2012 Community Health Needs Assessment. Implementation Plan Updated and Revised September 2013

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1 2012 Community Health Needs Assessment Implementation Plan Updated and Revised September 2013

2 Lake Regional Health System Community Health Needs Implementation Plan December 2012 Updated and Revised September 2013 Lake Regional Health System sponsored the 2012 Community Health Needs Assessment (CHNA) to identify health issues within the community, defined as ZIP codes within a 25-mile radius of the hospital. To be included in the survey area, these ZIP codes also must be located entirely within Camden, Miller or Morgan counties, where LRHS market share is at least 10 percent. The study helped hospital officials identify the three most prevalent health problems facing area residents: heart disease, cancer and diabetes. IMPLEMENTATION STRATEGY To address the priority health needs identified in the Community Health Needs Assessment survey, Lake Regional Health System will implement the Chronic Disease Self-Management Program (CDSMP) developed by Stanford University. The program is known locally as Show-Me Better Health. Additional strategies to address health needs are identified in Appendix A. Show-Me Better Health program partners will include the Camden and Miller County health departments and the Katy Trail Community Health Center in Morgan County; sessions will be held at various locations, rotating among the counties. The public program will begin in March 2013, with classes scheduled on an ongoing basis throughout fiscal year The program will be funded by Lake Regional Health System and will operate under the University of Missouri s grant and license for the Stanford University model. Show-Me Better Health introduces participants to self-management tasks, as well as medical management, role management and emotional management. Regardless of their specific condition, individuals are encouraged to learn and practice skills to manage their chronic disease condition on a daily basis. Participants meet 2.5 hours weekly for six weeks to develop needed skills and receive support. Sessions cover topics related to living with a chronic condition, including the following. problem solving goal setting physical activity nutrition communicating with health professionals managing emotions managing medication stress reduction The Show-Me Better Health program methodology encourages support and exchange of ideas, which helps participants build confidence and better manage their overall health. Baseline health screenings will help participants establish health improvement goals and allow program leaders to monitor program goals. Health screenings will collect biometric data, including complete blood count, comprehensive metabolic panel, A1c for diabetics, weight and BMI.

3 PROGRAM EXECUTION Lake Regional Health System will implement the Show-Me Better Health program during fiscal years 2013 and 2014, as follows. TIME LINE ACTION December 2012 Approval by Lake Regional Health System Board of Directors Budget adopted December 2012 January 2013 CDSM administrator educates referral sources, including primary care providers, social services, nurse managers, discharge planners, educators February 2013 CDSM leaders attend four day certification workshop Advertising/promotion of first session begins Registration for first six week CDSM session begins March April 2013 Baseline screening for Camden County participants March 7 Six week session begins March 14; concludes April 18 May June 2013 Baseline screening for Morgan County participants May 2 Six week session begins May 9; concludes June 13 July August 2013 Baseline screening for Miller County participants July 11 Six week session begins July 18; concludes Aug. 2 September October 2013 Baseline screening for Camden County participants Sept. 12 Six week session begins Sept. 19; concludes Oct. 24 November December 2013 Baseline screening for Morgan County participants Nov. 4 Six week session begins Nov. 4; concludes Dec. 16 January 2013 February 2014 Baseline screening for Miller County participants Jan. 16 Six week session begins Jan. 23; concludes Feb. 20 COMMUNITY BENEFIT The Lake Regional Health System Board of Directors, administration team and Medical Executive Committee meets annually in March to review strategic goals for the organization. The community benefit plan is reviewed during this session, and the Community Health Needs Assessment Implementation Plan will be added to annual operational plans, beginning in FY BUDGET The CDSMP budget is as follows. FY 2013 EDUCATIONAL MATERIALS BOOKS & VIDEO (1 SESSION) 375 SCALES 100 TESTING STRIPS & MISC MEDICAL SUPPLIES 100 REFRESHMENTS (1 SESSION) 150 GENERAL SUPPLIES (1 SESSION) 100 INITIAL TRAINING FOR 2 PEOPLE MEALS, HOTEL, MILEAGE FOR 4 DAYS 2,250 MILEAGE FOR WORKSHOPS 540

4 PROGRAM ADVERTISING 2,200 LOGO ITEMS PENS, NOTEBOOKS, WATER BOTTLES, PEDOMETERS 300 LABORATORY TESTING (COMPLETE BLOOD COUNT, COMPLETE METABOLIC 345 PROFILE & A1C) PHLEBOTOMIST (1 SESSION) 45 PHLEBOTOMIST MILEAGE (1 SESSION) FTEs SALARY AT $25.00 PER HOUR ABSORBED BY CURRENT STAFF 12,000 TOTAL EXPENSES 18,545 FY 2014 EDUCATIONAL MATERIALS BOOKS & VIDEO (5 SESSIONS) 1,877 TESTING STRIPS & MISC MEDICAL SUPPLIES 500 REFRESHMENTS (5 SESSIONS) 750 GENERAL SUPPLIES (5 SESSIONS) 500 INITIAL TRAINING FOR 1 BACKUP PERSON MEALS, HOTEL, MILEAGE FOR 4 DAYS 1,250 MILEAGE FOR WORKSHOPS (5 SESSIONS) 2,700 PROGRAM ADVERTISING 2,200 LOGO ITEMS PENS, NOTEBOOKS, WATER BOTTLES, PEDOMETERS 600 LABORATORY TESTING (COMPLETE BLOOD COUNT, COMPLETE METABOLIC 1,725 PROFILE & A1C) PHLEBOTOMIST (5 SESSIONS) 225 PHLEBOTOMIST MILEAGE (5 SESSIONS) FTEs SALARY AT $25.00 PER HOUR ABSORBED BY CURRENT STAFF 20,800 TOTAL EXPENSES 33,325 HEALTH NEEDS PRIORITIZATION The Lake Regional Health System Community Health Needs Assessment survey report helped hospital officials identify and prioritize community health needs. Top community health priorities were: Heart Disease Smoking/Tobacco Use Cancer Diabetes Mental Health To address mental health needs within the community, a psychiatric workgroup has been formed under the direction of Patti Muxlow, Lake Regional Health System director of nursing. An evidenced-based suicide risk assessment tool and withdrawal protocols have been developed for use by hospital staff. Educational sessions have been completed to train staff in high-risk units, including the Emergency Department and Intensive Care Unit. Care plans are currently being reviewed for revision or development. Tele-psychiatry services are being reviewed. (content moved to table below)

5 Following is a description of all other identified health concerns and how they are being addressed by Lake Regional Health System or within the community. Additional information is provided in Appendix A. HEALTH CONCERN Heart Disease Smoking/Tobacco Use Access to Specialists Cancer Diabetes Mental Health Affordable Health Care Physical Inactivity Access to Health Care Providers Alcohol Abuse Child Abuse Respiratory Health Transportation Access to Healthy Foods Drug Abuse LAKE REGIONAL/COMMUNITY RESPONSE implemented Show Me Better Health in FY 2013; promoted community awareness of heart disease risk factors through annual health screening events smoking cessation classes offered by county health departments and Mo. Tobacco Quitline specialist physician recruitment is ongoing implemented Show Me Better Health in FY 2013; developed low cost, year round screening program; implemented Cancer Resource Navigator program; promoted community education/awareness through health fairs and community events implemented Show Me Better Health in FY 2013; offered patient education through Lake Regional Education Resource Center implemented psychiatric workgroup, suicide risk assessment, staff education for high risk units charity care and self pay policy in place; counseling available Trim Kids 9 week program offered 2x annually; low cost yoga Physician/nurse practitioner recruitment is ongoing policy in place for detoxification/transfer to rehab; social work provides education/community resource listing maintain Sexual Assault Response Team, support Kids Harbor offer pulmonary function screenings 3x annually; partner with School of the Osage to offer asthma education; host Better Breathers support group monthly; Caring for Loved Ones at home provides training on home oxygen 2x annually community resources include the following: Health Care USA Missouri Care Camden With A Heart Morgan County Health Department Care Van Greyhound in Lebanon, Mo. OATS Mid MO Office 573/ Lake Ozark Casual Cab Eldon Cab Medical Cabs SKT Cabs Show Me Medical sponsored Buddy Back Pack nutrition program for school age children during school year; offer Trim Kids program 2x annually; donate annually to local food banks policy in place for detoxification/transfer to rehab; social work provides education/community resources

6 Caring for Adult with Disabilities Dental Health Motor Vehicle Crashes Domestic Violence Sexually Transmitted Disease Teen Pregnancy Caring for Loved Ones educational seminar offered 2x annually; support group offered monthly support Medical Missions for Christ Free Clinic (includes dental care) local law enforcement provides community education, teen programs maintain Sexual Assault Response Team program; policy in place/training for staff to identify domestic and elder abuse victims and inform them of options for reporting to proper authorities local health departments provide education/treatment; report STI to county health officials Kids Matter Program, all teen mothers have an automatic consult for social services

7 2012 Community Health Needs Assessment Implementation Plan Appendix A HEALTH ISSUE #1: Heart Disease CONTRIBUTING FACTORS TO HEALTH ISSUE #1: Smoking/tobacco use; obesity; hypertension THREE YEAR GOAL FOR IMPROVEMENT: TBD BUDGET FOR HEALTH ISSUE #1: TBD Staff Responsible Renee Riedel Strategies to Achieve Goal Implement chronic disease selfmanagement course, Show Me Better Health Specific Partners and Roles for Each Strategy Specific Actions to Achieve Strategies Specific 3 year Process Measure(s) Specific 3 year Outcome Measure(s) Camden County Health Dept./ Missouri Arthritis Foundation Offer 7 week course, including baseline screening for lipid profile <150 Miller County Health Dept./ Missouri Arthritis Foundation Offer 7 week course, including baseline screening for lipid profile <150 Katy Trail Community Health Center/ Missouri Arthritis Foundation Offer 7 week course, including baseline screening for lipid profile <150 Implement care coordination strategies to promote healthy lifestyles Lake Regional Medical Group Implement Patient Centered Medical Home model Identify patients at risk for hypertension to receive education on diet, exercise and medication (BP >140/90) Participants maintain BP <140/90 University of Missouri Extension and area grocery stores, churches & schools Partner with grocery stores within service area to offer "Cooking Matters" and "Shopping Matters" programs Classes offered 6x annually 10 participants per class Billye Bennett Promote community awareness about heart disease through education, screenings and follow up care Provide heart risk assessment at annual cardiovascular screening (February) Offer low cost lipid profile screenings at community health fairs (12x annually) <150 <150 Peter Rao Offer smoking cessation counseling/support Camden County Health Dept. Promote web based counseling assess smoking status of primary care Miller County Health Dept. Promote smoking cessation courses assess smoking status of primary care Morgan County Health Dept. Promote smoking cessation courses assess smoking status of primary care Cheri Sisson Mo. Tobacco Quitline Provide smoking cessation counseling assess smoking status of primary care # of referrals

8 2012 Community Health Needs Assessment Implementation Plan Appendix A HEALTH ISSUE #2: Cancer CONTRIBUTING FACTORS TO HEALTH ISSUE #1: Smoking/tobacco use THREE YEAR GOAL FOR IMPROVEMENT: TBD BUDGET FOR HEALTH ISSUE #2: TBD Staff Responsible Strategies to Achieve Goal Specific Partners and Roles for Each Strategy Specific Actions to Achieve Strategies Specific 3 year Process Measure(s) Specific 3 year Outcome Measure(s) Marcy Maxwell Improve access to cancer screening American Cancer Society Implement low cost, year round cancer screening program # of annual participants # of positive findings Billye Bennett Promote community awareness about cancer risk factors, early detection and prevention Community groups, including Totes for TaTas and Elks Lodge, and American Cancer Society Promote education through community health fairs and screenings; provide free colorectal cancer screening kits # of participants # of colorectal kits distributed Kim Gerike Increase access to resources and support for cancer patients American Cancer Society Provide free mammograms for those who qualify through the HOPE program Implement Cancer Center Navigator program # mammograms provided annually # of positive findings quarterly reports to Cancer Committee, beginning November 2013 TBD Nichole Stephens Increase access to resources and support for cancer patients American Cancer Society Increase awareness of cancer support groups offer Look Good Feel Better 11x annually # of participants Peter Rao Offer smoking cessation counseling/support Camden County Health Dept. Promote web based counseling assess smoking status of primary care Miller County Health Dept. Promote smoking cessation courses assess smoking status of primary care Morgan County Health Dept. Promote smoking cessation courses assess smoking status of primary care Cheri Sisson Offer smoking cessation counseling/support Mo. Tobacco Quitline Provide smoking cessation counseling assess smoking status of primary care # of referrals

9 2012 Community Health Needs Assessment Implementation Plan Appendix A HEALTH ISSUE #3: Diabetes CONTRIBUTING FACTORS TO HEALTH ISSUE #3: obesity; access to healthy foods THREE YEAR GOAL FOR IMPROVEMENT: A1c levels well controlled (<7) for community health screening and Show Me Better Health participants BUDGET FOR HEALTH ISSUE #3: TBD Staff Responsible Strategies to Achieve Goal Specific Partners and Roles for Each Strategy Specific Actions to Achieve Strategies Specific 3 year Process Measure(s) Specific 3 year Outcome Measure(s) Peter Rao Implement care coordination strategies to Lake Regional Medical Group clinics Implement Patient Centered Medical Implement PCMH by October 2015 TBD ensure diabetes care is provided Home model Renee Riedel Implement chronic disease selfmanagement course, Show Me Better Health Billye Bennett Promote community awareness through education and screenings Camden County Health Dept./ Missouri Arthritis Foundation Miller County Health Dept./ Missouri Arthritis Foundation Katy Trail Community Health Center/ Missouri Arthritis Foundation county health departments, school districts, major local employers Lake Regional Hospital Auxiliary Offer 7 week in person, including baseline screening for A1c, or online course, as appropriate Offer 7 week in person, including baseline screening for A1c, or online course, as appropriate Offer 7 week in person, including baseline screening for A1c, or online course, as appropriate Offer low cost A1c screenings at community health fairs (12x annually) with consultation for abnormal results Offer free annual employee and volunteer health screening with consultation for abnormal blood sugar results (>100) Conduct A1c test for diabetics Participants' A1C well controlled (< 7) Conduct A1c test for diabetics Participants' A1C well controlled (< 7) Conduct A1c test for diabetics Participants' A1C well controlled (< 7) Mail Diabetes 101 course information to participants with A1c >7 track employees/volunteers with blood sugar >100; offer low cost A1c screening Participants' A1C well controlled (< 7) Participants' A1C well controlled (< 7) Kristi Brown Provide diabetes education to patients American Diabetes Association Promote services through Lake Regional Education Resource Center Implement Diabetes 101 community course (6x annually) 10 participants per class Provide diabetes education for community University of Missouri Extension Promote services through Lake Regional Education Resource Center Implement Cooking Matters for diabetics (6x anually) 10 participants per class