmedical conditions that
negatively impact the health and wellness of our community are a priority.
WHAT ARE Community Benefits?
Community Benefits are programs and services provided by not-for-profit hospitals to improve
community health. They are designed to respond to identified community needs and address health
disparities among disadvantaged and vulnerable populations. Community Benefits are not provided for
marketing purposes and must meet at least one of the following criteria:
• Improve access to health care services • Enhance the health of the community
• Advance medical or health knowledge
• Relieve or reduce the burden of government or other community efforts
In 2013, UMass Memorial Health Care contributed nearly $154.0 million to positively impact the health
and well-being of the communities we serve. Our Community Benefits contributions support charity
care, subsidized health services, education of health professionals, community-based programming and
partnerships. In addition, almost $6.9 million in other non-Community Benefits expenses were absorbed
through bad debt write-offs and Medicare shortfalls.
Community Benefits Total
$154.0 Million
Subsidized
Health Services
$10.0 M
Health Professions
Education
$74.5 M
Contributions
Associated with
Charity Care
$64.8 M
Community Health Programs
Partnerships, Donations,
Community Building
$4.7 M
2013
Other Significant Expenses Total
$6.9 Million
Bad Debt*
$4.6 M
Medicare
Shortfall**
$2.3 M
* Bad debt: Expenses for receivables that can no longer be collected and are written off.
** Medicare shortfall: Net loss incurred for the cost of providing services to Medicare patients versus income received from the Medicare program.
Community Benefits Report 2013 1 1

A Road Map for
Worcester neighborhoods

Community health improvement plan update
First completed in 2012 through a joint effort co-led by
UMass Memorial, the City of Worcester Division of Public
Health and Common Pathways, the Greater Worcester
Community Health Improvement Plan (CHIP) is structured
around five principal “domains” with specific, measurable
objectives and an overarching mission of making Worcester
and the region “the healthiest in New England by 2020.”
Initial efforts included a Community Health Needs
Assessment (CHA) of the City of Worcester and the outlying
towns of Shrewsbury, Millbury, West Boylston, Leicester
and Holden and involved the collection and analysis of data
from multiple primary and secondary sources including
key informant interviews. An online survey to which more
than 1,300 individuals responded was also used. In total,
approximately 1,745 individuals representing a range of
populations and institutions including neighborhoods,
youth, immigrants, seniors, government, philanthropy,
education, social services and health care provided input.
In 2013, the first annual update of the CHIP was released at a
press conference attended by approximately 100 community
members and stakeholders. The revised report was developed
using key findings from the CHA and a detailed literature
review to assess and select appropriate data-driven priority
goals, objectives and strategies. Progress was made in
reevaluating goals to be challenging yet realistic; fine-tuning
measurements of success to reflect regional, state and
national trends; and refocusing or, in some cases, eliminating
strategies to more accurately address targeted outcomes.
The CHIP is a roadmap for the future health of the region
and intended to be a living document that will be reassessed
annually. By design, the UMass Memorial Community
Benefits Plan aligns with the report to maximize collective
impact. The original CHIP, the 2013 update and the CHA
are all available on the UMass Memorial website*.
*See http://www.umassmemorialhealthcare.org/umass-memorial-medical-
center/patients-visitors/community-benefits-programs/
community-health-needs-assessment
“ The five identified Priority Areas will be referred to as ‘Domain Areas’ to reflect
their equal importance: Healthy Eating/Active Living; Behavioral Health; Primary
Care/Wellness; Violence/Injury Prevention; and Health Equity/Health Disparities.”
–Derek Brindisi, Director of Public Health, City of Worcester
Prevention and Wellness GRANT AWARD grant partners
The PWTF grant is funded through Chapter 224 of the Acts
of 2012 Massachusetts Health Care Reform to lower costs
and make quality, affordable care a reality. Grant strategies
address preventable health conditions using evidence-based
and -informed program policy and system change.
PWTF Asthma Intervention Grant Partners:
City of Worcester Health Department
Edward M. Kennedy Community Health Center
Family Health Center of Worcester
UMass Memorial Plumley Village Health Services
UMass Memorial Pediatric Primary Care
UMass Memorial Pediatric Pulmonology
UMass Memorial Office of Clinical Integration
Worcester Community Legal Aid
Worcester Head Start Program
Worcester Public Schools
Building on the CHIP, the City of Worcester was selected
as one of nine communities in Massachusetts to receive
a 2013 Prevention and Wellness Trust Fund (PWTF)*
grant. UMass Memorial and the Worcester Division
of Public Health convened and led a group of diverse
community partners through an application process that
targets improving health outcomes for chronic conditions
while reducing health care costs. The award will bring
more than $7 million over 30 months for three citywide
interventions: pediatric asthma, hypertension and falls
prevention. Worcester’s strong collaborative effort is
serving as a leading example for public health initiatives
on a state and national level.
*www.mass.gov/eohhs/gov/departments/dph/
programs/community-health/prevention-and-wellness

