Friday, November 23, 2018

Five Forgetful Hospitals

Five Forgetful Hospitals in West Los Angeles. Major players, big names. If we don't intervene, they will forget, as before, to include healthy transportation in their program of community benefits. The process, required by the IRS, is called CHNA: Community Health Needs Assessment: It serves to confirm the non-profit status of a hospital. Currently they are working on a plan for the period 2019 - 2021.

While many doctors and all public health experts do know a whole lot about the health benefits of active modes (walking, cycling), the five forgetful hospitals are on the path to overlook the disease burden in their communities that could be lifted if people had more opportunities, and more encouragement, to leave the car at home. Prevention. Population Health. Cheap and effective.

Whence that forgetfulness? Why is it so difficult to implement public health knowledge in our local community? The stereotype that everybody drives in LA is overwhelming. The roads so crowded, the parking lots so full, the cyclists so few. Pedestrians? - Send the police to arrest them. We have been so firmly socialized into vehicular living that a special mental effort is required to recognize automobility as a health condition. But reduce driving we must, for our own well-being, and for that of our planet.

Hospitals are only in the business of curing bodies broken by too little exercise, bodies shattered by vehicles which move too fast? Prevention is none of their business? Not according to the IRS. Prevention is right up the CHNA alley. Even better, the IRS allows expenses for lobbying (like lobbying a council member for more and safer bicycle infrastructure!) Also allowed are expenses for community building activities like environmental improvements, community health improvement advocacy, leadership development and training for community members, coalition building, etc. IRS (schedule H, part II)



If that sounds like an opportunity, here are the CHNAs that currently face updating: Cedars Sinai (pdf), UCLA Ronald Reagan (pdf), UCLA Medical Center, Santa Monica (pdf), Kaiser Permanente West Los Angeles Medical Center, (pdf) (See also KP Data), Providence Saint Johns (Santa Monica) (pdf)

The CHNA process takes into account input from persons who represent the broad interests of the community served by the hospital, including those with special knowledge of , or expertise in, public health, or expertise relevant to the health needs of the community. There is a great deal of demand for healthy transportation in the Westside. Active transportation is an emerging issue that will be overlooked if stakeholders do not share their local knowledge. We need much much much more than the famous Westside Walkers who meet (drive there, of course) in a shopping mall to walk (laughter). What about a concerted effort, with local partners, aiming to offer our neighborhoods a safe way to leave the car at home and walk or ride a bike? Our hospitals must find a way to support advocates who demand healthy transport options for our neighborhoods. Doctors will be able to prescribe safe cycling training, hospital facilities will lead the way by conducting a bicycle master-plan for their premises and associated medical practices. Hospitals are quick to demand that streets must be suitable for their ambulances, now we want to hear from them that streets also need to be suitable for those neighbors who should move about without a car. Now is the time to take apart the poisonous notion that everybody drives in LA.

The current CHNA process for five forgetful hospitals is conducted by Biel Consulting. So far no public meetings have been scheduled. Which is a not a good sign. Through public meetings the hospital can build essential partnerships with community stakeholders. Failing a public meeting, the next best way to have your voice heard is to make written comments on the previous CHNA. Pick your favorite hospital and send emails to CommunityBenefit@cshs.org, smunoz@mednet.ucla.edu, CHNA-communications@kp.org, Ronald.Sorensen@providence.org. These comments count as public input and offer a privileged way to participate in the process. Now. Or wait three years for the long overdue dialogue of transportation and health.

No comments: