RFGH Strategies RFGH 2012 & 2013 Outcomes. Healthy Maine 2020 (established 2013) RFGH Health Plan / Goals / Objectives. RFGH 2014 Outcomes

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1 2012 ~ 2015 RFGH Community Health Work-Plan Community Health Improvement-directly, or in others, identifies and provides health, prevention and education services throughout the community. Offer community education, disease prevention and wellness initiatives based on community need. Key focuses: * Worksite wellness * Chronic Disease * Obesity * Collaboration / engagement NOTATION: Greater Public Health Collaborative changed name to Public Health in 2014 Topic Area People 2020 (established 2013) 2015 Access to Health Services Reduce proportion of individuals who are unable to obtain or delay in obtaining necessary prescription medications Nationally 3.1 % of all persons were unable to obtain or delayed in obtaining in 2007: Target 2.8% (10% improvement) Increase proportion of persons who have access to rapidly responding prehospital EMS - Population covered by BLS / pop. By ACLS proportion of persons with a usual primary care provider (from 82 to 89%) proportion of people of all ages with health insurance (from 90-% to complete coverage) proportion who are unable to obtain or delay obtaining necessary medical (reduce from 10% to 9.4%) proportion of persons with a usual PCP Reduce proportion of individuals who are unable to obtain or delay in obtaining necessary prescription medications Provide access to prehospital EMS: Prescription Assistance Program assists eligible patients in receiving prescription medications through manufacturer sponsored programs and to refer to other resources for which they may quality Service the area s population with RFGH - EMS BLS, ACLS and PALS 2012: PAP program ongoing 148 applications processed with 35 patients assisted through PAP program 2013: PAP continues Jan Dec patients received assistance total of : 74 applications processed RFGH service area has access to rapidly responding prehospital EMS (paramedic level prehospital EMS staff have BLS, ACLS, PALS, NRP) PAP continues Jan Dec patients received assistance total of : 132 applications processed Move More Kids initiatives transportation committee using NB funding and matching Fed and local funding offered MMK Summer Transportation for a total of 2,016 riders for opportunities to be physically active, commute to work, doctor s office, obtain needed food or supplies. Continue to service area with RFGH s ambulance service (paramedic level prehospital EMS staff have BLS, ACLS, PALS, NRP) PAP received assistance: 29 Applications processed = 105 Year Round public transportation services now provided in Skowhegan, Norridgewock, Madison and Anson through Move More Kids Support Yearly participation Explorer 7,488 riders for opportunities be physically active, commute to work, doctor s office, obtain needed food or supplies. Continue to service area with RFGH s ambulance service (paramedic level prehospital EMS staff have BLS, ACLS, PALS, NRP) 1