pediatric chronic
disease management
4 UMass Memorial Health Care

an inNOVATIVE partnership
IN-HOME ASTHMA EDUCATION
infestations. Referred by school nurses—a unique aspect of
this program—parents and students meet at home with a
known and trusted UMass Memorial community health
worker (CHW). “It’s important to provide family-centered
care in the context of home and culture,” continued Dr.
Nazarian. “If we focus solely on medication, we may overlook
something. A culturally competent CHW is an effective
liaison to a child’s home, school and medical home.”
Parents may keep asthmatic children at home due to cold
weather, lack of transportation to pick up inhalers or caring
for a young baby at home. When they gain awareness that
asthma is controllable and their child can participate more
fully at school, they become more invested in a management
plan. “We have to be proactive about asthma, and addressing
it only at an annual physical isn’t the best option,” added Dr.
Nazarian. “We need to see children more often and focus on
education and prevention. By engaging school nurses and
in-home CHWs to reiterate the message, we provide a multi-pronged
approach that works for these families who have so
many competing priorities for basic needs.”
In 2014, the asthma pilot will be expanded under the Prevention
and Wellness Trust Fund grant (see page 3) to include a
clinical care team comprised of a provider champion, a clinical
care manager and community health workers. The pediatric
pulmonology department will work closely with school nurses.
Asthma Pilot Program Partners
Belmont Street Community School
UMass Memorial Plumley Village Health Services
UMass Memorial Pediatric Primary Care
Worcester Community Legal Aid
“Asthma is a common condition that affects about 10
percent of our patients,” said UMass Memorial pediatric
primary care physician Beverly Nazarian, MD. “It’s serious
for children living in low-income housing because they
may be exposed to more triggers and parents cannot
make changes to their rented home. Based on successful
evidence-based programs elsewhere, we piloted an approach
coordinated through a local school that includes legal
assistance as well as in-home visits to identify triggers,
provide appropriate cleaning and bedding supplies, and
connect families to asthma education and other resources.”
One area of need, just two blocks from the hospital’s
Memorial Campus, is Belmont Street Community
School (BSCS) where principal Susan Proulx, EdD,
wanted to address the high rate of absenteeism among
asthmatic students. Located in a highly diverse, distressed
neighborhood with a large Latino population, BSCS serves
students who live in public housing and old housing
stock. Asthma is prevalent because in addition to common
triggers like cigarette smoke, pets and pollen, there are
more insidious problems: mold, dust mites, mice and roach
“ Our collaborative effort identifies students,
acquires parental consent, and conducts visits to
identify possible environmental causes. ”
– Susan Proulx, EDD, Principal, Belmont Street Community School
Emergency Room Pediatric Respiratory Visits
Worcester Massachusetts
(Per 100,000, ages 0-19)

VIOLENCE AND
INJURY PREVENTION

A SUCCESSFUL STRATEGY
goodS FOR guns
Michael Hirsh, MD, surgeon-in-chief of UMass
Memorial Children’s Medical Center and the Division of
Pediatric Surgery and Trauma, speaks passionately when
remembering a friend and medical colleague who was killed
by a teen with a handgun in 1981. “That event was seminal
in putting me on the path to prevent gun violence. I know
that the gun is a coveted object protected by our Bill of
Rights, but along with that right is the responsibility to
store it properly. In 2010, of 31,000 gun deaths nationwide,
12,000 were homicides and 19,000 suicides. Recent research
by the Harvard School of Public Health also reveals that in
the last five years, rifles were involved in more than half of
teen suicides. We have to look at the gun as a vector—in the
same way that the mosquito was a vector for yellow fever
that killed troops during the Spanish American War—that
quickly changes personal and interpersonal conflict into
lethal violence.”
Goods for Guns, in conjunction with the Worcester Police
Department and part of a more comprehensive injury
prevention agenda, is a buyback program that removes
weapons from homes and the streets. Coupled with the
spirit of the December holiday season, owners exchange
guns for gift certificates that can be redeemed in local
grocery stores. Buyback events have been more successful
here than in cities where cash is distributed.
“Worcester has the lowest rate of penetrating trauma—by
knife or gun—of any city in Massachusetts. Our track record
makes the point, but sometimes money speaks loudest,”
continued Dr. Hirsh. “Since 2002, 2,396 weapons have
been retrieved, two-thirds of which are handguns or semi-automatic
weapons. Supported in part by UMass Memorial,
we have paid $53 per gun, or about $127,000, which is less
than the cost of treating just four gunshot victims. While we
are pleased with our collection effort, the problem remains.
As Acting Commissioner of Public Health for the City of
Worcester, I can’t be complacent about it. We have made it
part of the Community Health Improvement Plan and use it
to have difficult conversations. If we make people aware and
responsible, tragedies will be averted.”
“ We have to look at the gun as a vector . . . that quickly changes
personal and interpersonal conflict into lethal violence. ”
–Michael Hirsh, MD, surgeon-in-chief of UMass Memorial
Children’s Medical Center and the Division of
Pediatric Surgery and Trauma
program goals
To teach safe gun storage
To distribute free trigger locks
To promote home gun safety
Goods for guns partners
UMass Memorial Medical Center
Wegman’s
Worcester Division of Public Health
Worcester Office of the District Attorney
Worcester Police Department
Guns Retrieved Since 2002
(Total = 2,396)
Semi-Automatic/
Automatic
884
Pistols/
Revolvers
913
Long Guns
599

cooking matters
Cooking Matters®, an interactive course developed by
Share Our Strength to fight hunger and poverty, empowers
low-income families to stretch their food budget and
serve healthy meals at home. With funding from UMass
Memorial, the series of six classes for adults—team-taught
by a volunteer chef and nutrition educator—focused
on food shopping, meal preparation, budgeting and
nutrition at five community sites in Worcester. “We use
an evidence-based curriculum structured on the United
States Department of Agriculture Dietary Guidelines
for Americans and MyPlate,” said Alicia McCabe,
Massachusetts State Director. “Our priority is mothers
with babies and young children. Parents are recruited,
not referred, by partner organizations and we adapt the
course to include what they want to learn. We respect that
participants make choices and decide what works best for
them in their own lives.” Everyone receives a cookbook and
kitchen tools, and is involved in meal preparation every
week. Families also take home groceries to replicate recipes.
The first class emphasizes a balanced diet. Participants read
nutrition fact labels, prepare recipes using a variety of food
groups and talk about kitchen safety—food handling and
knife use. The following week, they look at whole grains,
fruits and vegetables, and how to incorporate them more
often in their family meals. Week three addresses sources
of lean protein, healthy fat and calcium. The importance
of breakfast, making healthy choices away from home, and
ways to add flavor without salt round out the fourth class.
A field trip to the grocery store is scheduled in week five
where the group talks about store layout, unit pricing, and
how to make meals within budget. The course concludes
with a discussion of beverages and exercise.
Healthy cooking is a major contributor to a healthy life,
and sharing this knowledge with families on a budget is an
important preventive measure against obesity. The kitchen
classroom offers a safe space to acquire new skills, explore
different foods and make favorite recipes healthier. “It’s one
thing to say that squash is healthy, or expect that on your
advice someone is going to use limited dollars to buy it,”
observed Ms. McCabe. “The challenge is to make it appealing
to them, their family and even their picky four-year-old.”

HEALTHY EATING AND ACTIVE LIVING
A NUTRITIONAL FOCUS
Cooking Matters® was offered in response to
neighborhood residents who identified cooking classes
as an area of interest during the Community Health
Improvement Plan process (see page 3). Nearly 60
individuals participated, impacting about 135 family
members. Sites included YWCA, Plumley Village Health
Services, South Worcester Neighborhood Center, YOU,
Inc. Teen Living Program and Worcester Head Start.
key factors for Obesity
• Food insecurity and hunger are highly correlated with
overweight and obesity.
• Hunger and poor nutrition impair children’s
development and learning.
• Without supermarkets, neighborhoods rely on
convenience stores that offer lower-quality, less
nutritional food at higher prices.
Promoting CityWide Physical Activity
Wheels to Water
In collaboration with the City of Worcester, this
summer activity served 1,422 youth, provided 2,554
swimming lessons and created jobs for 144 teens. Free
transportation and a nourishing meal are also important
components of the program.
1,422
Youth participated in Wheels to Water activities
After-school and summer exercise for the underserved
UMass Memorial supports summer and after-school
programs at Belmont Community School, where 93 percent
of students receive free or reduced lunch and lack access to
fitness and sports opportunities. A total of 137 elementary
school students participated throughout the year.
Addressing high rates of obesity among Asian youth
More than 170 youth took part in MyPlate nutrition
workshops and Southeast Asian Coalition (SEAC) dance
and exercise activities. Annually serving 2,000 people of all
ages, SEAC also offers English language classes, job training
and a connection to the UMass Memorial Care Mobile.

a neighborhood effort
access to healthy food
UMass Memorial Health Care supports a range of efforts
in distressed, food-insecure neighborhoods to improve
nutrition among vulnerable populations and increase
access to healthy food.
Plumley Village Community Garden
Established at a public housing site in May 2011, the
garden is planted annually and maintained by
approximately 24 families.
Grant Square Urban Agriculture
Launched in 2010, this Bell Hill neighborhood garden is
made possible through a partnership with the Regional
Environmental Council (REC). UMass Memorial funding
employs five inner-city youths and leverages additional money
for seven more youth positions. Expanded from 10 to 20 beds
in FY13, REC’s YouthGrow garden supplies produce to its
Veggie Mobile (see map) and farmers’ markets, that are also
supported by the hospital. Funding doubles food stamp values
at Bell Hill Veggie Mobile stops.
Clinton Hospital and WHEAT Partnership
To address hunger locally, Clinton Hospital partnered
with Morrison Health Care Food Services and WHEAT
Community Services, an organization that helps people
to secure essential needs such as food, housing and
workforce assistance. WHEAT serves hot, nutritious meals
free of charge to 60 to 80 residents monthly in its café
and refers clients to the hospital for health insurance and
SNAP (food stamps) enrollment.
Worcester Food & Active Living
Policy Council (WFALPC)
UMass Memorial is a strong supporter of WFALPC,
which convenes the Community Health Improvement
Plan Healthy Eating & Active Living Work Group and the
Childhood Obesity Sub-Group targeting healthy weight
and healthy eating efforts. The group focuses on policy and
advocacy to promote healthy eating.
“ Having a vegetable garden in the back of my
house is the most wonderful experience for our
family and an excellent project for Bell Hill.”
Yanet Slovan, Worcester, MA (photo right)

Great Brook
Valley
Bell Pond
Backyard and Community
Gardens, and Worcester
Veggie Mobile Stops
Elm Park
Rt
290
Rt
9
Shrewsbury Street
Rt
190
Downtown
Rt
290
Green Island
backyard gardening
Tatnuck Square
Columbus Park
South Worcester
Quinsigamond Village
Rt
390
Rt
290
Backyard gardens are springing up in a food-insecure
Worcester neighborhood where access to fresh vegetables is
limited by lack of a supermarket and transportation. Even
the terrain presents a challenge. “Bell Hill is just that, a steep
hill that makes it difficult for residents to carry groceries
from store to home,” said Ana Rodriguez, community
liaison, UMass Memorial Community Relations. “Backyard
gardening is part of our strategy to combat obesity and
encourage healthy eating. I knocked on doors to recruit
families who agreed to water and weed the garden, and at the
end of summer, share homegrown produce with neighbors.
Immediately, six families signed up and more were on a
waiting list. Worcester Technical High School built the raised
bed gardens and the City of Worcester provided fresh soil.
Families selected what they wanted to grow.”
A barrier to backyard gardening in Bell Hill is soil
contamination— specifically lead from exterior paint on
old housing stock. While gardening is done in raised beds,
dust blown from the surrounding area, even in small yards,
can make vegetables unsafe to eat. Therefore, soil testing is
required at all home sites before gardens are established.
“This project is an ideal extension to a successful community
garden we started in nearby Grant Square Park through a
partnership with UMass Memorial and the City,” added
Amanda Debrusk, backyard garden assistant, of Regional
Environmental Council (REC), a grassroots organization
for environmental health and food justice. “By the end of
summer 2014, we will have 20 backyard gardens in Bell Hill.
REC staff and volunteers, with help from the Worcester
Carpenters Union, will build the 4' by 12' boxes, offer free
plants and be available for advice on methods and techniques.
We build relationships and community through this food
sharing effort.”
“We want to use the beds year-round by planting fall crops,
like garlic, for harvest in the spring,” said Ms. Rodriguez.
“The community gardens are amazing and have inspired
people to have one at their own home. All of the families
from our pilot program will continue to garden next year
because of the beautiful fresh produce that can be found
right in their backyard.”
Map Key: Backyard and community gardens Veggie Mobile stops
Community Benefits Report 2013 111

a positive approach
YOUTH development
HOPE Coalition Youth Worker Training Institute (YWTI)
This 15-week course is designed to enhance the knowledge,
skills and networks of front-line youth workers by increasing
their understanding of risk factors, effective planning,
program development and self-evaluation. YWTI is offered
in collaboration with Clark University and was developed
based on a needs assessment conducted among youth and
executive directors of youth-serving agencies. This educational
opportunity empowers youth workers to be more effective in
delivering services to high-risk youth. HOPE now partners
with Clark University to offer credit to youth workers who
take Institute courses.
HOPE Coalition Substance Abuse Task Force
Peer leaders of this youth-adult partnership—created to
reduce youth violence and substance abuse and promote
adolescent mental health—co-chair the Youth Substance
Abuse Prevention Task Force with the Worcester Division
of Public Health to reduce alcohol, drug and tobacco use,
which resulted in a city ordinance banning tobacco sales
from pharmacies. HOPE organizes “Kick-Butt” and lobbying
campaigns to discourage smoking.
Worcester Education Collaborative (WEC)
Working to ensure Worcester public school students are
prepared to succeed, WEC aims to reduce school suspensions
and improve educational attainment and graduation rates.
A published white paper “Not Present, Not Accounted For”
supports WEC’s holistic approach to reduce the use of out of
school suspensions. Training programs were held for parents,
students and the community.
YouthConnect (formerly YouthNet)
On average, 250 at-risk middle school youth participate daily
in YouthConnect summer recreational, educational and
cultural activities at Boys & Girls Club of Worcester, Friendly
House, Girls Inc., Worcester Youth Center, YOU, Inc., YMCA,
YWCA and the Massachusetts Society for the Prevention of
Cruelty to Children. Neighborhood programs reduce violence
and substance abuse, and include a healthy eating component.
Healthy Options for Prevention and Education (HOPE)
Coalition Art Initiative
Building on the Coalition’s 2012 Social Norms campaign and
in collaboration with the Worcester Art Museum, peer leaders
encouraged youth to express themselves positively through
art. Artwork focused on substance abuse was shared on social
media, and was displayed at the City of Worcester CHIP
report-out, the Massachusetts Organization for Addiction
Recovery annual meeting and the city’s Town Hall meeting on
underage drinking, marijuana use and prescription drugs.
Building Brighter Futures With Youth
Since 2005, UMass Memorial’s youth job initiative for high
school students provides summer and year-round employment
in many Medical Center departments. Working with the City
of Worcester, Worcester Community Action Council and
other agencies, 60 participants are selected and matched to
placements that offer valuable on-the-job experience.
250
At-risk middle school youth participate
daily in YouthConnect activities

