Community Health Needs Assessment Community Service Plan ...

Community Health Needs Assessment

Community Service Plan

2019-20212020 Update

2020 Update to 2019-2021 Community Service Plan 1

2019-2021 Community Service Plan 2020 Update

In 2020, Kaleida Health worked diligently to achieve its goals for community health improvement activities as identified in its 2019-2021 Community Health Needs Assessment-Community Service Plan. The interventions were targeted for Erie County and Niagara County, the primary service area of Kaleida Health hospitals including Buffalo General Medical Center/Gates Vascular Institute, John R. Oishei Children’s Hospital and Millard Fillmore Suburban Hospital, located in Erie County and DeGraff Medical Park (previously named DeGraff Memorial Hospital) located in Niagara County. This 2020 Update outlines Kaleida Health’s progress in meeting its intervention goals. In 2019, Kaleida Health participated in collaborative work groups led by the Erie County Department of Health and the Niagara County Department of Health and identified health issues of concern in each respective county. Each county work group conducted community needs assessments based on health data, community surveys and focus groups and identified the NYS Prevention Agenda Priority Areas to be addressed in each county from 2019 through 2021. The needs of the underserved were further identified as a priority. Kaleida Health adopted these priorities for its 2019-2021 Community Service Plan as follows:

Erie County and Kaleida Health Health Issues of Concern NYS Prevention Agenda Priority Area High rates of cardiovascular disease and high incidence of risk factors including high blood pressure, diabetes, obesity and smoking

Prevent Chronic Diseases

Increasing rise of opioid addiction and fatal overdoses

Promote Well-Being and Prevent Mental and Substance Use Disorders

Poor outcomes in maternal and infant health, particularly among underserved populations

Promote Healthy Women, Infants and Children

Niagara County and Kaleida Health Health Issues of Concern NYS Prevention Agenda Priority Area High rates of cardiovascular disease and high incidence of risk factors including high blood pressure, diabetes, obesity and smoking

Prevent Chronic Diseases

Increasing rise of opioid addiction and fatal overdoses

Promote Well-Being and Prevent Mental and Substance Use Disorders

Additionally, a Kaleida Health CHNA-CSP Steering Committee and work groups comprised of multidisciplinary staff and physicians met from May through October 2019 to discuss the selected county Priority Areas, community need and to determine the interventions that would best meet those


needs. The Kaleida Health work groups selected focus areas and interventions including disparities for its 2019-2021 Community Service Plan, as aligned with the county-focused Priority Areas. Throughout 2020, Kaleida Health made progress implementing the interventions outlined in its Community Service Plan and as aligned with the NYS Prevention Agenda, while also addressing the needs of the underserved. However, the COVID-19 pandemic presented some implementation challenges. During 2020, Kaleida Health hospitals experienced an influx of patients affected by the coronavirus in both inpatient and outpatient care. It was critical for employees to have appropriate PPE and be provided the most up-to-date information related to the care and treatment of the disease. All employee and corporate efforts to educate, screen and test employees, patients and the community was a top priority and continues to be so in 2021. Outpatient care and elective surgeries at Kaleida Health hospitals were cut back due to NYS mandates, and Kaleida Health outpatient clinics enlisted Telehealth programs to help meet patient care needs. Throughout the pandemic, Kaleida Health continued to implement the community interventions that were not hampered by the pandemic; and continues to work to re-assess the impact of COVID-19 on other interventions and in the advancement of its NYS Prevention Agenda Priority Areas. Intervention progress in 2020 and any resulting impacts due to COVID-19 are outlined below. Prevent Chronic Disease Diabetes and Pre-Diabetes Nutrition Education and Mobile Food Market at Buffalo General Medical Center (BGMC) – Erie County Nutrition Education Sessions In 2019, planning began on Nutrition Education Sessions as presented by a Kaleida Health registered dietician to underserved individuals at high risk for diabetes and pre-diabetes at local churches, community centers and employers. The goal of the program is to increase skills and knowledge for healthy eating among attendees leading to decreased high rates of chronic disease among high-risk populations. In 2019, nutrition education sessions were provided at the US Army Corps. of Engineers, William Emslie YMCA and Richmond Summer Senior Center. Due to COVID-19 restrictions and in consideration of the safety of participants, these nutrition education sessions for community groups as led by a Kaleida Health dietician were put on hold for 2020 and continue to be on hold through 2021. Mobile Food Market Planned in 2019, and implemented in July 2020 through October 2020, Buffalo General Medical Center hosted Alex Wright’s African Heritage Mobile Food Co-op to sell healthy fruits and vegetables every first and third Thursday, 2:30 p.m. to 7 p.m. at an outdoor location next to its Gates Vascular Institute. The mobile food market serves the hospital campus, the Buffalo Niagara Medical Campus and the adjacent low income Fruit Belt neighborhood. Nutritional brochures are provided at the market and periodically, a Kaleida Health dietician is available for on-site consult. To better serve low-income individuals, every third Thursday during COVID was designated as “pay as you can.” The market was supposed to kick-off in May 2020 but was delayed until July 2020 due to COVID-19. The Mobile Food Co-op will resume in spring/summer 2021.


Worksite Nutrition and Physical Activity Programs – Erie County Nutrition Tune Up Days for Employees Nutrition Tune Up Days are designated days at Kaleida Health facilities for employees to sign up to receive a 20 minute one-on-one nutrition education session with a registered dietician. The program is designed to increase employee skills and knowledge for healthy eating to improve health and wellness among Kaleida Health employees with the goal to decrease high rates of chronic disease. Nutrition Tune-Up Days were held in 2019, one at Buffalo General Medical Center (BGMC) and one at John R. Oishei Children’s Hospital. One was also held in January 2020 at Kaleida Health’s administrative offices at Larkin. Additional days were scheduled for 2020 but were cancelled due to COVID-19 restrictions. The Nutrition Tune Up Days are being evaluated for possible scheduling in late 2021. In the absence of the Nutrition Tune Up Days due to COVID-19, approximately 10 employees per month visit a Kaleida Health dietician at various times at BGMC for nutrition/wellness concerns and receive nutrition education and print materials. BNMC Wellness Activities for Campus Employees In 2019, Buffalo General Medical Center and John R. Oishei Children’s Hospital in collaboration with the Buffalo Niagara Medical Campus (BNMC) promoted employee/community participation in campus wellness events including Walks on Wednesday, Group Bike Ride, Zumba, Yoga and Market in the Park, among others. In 2020, BNMC Wellness Activities for Campus Employees, including Kaleida Health, were put on hold in 2020 and through 2021 due to COVID-19 restrictions. Farm to Hospital Program on Buffalo Niagara Medical Campus for Employees, Patients and Visitors Planning for the Kaleida Health Farm to Hospital program began in 2017 in partnership with the Buffalo Niagara Medical Campus (BNMC). The program provides an opportunity to work together with other hospitals and organizations of the BNMC to leverage available resources for the benefit of all campus members including employees, patients and visitors. The goal is to continue to provide the Farm to Hospital program and explore new ways to promote health and wellness in the community through innovation and partnerships to address chronic disease risk factors and to improve population health among Western New York residents. In 2020, a partnership between Kaleida Health and its food vendor, Metz Culinary Management, and the BNMC was initiated to help bring more locally grown and sourced produce, meats and other menu items to the cafeterias at Buffalo General Medical Center, John R. Oishei Children’s Hospital, and HighPointe on Michigan, all located on the BNMC. The BNMC Farm to Hospital team has been providing Kaleida Health employees, patients and visitors with information about healthy nutrition and featuring local produce and meats, as well as introducing the amazing farmers behind the products. The Metz chefs and general managers also visited local farms to learn new agricultural methods and sustainable practices. In 2018, the BNMC was one of 44 organizations nationwide and one of just four organizations in New York State to receive a grant from the United States Department of Agriculture Local Food Promotion Program to help create a culture of healthy food practices and increase local food


procurement. “BNMC Fresh: Farm to Hospital Implementation” works to prioritize local agriculture within hospitals and enables farms to access new markets such as healthcare institutions. Through the Metz Farm to Hospital partnership, Kaleida Health provides emails via Campus E-News to employees of participating facilities, promoting facts on the benefits of local fruit and vegetables, as they are fresher and safe than many store-bought options. A specific fruit or vegetable and a local farm is a feature of each promotion. Cardiovascular Screening and Risk Factor Education Program in OB/GYN Centers – Erie County Since 2014, Kaleida Health successfully implemented a cardiovascular screening and risk factor education program targeting primarily at risk, underserved females in the OB/GYN Centers of Oishei Children’s Hospital leading to improved rates of cardiovascular disease in the community. Participating clinics include Kensington OB/GYN and Niagara Street OB/GYN. The program is offered to all patients presenting for their annual OB/GYN assessment. The program’s strength is that it targets a low income, underserved and high-risk female population and provides needed cardiovascular screening and education on the preventive risk factors for heart disease. The program also facilitates primary care referrals for patients who may only see their OB/GYN provider once a year and do not have a primary care provider. The OB/GYN Centers have high rates of patients insured through Medicaid and most reside in the city of Buffalo, a city with a 30.9% poverty rate and ranked the fourth poorest city in the nation by the 2018 American Community Survey (US Census). The Niagara Street OB/GYN Center is located on the west side of Buffalo with a high Hispanic and refugee population and the Kensington OB/GYN Center is located on the east side of Buffalo with a high black/African American population. Another significant strength of the program is the role of the OB/GYN providers and their commitment to provide the cardiovascular screening, education and referrals. In 2019, the OB/GYN providers and clinic staff in collaboration with primary care reviewed the existing program and made some changes to better meet the needs of providers and patients. The patient self-assessment was revised and EMR was modified to offer only an “at risk” option since the providers felt that all of their patients with few exceptions were at risk. Patients also receive cardiovascular and risk factor education and advisement with primary care provider referrals as needed. 2020 was a transition year for the new EMR option and also presented a challenge due to COVID-19 restrictions. 2020 participation data indicates the following for the program at Kensington OB/GYN and Niagara Street OB/GYN: 1/3/20 – 12/29/20: 566 total participating patients *1/3/20 – 3/24/20: 19 “high risk” patients with 19 receiving CVD counseling/education *1/3/20 – 3/24/20: 63 “no risk” patients with 56 receiving CVD counseling/education **1/3/20 – 12/29/20: 484 “at risk” patients with 479 receiving CVD counseling/education *Due to COVID-19 restrictions, no patients participated in the program from 3/25/20 – 6/9/20. Patients were not being seen in-person in the OB/GYN Centers during this time period. Many appointments were re-scheduled for later in the year or conducted by providers through Telehealth. **EMR change to stratify patients as “at risk only” began on 6/10/20.


Health Literacy Task Force with Erie County Department of Health – Erie County The Health Literacy Task Force is in the development phase as a collaborative initiative of the Erie County Department of Health to include representatives from Kaleida Health, Catholic Health System and other organizations. The task force will work to improve health education materials for those with limited language and literacy skills in Erie County to revise materials to be more patient/user friendly. Due to the impact of COVID-19 on the Erie County Department of Health and participating hospitals, this initiative had been put on hold in 2020 and most likely throughout 2021. The program will be re-evaluated for future implementation. Chronic Disease and Risk Factor Education Programs – Erie County and Niagara County Healthy U Due to COVID-19 restrictions and the need for community safety from the virus, in-person Healthy U risk factor education and screening events were not held in 2020. As the initial pandemic surge subsided in summer 2020, Kaleida Health turned to virtual options. During 2020, 4,525 individuals participated in the following virtual Healthy U programs via Facebook: 8/20/20 – Inflammatory Bowel Disease – 885 viewings 9/16/20 – Childhood Obesity – 2,169 viewings 10/15/20 - Flu Season and COVID-19 – 1,985 viewings 11/20/20 - Managing Type 2 Diabetes – 1,386 viewings Other virtual health and education programs emerged including: Medical Minute One-minute videos on health related topics that air every Monday on WIVB-TV, Channel 4 and on Kaleida Health social media channels. The 52 videos were held weekly from January 6, 2020 – December 25, 2020 reaching 15,746 individuals. A wide variety of topics were featured and include among others: Lung Cancer, Cervical Cancer, Colorectal Cancer, Breast Cancer, Lead Exposure, Stroke, flu shots, Cardiac-a fib, Opioids, Summer Safety and COVID 19 related topics including Safe to Come to the ED and Pediatric Telehealth. Medically Speaking Kaleida Health’s Medically Speaking interview series features guest speaker video interviews on a wide range of health and healthcare topics; and are aired on Facebook and featured on the Kaleida Health website at www.kaleidahealth.org/medically-speaking. In 2020, the Medically Speaking interview series included 53 videos with a total reach of 294,011, averaging 5,547 individuals per video. Also in 2020, Kaleida Health’s Medically Speaking video series launched a special series on the fight against coronavirus, featuring interviews with Kaleida Health experts discussing the latest information about the COVID-19 pandemic. While virtual, this chronic disease education program went well over its goal by reaching over 314,282 individuals through Healthy U, Medical Minute and Medically Speaking virtual presentations. Increasing


chronic disease and risk factor education programs for the public will lead to improved rates of cardiovascular disease, diabetes and other chronic diseases in Erie County.

Health Education for Children through DeGraff Medical Park (previously named DeGraff Memorial Hospital) – Niagara County Through Teddy Bear Clinics in Schools, DeGraff clinical staff provide health education to children ages 3-8 years in local schools. Children visit four health education stations during the one-hour program. Take home educational materials are provided to the participating students. Stations include:

• Hand Hygiene – proper handwashing techniques and information about germs • Triage – bandaging of a bear will be demonstrated and information about care in an ED or other

clinical setting • Nutrition – healthy food choices, fruits and vegetables. Evidence-based sources: Hirsch, Perdue,

Ambroz and Boucher (2014), Garcia, Reardon, McDonald, & Varga-Garcia (2016) • Exercise – health activities and importance of exercise as it related to chronic disease; i.e. heart

disease, diabetes. Evidence-based sources: Zulke, L.J. & Engel, M.E. (2013), Global Heart, 8(3): 235-239

In 2019, program planning took place and one Teddy Bear Clinic was held October 30, 2019 for 60 student participants at St. John’s Lutheran School. The goal was to implement one Teddy Bear Clinic in 2020 and 2021. Due to COVID-19 with schools primarily operating through hybrid or remote learning, the Teddy Bear Clinics were put on hold for 2020 and continuing into 2021. Nutrition Education/Cooking Classes at DeGraff Community Center – Niagara County The Nutrition and Healthy Cooking Education Program was planned in 2019 and developed in partnership with the Cornell Cooperative Extension to increase awareness and knowledge of the importance of healthy nutrition and its impact on chronic disease. Through this program, a nutritionist from the Cornell Cooperative Extension Niagara County will present nutrition education and healthy cooking demonstrations to community members through Eat Smart NY. The program is a statewide, USDA funded Supplemental Nutrition Assistance Education program (SNAP-ED). It helps families with limited incomes to eat more fruits and vegetables, drink fewer sweetened beverages and practice healthy lifestyles. The programs will be held at the DeGraff Community Center and will be promoted throughout the community. The goal was to provide one program in 2020 and one in 2021. Due to COVID-19 restrictions, the program was not held in 2020 and will only be provided in 2021 if restrictions on group gatherings ease. Little Free Pantry at DeGraff Medical Park (previously named DeGraff Memorial Hospital) – Niagara County In 2019, a partnership with DeGraff Medical Park (previously DeGraff Memorial Hospital) and the Little Free Panty of North Tonawanda in Niagara County was developed to provide community access to a free source of food at a self-contained pantry to promote food security among underserved populations. In December 2019, the Little Free Pantry was set up outside on location at DeGraff and became


operational. The Little Free Pantry was utilized by the local community in 2020 and continues to be operational in 2021. The Little Free Pantry is a 4’ x 4’ standing display crate that serves as a food pantry for those who are food insecure. Hospital staff monitor the pantry, keep the pantry filled and maintained and members of the community are welcome to access the food in the pantry 24/7 as needed to meet their needs. Community members may also help to stock the pantry and take-home nutrition education materials are made available. The Little Free Pantry is an international initiative that utilizes a familiar, compelling concept to pique local interest in and action against local food insecurity (http://www.littlefreepantry.org/). Promote Well-Being and Prevent Mental and Substance Use Disorders – Erie County and Niagara County New York MATTERS The Kaleida Health emergency departments of Buffalo General Medical Center/Gates Vascular Institute (BGMC/GVI) and Millard Fillmore Suburban Hospital (MFSH) in Erie County and DeGraff Medical Park (previously DeGraff Memorial Hospital) in Niagara County participate in New York MATTERS, a Hospital-Initiated Buprenorphine and Treatment Referral Program. New York MATTERS is a program developed by Joshua Lynch, MD and others in the Department of Emergency Medicine at the UB Jacobs School of Medicine and Biomedical Science. Dr. Lynch is a UBMD physician affiliated with Kaleida Health. The program’s purpose is to increase access to the Buprenorphine-based opiate use disorder treatment and to immediately refer patients to community-based treatment. An online, real-time referral program directly in the emergency department connects patients with a network of 20 Western New York treatment agencies with 120 weekly treatment appointments available to Western New York patients. From January 1, 2019 through September 30, 2019, 9 referrals to New York MATTERS were made for patients in Kaleida Health emergency departments located in Erie County including BGMC/GVI (six referrals) and MFSH (three referrals). From January 1, 2020 through December 31, 2020, 21 referrals were made to New York MATTERS at Kaleida Health emergency departments as follows: 10 – DeGraff Medical Park 8 – Buffalo General Medical Center/Gates Vascular Institute 2 – Millard Fillmore Suburban Hospital 1 – John R. Oishei Children’s Hospital As a best practice and effective opioid treatment and referral program, New York MATTERS recently expanded across New York State to include the Capital Region, Dutchess County and the Oneida Region. New York City Health & Hospitals is now in various stages of adopting similar practices. New York MATTERS also continues to partner with local EMS agencies on a “Leave Behind Naloxone at the location of any suspected overdoses (homes, businesses, etc.)