2 Topic Area People 2020 Adolescent Health Arthritis, Osteoporosis and Chronic Back Conditions Blood Disorders and Blood Safety Cancer Multiple school related objectives Increase proportion of adults with doctor-dx arthritis who have had effective, evidence-based arthritis education as an integral part of the management of their condition Baseline: 10.6% of adults in 2006 Target: 10% improvement Reduce activity limitation due to chronic back conditions Baseline: 30.7/1000 Goal 10% improvement Reduce proportion of persons who did not receive a transfusion due to a blood product shortage cancer survivors who are living 5 years or longer after diagnosis Maine 30% 2003 Maine % Maine % Maine data source (BRFSS) Increase the % of cancer detected at local stage. Reduce rates of late stage breast cancers and colorectal cancer School related objectives addressed at local districts. Reduce activity limitations due to chronic back conditions proportion of cancer survivors who are living 5 years or longer after diagnosis Support survivors RFGH Strategies to address goals / needs RFGH will collaborate where applicable to reduce rate of high school student tobacco use of 19.6% (2015 CHNA Health Indicators) Provide education (web based article, community newsletter, presentation) Provide education, promote physical activity Support Red Cross and local high school initiative of blood drive Support cancer survivors and current cancer patients / caregivers RFGH 2012 & 2013 GSPHC supported physical activity work in schools Community Health programs tobacco and nutrition 2012: Parkinson presentation w/dr Goodman 4/17/12 34 Arthritis presentation with Dr. Crofoot on 5/29/12 ; : Website information offered RFGH pool classes Continued 2014 SPH supported physical activity work in schools Community Health programs tobacco and nutrition Website information offered RFGH pool classes Women s Health: Breast and Bone Nuclear Technicians presented on bone health 12 RFGH 2015 SPH supported PA work in schools Community Health programs tobacco at HS classroom (health) and 4 th /5 th grades for Tar Wars Hand arthritis presentations by OT 129 participants RFGH pool classes See PA initiatives See PA initiatives See PA initiatives 2012: RFGH blood drives X2 3 nurses from RFGH volunteered at HS blood drive 2013: Blood drives X2 with 125 donors Cancer monthly support group - total of 129 attendees in 2012 ; 84 in 2013 Survivor tea 3/31/ Relay for Life 2012 with 400 attending 2013: Relay supported with GSPHC and teams from RFGH supporting 2 blood drives in 2014 at RFGH in Red Cross total of 96 units collected Fatty Liver presented in March by Dr. Henry 48 Cancer Support Gp- 178 the 11 programs offered in 2014 (average 16/session) Breast Cancer Article by Alicia Forster, MD 2 blood drives in 2015 total 72 units collected Breast Cancer presentation with Oncologist 11 Radon presentations (Cedar Ridge by CHE and at RFGH by Maine DHHS; total participation 57) 2

3 Topic Area People 2020 Cancer continued 65 RFGH staff Information booth about Colorectal Cancer 3/9/12 Happy Colon Day 2012: Road to Recovery Semper Fidelis Senior Comp, Road to recovery program (54 participants) in Winter, 2014 RFGH Caring for the Community Newsletter Women s Health: Breast and Bone with Dr. Forster 12 SPH participated in Relay for Life 2015 Colorectal prevention 24 Cancer support Group 10 sessions offered with average 15 per month Following screening objectives combined: cervical screening, colorectal screening, breast cancer persons who participate in behaviors that reduce their exposure to harmful UV irradiation and avoid sunburn Following screening objectives combined: cervical screening, colorectal screening, breast cancer same Support free screening initiatives to eligible women. Plan for /provide skin screening 2013: ACS Look Good Feel Good program supporting 4 patients 2013: Food in Prevention of Colon Cancer (Dr. Henry, : Breast Cancer Awareness Dr Stannard 12 attend 2012 & 2013:Supported free screening initiatives to eligible women. 2012: Skin cancer presentation with senior companion Skin cancer presentation with work site support free screening initiatives to eligible women (funds available) Skin Cancer prevention poster and discussion with individuals triathalon 125; presentations by RN and CHE to two worksite groups 37 attend support free screening initiatives to eligible women (funds available) Skin cancer prevention topic: adolescents 20 Worksite 22 Farmer s Mkt - 50 Oncology nurse and CHE presented to 30 community members onsite 3

4 Topic Area People 2020 Chronic Addressed with diabetes or Kidney heart disease Disease Addressed with diabetes or heart disease Addressed with diabetes or heart disease Addressed with Addressed with diabetes or heart diabetes or heart disease disease Addressed with diabetes or heart disease 2015 outcomes Addressed with diabetes or heart disease Dementias including Alzheimer s Diabetes persons with diagnosed dementias who are aware of the dx Improve glycemic control among the population with diagnosed diabetes 1. the proportion of the diabetic pop with an A1c value > 9% by 10% (baseline 16.2%) 2. the proportion of the diabetic pop with an A1c less than 7% by 10% (baseline 53.5%) 3 the proportion of the diagnosed diabetes whose B/P is under control by 10% (baseline 51.8%) 4. the proportion of adults with diabetes who have at least an annual foot exam by 10% (baseline 68%) 5. the proportion of adults with diabetes who perform self blood glucose monitoring at least once 2012 The % Diagnosis Maine 10% County 11% 90% of adults with DM have Type II Maine Goal by 2015, increase % of adults who have taken DSMT from 61% to 80% the proportion of persons with diagnosed dementias who are aware of the dx Improve glycemic control among the population with diagnosed diabetes Provide education for caregivers Group DSMT 6X / year 1: 1 DSMT as needed Telephonic DSMT ongoing Dementia community home (Redington Memorial Home (1/23/13) with 25 attendees Savvy Caregiver provided for caregivers X 2 10 each time Dementias and early Detection Dr. Renfrew 70 Diabetes Champion presentations in 2012 and Diabetes presentation at elderly complex for meal planning and CHO counting 15 (outcome 2 residents DSMT class) Diabetes for staff and community at Cedar Ridge patients involved in the Diabetes Self Management Program in 2012; 125 in 2013 including CGM patients Senior Spectrum Savvy Caregiver provided for caregivers (five wk program offered X 2 18 total Pre-diabetes & Type 2 Diabetes in Kids 25 Diabetes and Nutrition (Senior independent living) 12 presentation by dietitian Diabetes BBQ/Education exercise, mindful eating (September, 2014) Support group ongoing average 8 in the 10 sessions offered See older adult section Diabetes support group barbeque / education 40 attend Monthly support group offered X9 with average of 9 each session Monthly bulletin board by Certified Diabetes Educator DSMT classes See full DSMT Program plan for deteail 4

5 Topic Area People 2020 Diabetes daily by 10% (baseline 64%) See above See abive 2012 & 2013Support cont group monthly by 15 on average 2013: *Parrot party (Support Group special occasion) by > : Gestational diabetes awareness at Birth and Beyond Celebration (300 attendees) 2013: Diabetes prevention program for those with Prediabetes or at high risk: collaboration with GSPHC 15 attend pilot program year long program (August, 2013) Environmental Health % of homes with an operating radon mitigation system for persons living in homes at risk for radon exposure # of homes with an operating radon mitigation system in those homes at risk for radon exposure Reduce the proportion of children with elevated blood lead levels Increase awareness of potential of risk for radon exposure in homes Provide educational programs at community level 2012 Lead screening RFGH lab and KVCAP spring and fall. Approx 80 lead screenings 2013: Radon education to Cancer support group Lead screening RFGH laboratory and KVCAP spring and fall Lead Poison Prevention Grant work (GSPHC) Nutrition and Diabetes for elderly (see older adults) Diabetes prevention program ongoing with SPH Radon & Behavior Change skills (Diabetes Support Group) 10/7/ Lead Poison Prevention Grant work (SPH) Lead Screening RFGH lab and KVCAP preschools Radon in our Homes article in the community newsletter written by CHE. (winter, 2014 edition) 2015 Radon exposure 30 Also see cancer section for other radon presentations Lead Poison prevention grant SPH Preschool Lead Screenings Lab and KVCAP 3 schools total of 31 preschoolers tested Free lead dust test kits for Maine families for those with children <6 5

6 Topic Area People 2020 Food Safety Reduce infections caused by key pathogens transmitted commonly through food (e-coli, listeria, salmonella, vibrio, yersinia, Reduce infections caused by key pathogens transmitted commonly through food Provide certified 100% RFGH nutrition SafeServe program staff SafeServe trained (schools, hospital, other) as requested Promote handwashing Hospital wide hand hygiene campaign Same 2015 same Health Communicati on Healthcare- Associated Infections persons who report their health care provider always explain things so they can understand them: national baseline 60% in 2007 target 10% improvement persons who report that their health care providers have satisfactory communication skills: baseline 59%F in 2007 Target 10% improvement persons who report their HCP always showed respect for what they had to say: national baseline in 2007, 62%, target 10% improvement Focus on hospital Central line, MRSA infections caused by key pathogens transmitted commonly through food proportion of persons who report their health care provider always explain things so they can understand them # of community members who are informed about hand washing Use TeachBack as preferred method (i.e. DSMT) Monitor Avatar Hand Hygiene education in schools (collaborative effort) and with worksites 2012: Avatar questions explained in a way I could understand Inpatient 94.75; AS and ER : Avatar questions: my doctor explained my illness or treatment in a way I could understand inpatient my surgeon explained my surgery in a way I could understand AS the ER physician explained the medical findings in a way I could understand & 2013 Hand Hygiene education in schools (collaborative effort) Doctor Explained Illness/Treatment Understandably Hospital wide hand hygiene focus Doctor Explained Illness/Treatment Understandably Hospital wide hand hygiene focus 6

7 Topic Area People 2020 Heart Reduce proportion with Disease and hypertension baseline Stroke 29.9% of adults in Target 10% improvement Reduce the proportion of adults with high total blood cholesterol levels baseline 15% of adults age 20 and older had total cholesterol level of 240 mg/dl or greater in target 10% improvement adults aged 20 and older who are aware of and respond to, early warning symptoms and signs of a heart attack (i.e call # baseline 39.2% of adults aged 20 years ; warning S&S of a heart attack(baseline 42%; aware of accessing rapid emergency care Baseline 92.9 Target in all above 10% improvement adults aged 20 and older who are aware of and respond to, early warning symptoms and signs of a stoke No baselines identified therefore no targets identified for improvement Maine % high blood Pressure (2010) 30% County rate (35%) Maine % High Cholesterol (2010) 29% % high Cholesterol rate 32% 2020 goal increase the proportion of adults who report htn who are at healthy wt Baseline 22.1;goal 24% Reduce proportion with hypertension Reduce the proportion of adults with high total blood cholesterol levels proportion of adults aged 20 and older who are aware of and respond to, early warning symptoms and signs of a heart attack proportion of adults aged 20 and older who are aware of and respond to, early warning symptoms and signs of a stoke Provide screenings on request Provide presentations and educational materials Website information 2012 B/P screenings: 45 individuals 2 Heart health presentations 42 attend 2012: 525 attend Heart and Cardiac support groups 2013: Heart Group with 45 / group monthly Approx 100 attend educational classes Quarterly B/P screening at elderly local complex Heart presentation to share risk factors 30 Website health information Heart Group with 413 attending 9 sessions (average 46 per session 0 Cardiac Rehab education classes X 24 to 77 individuals Planning for February 2015 community health program on Stroke with Dr. Goodman as well as community news article 2015 Heart Support Group with 460 attending 9 sessions (average 51 per session ) Cardiac Rehab education classes X 26 to 96 individuals B/P screenings multi settings 192 B/P s taken with education provided by nursing Stroke presentation Dr. Goodman and Speech Therapy 30 Website information Website health information 7

8 Topic Area People 2020 Immunization and maintain elimination of Reduce, eliminate, or Infectious cases of vaccinepreventable diseases Disease Pneumococcal infections Influenza pediatric Influenza - adult 2012: Maine rates 73% influenza (> age 65) County goal: Increase routine vaccination coverage levels for children and adolescents Reduce, eliminate, or maintain elimination of cases of vaccinepreventable diseases Pneumococcal infections Influenza pediatric Influenza adult Influenza school 2012; 612 pediatric clinics TBD Fall vaccinations given in school clinics 82 vaccinations given to school staff Pertussis clinic 6/29/ vaccinations given in community clinics 2013: Fall vaccination clinics school (4 districts + community school =713 and community =322 Fall vaccination clinics school to 4 districts and 2 community schools (students and staff) = 944 and community members = 253 ICP presented Ticks / Lyme Disease to two worksites 34 and to community members at RFGH to another Community Flu clinics children vaccinated = 9; adults vaccinated 158 School flu clinics = 4 school districts, 2 community schools: children vaccinated = 481; adults vaccinated = 218 ICP presented at Skowpendus Fair: ticks and mosquitos 225 and worksites X2 Injury and Violence Prevention Increase use of safety belts Increase age-appropriate vehicle restraint system use in children Reduce pedestrian death Increase helmet usage (bicycles, motorcycles Reduce sports and recreation injuries Reduce drowning deaths Appropriate protective gear when engaged in school sponsored intramural activities Violence reduction % ever physically hurt by intimate partner county 9%; Maine 12% % physical violence or unwanted sex from intimate partner Increase use of safety belts Increase ageappropriate vehicle restraint system use in children Reduce pedestrian death Increase helmet usage (bicycles, motorcycles Reduce sports and recreation injuries Reduce drowning deaths Appropriate protective gear when engaged in school sponsored intramural Provide car seat safety training Athletic training and appropriate protective gear when engaged in school sponsored intramural activities Collaborative effort with family violence project and others for abuse prevention Don t Bug Me! Cedar Ridge Center antibiotic Resistant Bacteria, prevention and control 2012 & 2013 Every newborn s parent trained in car seat safety In addition 26 car seats given out in 2012 / 15 in 2013and parents trained in use RFGH athletic trainers work with local school districts Collaborative effort with family violence project and others for abuse prevention through poster display in lobby with handouts. RFGH athletic trainers provide ongoing support to coaches and athletics Every newborn s parent trained in car seat safety 18 Convertible Car Seats, 1 High Back Booster Seat, and 2 Combination Car Seats were given out in 2014 and parents trained. Collaborative effort with family violence project and others RFGH athletic trainers provide ongoing support to coaches and athletics Every newborn s parent trained in car AARP Driver Safety 14 (July. 2014)were given out in 2015 and parents trained (in Maine Bureau of Highway safety 8

9 Topic Area People 2020 Injury prevention continued activities Violence reduction Reduce Family violence through poster Skowpendus event family violence initiative Safesitter- ages approx 75adolescents each yr trained in safe national standards) CPR outreach to community members ongoing 540 individuals schools, fire volunteers, etc in 2013 In Kind collaboration with KVCAP for Kids First Parenting class quarterly. for abuse prevention through poster display in lobby with handouts. I n Kind KVCAP for Kids First Parenting class quarterly. Safesitter- ages (41 adolescents in 2014 trained in safe national standards) Community Basic Life Support and First Aid to 624 Local Fire, Schools, church groups and other individuals RFGH 2015 Community Basic Life Support and First Aid to 849 Local Fire, Schools, church groups and other individuals Safesitter- ages adolescents in 2015 trained in safe national standards In Kind collaboration with KVCAP for Kids First Parenting class quarterly. Maternal, Infant, and Child Health Medical Product Safety Increase proportion of pregnant women who attend a series of prepared child birth classes No baseline safe and effective treatment of pain Increase proportion of pregnant women who attend a series of prepared child birth classes goal 90% will attend safe and effective treatment of pain CBE class offered monthly Monitor CBE class offered monthly to expectant mothers 45 in Environmental Preschool lead screening KVCAP SAD 74 and 54 for 38 preschoolers In process of consent agreement update (medical offices) Safety, first aid by EMS to 3 locations 400 youth and family CBE class offered monthly to a total of 45 expectant mothers Lead screening in five local preschools KVCAP is involved in (SAD 74 & SAD 54) approximately 60 preschoolers with 3 follow up recommendations to PCPs monitor CBE class offered monthly to a total of 31 expectant mothers See environmental health section for lead screening efforts all follow up recommendations to PCPs monitor 9

10 Topic Area People 2020 Nutrition and Weight adults who are at a healthy Status weight baseline in age 20 and older were at healthy wt Reduce proportion of adults obese Baseline and over were obese in Reduce proportion of children and adolescents who are considered obese Children age 2-5 baseline 10.7 in same years 2010: Adult overweight County 40% Maine 37% Adult obese County 28% Maine 28% Youth overweight county 14% Maine 16% Obese county 14% Maine 13% 2020 Goal: Reduce the portion of children and adolescents who are considered obese proportion of adults who are at a healthy wt. Increase fruit and veggie consumption proportion of adults who are at a healthy weight Reduce proportion of adults who are obese Reduce proportion of children and adolescents who are considered overweight or obese Offer 8 wk wt loss program for individuals who need to lose > 100# Offer Medical nutritional therapy per referral Weigh to go 3 4X / year Offer 8 wk wt loss program for individuals who need to lose > 100# Fruit & Veggie Program June month grant program 108 participants 26 families collaborative effort with SHH, cooking matters, Cooperative Ext, RFGH, Master Gardiners, Dr. Lambke Supports efforts of Let s Go! Program; Support Eating Well for Weight family focused childhood obesity initiative Referrals sent to Nutrition Services individuals completed Weigh to Go, losing an average of 5.25# each over 8 weeks. There was a total of 893# lost. 2013: 142 individuals completed Weigh to Go, losing an average of 5 # each over 8 weeks. Ttotal of 708 # lost. Road to Wellness for those who need to lose >100# - initiated in 2012; 23 in 2013 Success Story with community member and dietitian 3/14/ Wt loss with Sappi 20 GSPHC with Kids local elementary school w/60 children GSPHC work with Feed the Kids rotary, NB and SAD 59 served over 1500 meals at no cost to families in # SNAP Ed participants through the work of GSPHC 741 # of schools registered for Let s Go through the work of SSPH 13 Referrals sent to Nutrition Services for NMT 157 individuals completed Weigh to Go, losing an average of 4.55# each over 8 weeks. those who need to lose >100#. Weight loss not evaluated although one participant reports 34 # wt loss. Average size of class 10 15, 45% completion rate. All ten schools (elementary) in all four school districts are registered and engaged with Let s Go. 100% of head start programs are enrolled as well. 16 sites received Let s Go recognition. Redington Family Practice and Redington Pediatrics received Healthcare Sites of Distinction individuals reached through the SPH work of SNAP-Ed RFGH 2015 Referrals sent to Nutrition Services for NMT 139 individuals completed WTG losing an ave of 4.97# each over 8 wks. Total wt loss 691# Road to Wellness, ave size of class15; 27 participants completed class 27 of 41 sites recognized in Move More Kids; Let s Go Program grains education and cookbook to approximately 400 at following sites: Farmer s Market Kneading Conference Triathalon Cedar Ridge SPH- 73 Teens and Adults took Cooking Matters class SPH-21 older adults took Eat Smart, Live strong SNAP ED nutrition class 10

11 Topic Area People 2020 Nutrition Continued Occupational Safety and Health Older Adults employees who have access to workplace programs that prevent workplace stress Prevention of Falls, Abuse proportion of employees who have access to workplace programs that prevent workplace stress the # of falls & abuse of older adults 2012:Supported efforts of Fruit & Veggie Program: Support to pregnant moms with BMI >30 before pregnancy and children/families 2-18 with BMI >95% percentile; families involved engaging 109 individuals Support workplaces with programming re: stress reduction and goal setting Fall prevention hospital wide initiative Ongoing messaging about goal setting (S.M.A.R.T) goals GSPHC / RFGH online Eight Weeks to Wellness Community group stress management 10 GSPHC / RFGH online Eight Weeks to Wellness 2013 initiatives: GSPHC A Matter of Balance program to manage falls and increase activity March 2013 Balance Screening rehab for fall prevention 45 screened Safe Driving program with AARP Medications and Aging medication necessity, risk Maine Savvy Care Ongoing messaging about goal setting (S.M.A.R.T goals)at worksites and all community programing Offering prevention programs at workplace Savvy Care Giver program 18 participants X 5 week program (July August, 2014) AARP Driver Safety 14 (July. 2014) Nutrition and Diabetes June, this offsite program for independent living RFGH 2015 SPH-Exceeded goal of having 1,750 participants in SNAP Ed program SPH-375 kids in grades K-3 enrolled in Pick a better snack and act curriculum SPH-872 involved in a single session of SNAP ED nutrition class Ongoing messaging about goal setting (S.M.A.R.T goals)at worksites and all community programing Balance Screening rehab for fall prevention 47 screened Savvy Care Giver program 7 participants X 5 week program AARP Driver Safety 18 11