A 20-year collaboration
worcester youth center
When a group of youths was arrested for loitering and
disturbing the peace in the early 1990s, a grassroots
effort sprang up to address violence and the lack of youth
development opportunities in Worcester. The idea? To create
a free, safe drop-in center where teens and young adults
could make lasting, positive life choices. During three years
of planning, the City Manager’s office reached out to UMass
Memorial Medical Center as a key community partner
for the financial support needed to launch a fledgling
organization. The result was the establishment of the
Worcester Youth Center (WYC) in 1994 as “not just a place
to go, but a place to go further.”
Samuel Martin, executive director, describes this 20-
year commitment as the “first aid” that was needed in its
formative years. “UMass Memorial stepped to the plate
and funded salaried staff who could lead and develop the
center, as well as create meaningful activities for youth. If
it hadn’t been for the hospital, we wouldn’t have survived.”
Expanding services with a larger building in 2008, WYC is,
today, more education- and job-focused. “While we’re still
“ UMass Memorial stepped to the plate and funded
salaried staff who could lead and develop the center,
as well as create meaningful activities for youth. ”
... C.H.I.P. provides an approach that is structured
–Samuel Martin, executive director
and specific enough to guide decisions and flexible
enough to respond to new health challenges.”
committed to the original idea as a place for adolescents
who have nowhere else to go, we have moved toward more
organized programming,” said Mr. Martin. “Our high school
equivalency program is a failsafe for those who are displaced
from school—who were pushed out, dropped out, or whose
life just got in the way.” Additional emphasis is being placed
on youth community leadership, individualized mental
health services, violence prevention and work-based training.
As WYC and UMass Memorial celebrated the culmination
of a two-decade partnership, Mr. Martin reflected, “In the
short term, we look to maintain a strong correlation between
our programs and what society demands of young people.
When we started, it was easier for someone with a high school
diploma to land a job. Those days are gone and technology
is driving this change. Youth are good consumers of
technology, but we also want them to have the curiosity and
drive to, some day, fully participate in this new economy.
We want to serve youth and meet their present and future
needs. In the long term, the sky is the limit.”
YOUTH EMPLOYMENT
City of Worcester Youth Office
The office coordinates employment and pre-employment
training for youth ages 12 to 21. Working with the state-funded
YouthWorks summer program, more than 700
meaningful job placements for young people were created at
nonprofits and local businesses in 2013. UMass Memorial
leadership has helped Worcester youth job programs to
collectively secure annual funding.
Health Career Expo
UMass Memorial, the University of Massachusetts Medical
School, Worcester Public Schools, Boys & Girls Club and
the City of Worcester Youth Opportunities Office hosted
this annual event at The College of the Holy Cross. About
60 providers from a range of health professions and 14 area
colleges participated. Nearly 600 high school students took
part in this program that exposes students to careers in the
health care industry.
Photo (above): Eric W. Dickson, MD, UMass Memorial president
and CEO, congratulates executive director Samuel Martin on
Worcester Youth Center’s 20th anniversary.

Great Brook
Valley
Bell Pond
Care Mobile Stops
and Affiliated Schools
Elm Park
Rt
290
Rt
9
Shrewsbury Street
Rt
190
Rt
290
Downtown
Green Island
Worcester
Tatnuck Square
Columbus Park
South Worcester
Quinsigamond Village
Rt
390
Rt
290
improving access
Wellness Education at Belmont Street Community School
UMass Memorial holds monthly Parent/Teacher
Organization meetings at this Worcester elementary
school in the Bell Hill neighborhood to connect parents to
needed health and prevention resources. Experts from the
clinical system speak about nutrition, oral health, asthma,
behavioral disorders and other chronic conditions.
Central Massachusetts Oral Health Initiative
To address the high rate of tooth decay among children
due to the lack of fluoride in the Worcester water supply,
UMass Memorial coordinates the region’s oral health
initiative. Working to ensure the provision of preventive
dental services in public and charter schools, the
collaboration of a broad range of community stakeholders
includes Edward M. Kennedy Community Health Center,
Family Health Center of Worcester, Quinsigamond
Community College, Massachusetts Department of Public
Health, Massachusetts College of Pharmacy and Worcester
Public Schools.
Plumley Village Health Services (PVHS)
A satellite family clinic serving the needs of low-income
public housing residents, PVHS is the medical home of
1,400 primarily Latino families. Approximately 80 percent
of its 3,000 patients are covered by Medicaid. The clinic
manages an on-site Wellness Center offering health and
community engagement programs, including a garden
initiative, fitness and cooking classes. A community health
worker conducts home visits to identify and address
complex social factors that adversely affect patient health.
PVHS is an integral part of the UMass Memorial pediatric
asthma home visiting pilot program (see page 5).
Worcester Free Clinics Coalition
This coalition comprised of providers, focuses on
opportunities to better serve vulnerable populations
that are attracted to Worcester’s network of free clinics.
In collaboration with students from the University of
Massachusetts Medical School, the group conducted an
assessment to increase understanding of health care needs.
An electronic medical record option was explored to improve
communication among clinics. Sara Connor, UMass
Memorial Care Mobile manager, co-leads the coalition.
Map Key: Care Mobile stops Worcester Public Schools
Photo: James Broadhurst, MD, medical director of the UMass
Memorial Ronald McDonald Care Mobile, examines a young patient.

UMass memorial ronald mcdonald care mobile
schools (see map). Children receive screenings, fluoride
treatments and sealants, and as needed, a hygienist makes
referrals to two community health centers for follow-up.
“Severely decayed teeth can be the source of other illness,”
added Ms. Connor. “Dental pain negatively affects children’s
ability to learn, but they might not know to tell someone
about a toothache. We can cover them with antibiotics
until they get to a dental clinic, keeping them out of the
emergency room, and ideally helping them to participate
more fully in the classroom.”
There is more to health care than how it is traditionally
defined. An experienced outreach worker connects families
to resources that include, but are not limited to food,
housing or domestic violence prevention. “The Care Mobile
is an open door that helps bridge barriers to health care,”
continued Ms. Connor. “When families connect to our very
caring health care professionals in a welcoming space, good
health becomes a group effort. I am proud of that.”
CARE MOBILE services and community outreach
Through partnerships with local organizations, the Care
Mobile educates the community about the importance of
primary care at these and other community events:
Lutheran Social Services
National Night Out
Plumley Village Health Fair
Southeast Asian Coalition Festival
Star of Jacob Evangelical Church
UHAI African Women’s Health Fair
Developing
A brand new UMass Memorial Ronald McDonald Care
Mobile rolled out in July 2012. It brings consistent,
dependable medical and dental care to low-income
Worcester neighborhoods with its bright and expanded
user-friendly spaces and state-of-the-art equipment. “Think
of it as a medical and dental office on wheels, instead of a
truck, and one gets a sense of how complicated it is to run
a mobile clinic,” said Sara Connor, FNP, manager. “We also
drive to 10 community outreach events. It’s a working clinic
wherever it goes. While checking BMI and blood pressures
at community health fairs, the staff is constantly evaluating
people ‘on the fly’ for medical or dental needs, and if they
require immediate attention, we can provide it.”
Now in its thirteenth year, the program focuses on children
and their families. Outreach to the Worcester Public
Schools Adult Learning Center and English language
classes at Lutheran Social Services makes parents aware
of the schedule and how to get started in the preventive
care system. The Care Mobile meets people in their
neighborhood. Its dental program is affiliated with 22
“ The Care Mobile is an open door that helps bridge
barriers to health care. ”
–Sara Connor, care mobile manager and family nurse practitioner
The Care Mobile serves medically underserved populations
who cannot access or are not connected to care, thereby
minimizing unnecessary visits to emergency rooms and
increasing the likelihood of establishing a medical home.
3,010 patients
22 Worcester Public and Charter Schools
10 city neighborhoods
4,389 sealants
4,217 fluoride varnish applications
1,451 pediatric oral health screenings
10 community outreach events
Insurance enrollment assistance
Referral to other social support resources
Vietnamese Elder Day Care
YWCA Young Parents Program
Worcester Latino Festival
Worcester Public Schools Parent and Guardian Expo

access to health care

A COMMON LANGUAGE
Elder Semi-Urgent Care
As baby boomers reach age 65, seniors account for the
fastest growing sector of the general population and,
according to the 2010 census, represent 11.6 percent of
Worcester residents. This statistic demands consideration,
as seniors often encounter more barriers to accessing
medical and dental care due to physical immobility and lack
of transportation, particularly in low-income areas.
Through a relationship with the Worcester Housing
Authority (WHA), UMass Memorial conducts on-site urgent
medical evaluations at seven public housing sites and two
Latino-centric nonprofit community clinics—Centro Las
Americas, a social services provider, and Hector Reyes
House, a men’s substance abuse recovery home. Matilde
Castiel, MD, hospital internist and executive director
of Reyes House, serves more than 400 ethnically diverse
residents and sees about 60 patients every week.
While largely focused on triage for acute medical
conditions, such as possible stroke or heart attack, Dr.
Castiel doesn’t turn anyone away. “Patients who see me for
urgent care often present with chronic problems that need
attention and management as well: diabetes, hypertension,
pulmonary disease and asthma, hepatitis, substance abuse
“ UMass Memorial subsidizes this important
service because these people would not go
to a doctor otherwise. ”
xxxxxxx
Meals were served through
–Matilde Castiel, MD, hospital internist
Wheels to Water
On-Site Urgent Care
Belmont Tower Apartments
Centro Las Americas
Curran Terrace
Elm Park Tower Apartments
Hector Reyes House
Lafayette Place
Lincoln Park Tower Apartments
Pleasant Tower Apartments
Webster Square Towers
Wellington Apartments
and mental health issues. It’s a matter of noticing what else
might be going on.
“UMass Memorial subsidizes this important service because
these people would not go to a doctor otherwise. Lack of
transportation is a major obstacle for my patients, but the
inability to understand and be understood in a medical
setting also makes them feel uncomfortable. My assistant
and I are Hispanic and we speak Spanish to most of our
patients. By offering services where they live, particularly in
large housing developments, we can lower costs as well as
provide the care they really need.”
Ultimately, going to the emergency room isn’t always
appropriate or the best option for a patient’s health, and
education can make a difference in lowering the frequency
of such visits for elders and vulnerable populations.
The hospital’s partnership with WHA is very effective in
getting the word out by advertising services through its
programs, and by offering a video and a printed package of
information when people move into housing. Together with
WHA, we serve some of Worcester’s most vulnerable people
in a language they understand.
Access to Care/Wellness Domain Work Group
Promoting access to medical and oral health care and
reducing the prevalence of chronic disease, emergency room
utilization, infant mortality, preventable hospitalizations
and readmissions emerged as key areas of focus in the
Greater Worcester Community Health Improvement Plan
(CHIP, see page 3) Working on these priorities, UMass
Memorial convenes the CHIP Access to Care/ Wellness
Domain Work Group.

A HEALTHY COMMUNITY
a focus on public health
Wing Memorial Hospital
To improve access to care as well as monitor and educate
seniors who have or are at risk for diabetes and hypertension,
Wing Memorial provides monthly screening clinics at the
Belchertown Senior Center. The staff additionally offers
educational programs on nutrition and healthy eating for
people with diabetes at the Monson and Palmer Senior Centers.
A total of 265 elderly patients were served by these programs.
Marlborough Hospital
Promoting heart health among seniors, Marlborough Hospital
presented “Know Your Heart” sessions at the New Horizons
Retirement Community. Including topics such as exercise
for seniors, preventive medicine, heart tests and treatments,
the programs were attended by 60 people. The hospital also
conducted cholesterol and glucose screenings at a senior
health fair visited by approximately 500 people.
An “As We Age” Health Expo, presented by HealthAlliance
and attended by 150 people, was held at Montachusett Home
Care in Leominster, a not-for-profit agency established to
assist elders and disabled persons to remain safely in their own
homes and prevent unnecessary nursing home placement.
Youth Mental Health
Peer leaders from the Healthy Options for Prevention and
Education (HOPE) Coalition developed a model to include
mental health counselors with staff at the Boys & Girls
Club, Worcester Youth Center and YouthConnect. Targeting
the stigma and barriers associated with mental health
services, the program served 800 youth through one-on-one
counseling, therapeutic groups and crisis intervention
delivered by the Massachusetts Society for the Prevention of
Cruelty to Children.
Insurance & SNAP (Food Stamps) Enrollment Assistance
While health insurance is required for Massachusetts residents,
approximately four percent remain uninsured resulting
in a significant need for continued insurance enrollment
assistance. UMass Memorial Health Care and its affiliates—
HealthAlliance, Clinton, Marlborough and Wing Memorial—
helped 13,547 patients and members of the general public to
apply for health insurance, SNAP (food stamps) and Women,
Infants & Children (WIC) nutrition vouchers.
The Commissioner of Public Health
UMass Memorial’s close partnership with the City of
Worcester Division of Public Health creates a framework
for preventive community-based programs for vulnerable
groups, promoting public policy and the greatest collective
impact through collaborative programs and initiatives. As
part of a mission to promote health and address disparities
among underserved populations, the hospital financially
supports the public health commissioner position.
13,547
People assisted with insurance and SNAP (food stamps)
enrollment systemwide

reducing health care disparities
hepatitis screening and treatment
Hepatitis C (HCV) is transmitted through blood-to-blood
encounters such as sharing needles, transfusions
and sexual contact. The virus leads to cirrhosis and
hepatic carcinoma, and is the number one reason for liver
transplant. According to the Centers for Disease Control,
it infects more than 3.2 million Americans and about
100,000 Massachusetts residents live with chronic HCV.
Three percent move toward end stage liver disease each
year. For patients co-infected with HIV, hepatitis B, or
who abuse alcohol or drugs, end stage disease arrives more
quickly and requires more complex treatment.
“It is a dormant epidemic and people should be tested,”
said UMass Memorial infectious disease specialist Mireya
Wessolossky, MD. “Most won’t know they have it until it
may be too late. Two populations are at increased risk:
users of cocaine or other substances; and patients who
were transfused prior to 1992. Men engaging in sex with
other men and baby boomers are also at risk.”
At Hector Reyes House, a men’s residential substance
abuse treatment program for Latinos, many residents
have a history of drug use and are HCV positive. “Initially,
patients were referred from Reyes House to my hospital
clinic,” continued Dr. Wessolossky. “But after teaching
house residents about infectious diseases I thought, why
not hold monthly office hours, too? By going where the
need is, I have significantly decreased the number of no-shows,
good cultural match.”
Dr. Wessolossky evaluates patients, hears their stories,
orders tests and looks for additional risk factors. HCV
medication is more than 90 percent effective but costly,
making longer-term lifestyle changes necessary for
recovery. Therefore, patients must be truly ready to
undergo treatment. They learn about treatment goals,
commit to a full course of medication, and return for
ongoing post-treatment counseling because they are not
immune to new infection. “As a community, we want
to eradicate diseases that are costly not only from a
financial perspective, but also the personal toll it takes
on individuals,” said Dr. Wessolossky. “I see all patients
as human beings first. If I can provide care in a more
convenient setting, that positive feeling is going to
continue to resonate with them emotionally.”
“ As a community, we want to eradicate diseases that are
costly not only from a financial perspective, but also the
... C.H.I.P. provides personal an toll approach it takes that on individuals. is structured
”
and specific enough to guide decisions and flexible
enough to respond to new health challenges.”
– infectious disease specialist Mireya Wessolossky, MD
and because my native language is Spanish, it’s a
Who should be tested for Hepatitis C?
(From the Center for Disease Control)
• Baby boomers (born 1945 to 1965)
• Current and past injection drug users
• Those treated for blood clotting problems before 1987
• Blood transfusion or organ transplant patients before 1992
• Long-term dialysis patients
• Those with abnormal liver tests or liver disease
• Health care and public safety workers
• Those infected with HIV
8,744
The average number of new HCV infections
each year since 2002
(From the Massachusetts Department of Public Health)

our system supports a variety of community and neighborhood initiatives
Access to Care
• Oral health and primary care at community
health centers
• UMass Memorial Ronald McDonald
Care Mobile
• YMCA Men’s Health & Families Program
• Elder medical services at Worcester Housing
Authority and Centro Las Americas
• Southeast Asian Coalition
• Health insurance enrollment
• Plumley Village Health Services
• Hector Reyes House
• Akwaaba African Free Clinic
• Outreach education programs
• UHAI African Women Organization
Bell Hill Healthy Community Outreach and
Revitalization
• Crime Watch and Bell Hill Task Force meetings
• Family health and support services at two
schools
• Increased availability of fresh produce
Chronic Disease
• Pediatric Asthma Home Visiting Program
Coalition-Building Efforts
• Central Massachusetts Oral Health Initiative
• Common Pathways
• North County Minority Collaboration for
Community Development & Health Equity
Literacy
• Reach Out & Read
• Health literacy outreach
• YWCA Teen Parent Program
• Worcester Education Collaborative
Obesity and Healthy Weight
• Wheels to Water
• Belmont Street Community School
exercise programs
• Plumley Village Path to Wellness
• Act FRESH campaign
• Community gardens
• Regional Environmental Council mini-farmers
market and Veggie Mobile
• Food pantries and SNAP food stamp
enrollment
• Community nutrition, education, outreach
and screenings
Programs Enhancing Community Health
• Injury prevention programs
• City of Worcester Commissioner of
Public Health
• Public health nursing program, Belchertown
• Palmer Senior Center nurse
• Smoking cessation education programs
Youth At Risk
• Building Brighter Futures With Youth
• HOPE Coalition
• Workforce and mentoring programs
• Health career scholarship fund
• YouthNet violence prevention
• Worcester Youth Center
• Career Expo at the Boys & Girls Club
• City of Worcester Youth Opportunities Office
• Mental health services at community sites
• Worcester Youth Training Institute
Other Contributions
• American Heart Association
• Community-based support groups
• Central Massachusetts Walk for Homelessness
• Advocacy for health care access

UMass Memorial Health Care System
Wing Memorial Hospital Marlborough Hospital
Licensed Beds
System Total
1,083
Our Community Benefits Partners
• Advocacy groups
• Medically underserved populations
• Neighborhood groups
• State and local government officials
• State and local health departments
• The City of Worcester
• Community health centers
• Schools and community-based organizations
Hospital
Admissions
(including newborns)
System Total
57,581
Emergency
Room
Visits
System Total
260,716
★ ★
★
★ ★
★
Outpatient
Visits
System Total
1,052,673
Clinton Hospital
UMass Memorial
Medical Center
★
Plumley Village
Health Services
Barre Family Health Center
Care Mobile
7,612 Patient Visits
Life Flight
472 Flights
Active
Medical Staff
System Total
1,628
ABOUT OUR SYSTEM
Photo Credits
Unless otherwise noted, all photos were provided by UMass Memorial Community
Benefits; Kim Reckert, photographer.
• Front Cover: View of Belmont Hill, Worcester, MA, Dany Pelletier, photographer
• Page 2: View of downtown Worcester, Dany Pelletier, photographer
• Page 4, 5: In-Home Asthma Education, Dany Pelletier, photographer
• Page 6: Michael Hirsh, MD, Courtesy of UMass Medical School
• Page 8: Cooking Matters classes, Courtesy of Alicia McCabe, Massachusetts
State Director | No Kid Hungry®
• Page 9: Cooking Matters class, Dany Pelletier, photographer
• Page 11: Backyard Gardens, Dany Pelletier, photographer
• Page 12: Youthreach Program artists. Courtesy of the Worcester Youth Center
• Page 13: Worcester Youth Center, Dany Pelletier, photographer
• Page 14: Care Mobile, UMass Memorial Health Care
• Page 16: Robert Kneschke, photographer, Dreamstime.com
• Page 17: Dr. Castiel, Tammy Woodard, photographer
• Page 18: Care Mobile, Courtesy of UMass Memorial Health Care
• Page 19: Dr. Wessolossky, Courtesy of UMass Memorial Health Care
• Back Cover: Inside the Care Mobile, Courtesy of UMass Memorial Health Care
• Largest not-for-profit health care system
in Central New England
• Largest provider to the uninsured outside Boston
• Only Safety Net Provider in Central New England
and the 4th largest in the Commonwealth
• Supports a dedicated financial benefits program that
connects the medically underserved and uninsured
populations to health insurance and other services
Photo (left): Kids cool off at Christoforo Colombo Park in Worcester, part of the Wheels to Water summer program.

UMass Memorial Health Care is a not-for-profit health care system in
Central New England with nearly 2,000 physicians and more than 13,000 employees.
Our member hospitals, all fully accredited, are:
• Clinton Hospital • HealthAlliance Hospital • Marlborough Hospital
• UMass Memorial Medical Center • Wing Memorial Hospital and Medical Centers
UMassMemorial
Health Care
UMass Memorial Health Care, Biotech One, 365 Plantation Street, Worcester, MA 01605
Tel: 508-334-1000 www.umassmemorial.org

2013 UMass Memorial Community Benefits Report

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