Patient Availability, Access and Linkages to Overdose Reversal Medications

Kaleida Health emergency departments at Buffalo General Medical Center/Gates Vascular Institute and Millard Fillmore Suburban Hospital in Erie County and DeGraff Medical Park (previously DeGraff Memorial Hospital) in Niagara County provide patient access to overdose reversal medication include Naloxone through the Kaleida Health Pharmacy. Kaleida Health emergency department staff are trained in dispensing of Naloxone.

In January 2019 through August 2019, 9 Naloxone Kits were provided to patients/families in Kaleida Health emergency departments through the Kaleida Health Pharmacy.

In January 2020 through December 2020, 10 Naloxone Kits were provided to patients/families in Kaleida Health emergency departments through the Kaleida Health Pharmacy. This included two at Buffalo General Medical Center/Gates Vascular Institute, two at Millard Fillmore Suburban Hospital and six at DeGraff Medical Park.

Additionally, in 2020, Kaleida Health disseminated flyers to its community partners as provided by The Erie County Department of Health and the Erie County Opiate Epidemic Task Force entitled, “Narcan Saves Lives.” The flyer was also distributed through Kaleida Health’s weekly update email and was posted on Kaleida Health social media.

Medication and Syringe Drop Boxes and Drug Take Back Days at Kaleida Health Hospitals – Erie County and Niagara County

The Medication and Syringe Drop Boxes provide for permanent, safe disposal sites for prescription drugs and syringes and participation in organized take-back days to decrease the availability of these drugs in the community.

In partnership with the Erie County Department of Health, Medication and Syringe Drop Boxes are provided at the emergency departments of Buffalo General Medical Center/Gates Vascular Institute, John R. Oishei Children’s Hospital and Millard Fillmore Suburban Hospital in Erie County and DeGraff Memorial Hospital in Niagara County. Erie County and Niagara County Sheriff’s Offices pick up and transport contents of drop boxes on a regular basis to Covanta Energy for incineration. The drop boxes continued to be on sites in the hospital emergency departments throughout 2019, 2020 and will continue throughout 2021.

Millard Fillmore Suburban Hospital and DeGraff Medical Park participated in National Prescription Drug Take Back Day on October 24, 2020. Through this national initiative, the community is encouraged to keep their homes safe by disposing of expired and unused prescriptions and over-the-counter medications. Disposing of medications in a proper way prevents people from pouring drugs down sinks or into toilets, contaminating the water system. It also removes the drugs from homes for illicit use.

Kaleida Health offers Prescription Drug Take Back Days at Millard Fillmore Suburban Hospital and DeGraff Medical Park each fall and spring. In 2020, the spring events were not held due to COVID-19 restrictions. The program resumed in the fall; and to keep everyone safe, collection sites followed local COVID-19 guidelines and regulations. Kaleida Health is waiting to hear from the DEA to determine the scheduling of an event for spring 2021.


Promote Healthy Women, Infants and Children Centering Pregnancy at Kensington OB-GYN Center – Erie County In 2019, The Kensington OB/GYN Center of John R. Oishei Children’s Hospital worked to expand its Centering Pregnancy Program through a grant and partnership with the New York State Department of Health’s First 1000 Day’s on Medicaid Centering Pregnancy Expansion Project. Centering Pregnancy is group prenatal care bringing 8-10 women who are at the same time out of exam rooms and into a comfortable group setting. Centering group prenatal care follows the recommended schedule of 10 prenatal visits, but each visit is 90 minutes to two hours long – giving women 10 times more time with their provider than women in traditional care. The same medical provider and a trained facilitator lead a group of 8-10 patients at each visit. The facilitator, along with the medical provider, provide support and education in what is pertinent to that week’s gestational age. The program aligns with the guidelines of the Centering Healthcare Institute to increase patient compliance with prenatal care, increase patient satisfaction, decrease pre-term birth rates and increase breastfeeding rates. In 2019, Centering Pregnancy was provided to three groups of Medicaid patients at the Kensington OB/GYN Center. In 2020, the program was put on hold due to COVID-19 restrictions. Program staff will review the program and its NYS grant guidelines for future continuation in light of COVID-19. The 2019-2021 goal was to provide the program to 11 groups of 8-10 Medicaid patients at the Kensington OB/GYN Center over the 3-year period. Safe Sleep Initiative – Erie County John R. Oishei Children's Hospital (OCH) and Millard Fillmore Suburban Hospital (MFSH) kicked off their Safe Sleep Initiative on October 1, 2019 to educate parents on the practices of safe sleep and also distributed the HALO® Sleep Sack to infants to reduce the incidence of SUID (Sudden Unexpected Infant Death). Sudden Unexpected Infant Deaths or SUID is accidental suffocation and strangulation in bed and sleep-related deaths of an unknown cause. Through the Safe Sleep Initiative, OCH and MFSH provided safe sleep education and the HALO® Sleep Sack® for all newborns; and at OCH for admitted pediatric patients up to one year of age. The HALO® Sleep Sacks® were provided by corporate partners: Pegula Sports + Entertainment, The Buffalo Bills and The Children’s Hospital of Buffalo Foundation. Safe sleep education materials including the NYS Department of Health brochure, “Follow the ABCs of Safe Sleep,” were included in all new mom packets. An educational video was shown to all new moms via TVR in patient rooms at OCH and MFSH via pCare TV. Hospital nurses continued to model safe sleep practices. Public awareness and education was developed in coordination with Pegula Sports + Entertainment, The Buffalo Bills and The Children’s Hospital of Buffalo Foundation. The HALO® Sleep Sack® is a wearable blanket that is intended to eliminate the likelihood that a baby can get entangled with clothing and loose bedding during sleep. It is sleeveless and can be worn over pajamas or a bodysuit to take the place of loose blankets. Bedding can accidentally cover a baby’s face and interfere with breathing. The SUID education and the distribution of HALO® Sleep Sacks® will provide a safe sleep environment for infants and help to alleviate the risk of SUID.


In 2020, all newborn caregivers were provided Safe Sleep education as follows:

• MFSH – 2,733 total live Births • OCH - 3,224 Total Live births:

In 2020, the following infants and children were also provided the Halo® Sleep Sack®:

• MFSH – 1,170 newborn swaddles distributed • OCH – 1,180 newborn swaddles distributed • OCH - 800 “small” sleep sacks distributed for patients up to age 1 (non-newborn)

Unfortunately, a swaddle/sleep sack was not provided to every baby due to COVID-19 supply chain issues.

Yomingo® Parent Education – Erie County Millard Fillmore Suburban Hospital (MFSH) offers childbirth education to pregnant women and parents with information on prenatal, perinatal, infant and child care through the use of the YoMingo® app (www.myyomingo.com) to improve maternal and infant health outcomes. MFSH offers anytime, anywhere parent education (at no charge) to new moms/parents through the online YoMingo® program. It is available on any device with an internet connection and also as a mobile app called YoMingo®. YoMingo® provides access to evidence-based information on prenatal care, labor and birth, postpartum, breastfeeding and newborn care including detailed videos, kick counter, contraction timer, person journal, feeding log, immunization log and other tools. MFSH provides YoMingo® informational brochures to physician offices to promote the availability of the program. In 2020, MFSH recorded 377 active users on YoMingo® while the goal was just 150 participants. A possible reason for the increase in expected users may be due to an overall increase in the use of virtual learning options due to the COVID-19 pandemic. The program was promoted through the distribution of 1,250 Yomingo® promotional cards to physicians/providers throughout the community. Breastfeeding Promotion and Education – Erie County Throughout 2020, John R. Oishei Children's Hospital (OCH) and Millard Fillmore Suburban Hospital (MFSH) continued their breastfeeding promotion and education activities to increase initiation and exclusive breastfeeding rates at each hospital. Given that an estimated 65% of patients at OCH are Medicaid beneficiaries, many of the women targeted for this program are low income and medically underserved. Clinical leaders, clinical education staff and clinicians are all working together to implement initiatives and achieve goals. At OCH, the average breastfeeding rates from January 1, 2020 through December 31, 2020 are as follows:

• OCH Initiation: 72% • OCH Exclusive: 41%


• OCH Total Live Births: 3,224 OCH experienced an increase in 2020 rates over 2019 rates, given that from January 1, 2019 through August 31, 2019, the initiation breastfeeding rate at OCH was 71.1% and exclusive breastfeeding rate was 39.1%. It is important to note that Medicaid insures approximately 65% of OCH patients, and the hospital’s exclusive breastfeeding goal of 38% aligns with the NYS 2024 Prevention Agenda goal of 38.2% among infants insured by Medicaid. At MFSH, the average breastfeeding rates from January 1, 2020 through December 31, 2020 are as follows:

• MFSH Initiation: 82.4% • MFSH Exclusive: 49.5% • MFSH Total Live Births: 2,733

From January 1, 2019 through August 31, 2019, the initiation breastfeeding rate at MFSH was 82.4% and the exclusive rates was 54.1%. Both OCH and MFSH have been implementing evidence-based policy and education initiatives and will continue to do so to increase breastfeeding rates in alignment with the Healthy People 2020 Goals and NYS Prevention Agenda, as follows:

• OCH and MFSH continue to provide the Breastfeeding Bill of Rights for inpatients, foster skin-to-skin contact, offer rooming in, limit access to formula and have trained lactation support and to provide formula only upon request and not provide free formula. Evidenced-based patient education materials in English and Spanish will continue to be provided for labor and delivery patients at OCH and MFSH and for OB patients at OCH’s two OB/GYN Centers. OCH will provide staff training modeled after the 10 Steps Curriculum-4th Edition/Healthy Children Network; and online provider education. MFSH will provide breastfeeding education in its maternity orientation for newly hired staff.

• In January 2020, OCH achieved the highly prestigious international Baby-Friendly Designation after a rigorous review process conducted by Baby-Friendly USA. This distinguished honor demonstrates that OCH adheres to the highest evidence-based standards of care for breastfeeding mothers and their babies as set forth by the World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) for optimal infant feeding support in the precious first days of a newborn’s life.

• OCH will offer an online provider education module on breastfeeding practice and promote it to OB and pediatric providers.

• OCH will continue to operate its hospital-based Baby Café that was established in 2019, and in 2020, the hospital started an offshoot of the Baby Café called the Latch Crew that is targeted to support NICU moms.

• OCH also set up a lactation suite that is open to visitors at Sahlen Field, home of Buffalo Bison’s baseball team. http://www.babycafeusa.org/. Full use of the lactation suite was hampered in 2020 as the ballpark was not open to the public due to COVID-19 restrictions.


• OCH identifies and refers at-risk moms for home case management and breastfeeding support through Buffalo Prenatal and Perinatal Network and Maternal Infant Community Health Collaborative

• OCH and MFSH will continue to increase collaboration and the sharing of resources. • MFSH reinforces breastfeeding education on the hospital’s Mother Baby Unit with the p-Care

maternity videos that have many breastfeeding specific offerings. • MFSH breastfeeding outreach and promotion continued with virtual Zoom events in August and

October 2020 featuring “Is Breastfeeding for Me?” with Mona Bonanno, MD, the Medical Director of Pediatrics at MFSH and the lead for breastfeeding outreach events. MFSH networks with the United Way, area IBCLCs (Internationally Board Certified Lactation Consultant) and the Erie County Department of Health.

• OCH and MFSH continued breastfeeding classes through virtual means during the COVID-19 surge.

• Evidence-based sources: The 2011 US Surgeon General’s Call to Action to Support Breastfeeding, Baby Friendly USA© and New York State Department of Health

The goal of this Breastfeeding Education and Promotion Program is to increase the rate of newborns who are breastfed and at Oishei Children's Hospital and Millard Fillmore Suburban Hospital to improve the health and wellness of mothers and children throughout Western New York, including the underserved. Dissemination to the Public This 2020 Update and the full Kaleida Health 2019-2021 Community Health Needs Assessment-Community Service Plan, is available to the public in the Community Health section of the Kaleida Health website at http://www.kaleidahealth.org/community/publications.asp. A paper version of this report is available at Kaleida Health hospitals upon request.

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