12 Topic Area People 2020 Older Adults cont Oral Health Physical Activity Addresses schools / dental health / Fluoride sealants 2020 goal 49% persons with dental visit Reduce the proportion of adults who engage in no leisure-time physical activity baseline 36.2 % in 2008 Increase portion of children with restricted TV, video, or play video games per guidelines Target 10% improvement Require children to engage in vigorous or moderate physical activity (to become state requirement for schools) % sedentary Maine 21% (no physical activity) % county 26% % Regular physical activity (60 minutes 5 out of 7 days 39% Maine; 39% PA Is a requirement in Maine School initiative Reduce the proportion of adults who engage in no leisure-time physical activity amount of children and adults who consume fruits and vegetables 5 or more times / day % of children with regular physical activity (at least 60 min on 5 of last 7 days) Giver 2 programs in 2013 for individuals caring for family members with dementia Dementia and early Detection with Dr. Renfrew and Alzheimer s Association 70 Polypharmacy Dr. Renfrew and Lisa Caswell, pharmacist 14 attend Support efforts in Education materials schools updated Promote oral health 2013: Birth and update patient Beyond program - a education materials / focus on the First toothbrushes for Tooth Program Pediatric offices Promote SHH Move More program, Promote participation in and activity portion >11,000 adults and children involved in Move More program promoting physical activity to date Getting Excited About PA presentation with Kelly Dangler 16 (6/20/2012) Addressed through Public Health grant Yearly participation in MMK equipment usages before, during, and after school in 3 school districts and parks and recreation = 34,000+ 6,237 after school program usages Promotion of County Indoor Walking in winter, 2014 RFGH community newsletter through posting of all gyms with public winter walking access through Move More RFGH 2015 Addressed through Central District Grant and SPH work SPH- Yearly participation in MMK equipment usages in 4 school districts and parks and recreation 11,346 after school program usages; Winter walking open in 12 sites 12

13 Topic Area People 2020 Respiratory Asthma hospital ed visits Diseases Children and adults aged 5-64 Baseline 56.4/10,000 Children under five Baseline visits / 10,000 Sexually Transmitted Diseases Sleep Health Persons with current asthma who receive education about appropriate response to an episode, including recognizing early S&S or monitoring peak flow results Baseline 64.8% Persons with current asthma who have been advised by a Health professional to change things in their home, school, and work environments to exposure to irritants or allergens to which they are sensitive Baseline 50.7% in 2008 activity limitations among adults with COPD (baseline 23.2 % age 45 and older experience activity limitations due to chronic lung and breathing problems in 08 Targets 10 % improvement for HPV, herpes and other sexually transmitted diseases Increase proportion of persons with symptoms of obstructive sleep apnea who seek evaluation : baseline 25.5% (minimal) Reduce hospital ED visits for asthma Bronchus and asthma ED visit rate County 1495 / 100,000 % COPD 4.2 (Maine) Maine hospitalizatio n rates baseline 337/100,000 Reduce hospital emergency visits of children and adults Persons with current asthma who receive education about appropriate response to an episode, including recognizing early S&S or monitoring peak flow results Persons with current asthma who have been advised by a Health professional to change things in their home, school, and work environments to reduce exposure to irritants or allergens to which they are sensitive Reduce activity limitations among adults with COPD % County COPD data Reduce hospitalizations for COPD Educate community to reduce sexually transmitted diseases Increase proportion of persons with symptoms of obstructive sleep apnea who seek evaluation Offer pulmonary Pulmonary support support group group averages 25/program Pulmonary Rehab Educational materials available for community Pulmonary Rehab ongoing COPD program Oct 2012 Educational materials available Inpatients referred for evaluation to sleep labs RT booth at Birth and Beyond Managing sleep before and after Pulmonary support group averages 10 programs offered with 308 individuals attending in 2014 (averages 31 / session) Chronic Respiratory Issues (Senior Companion Program Volunteers) with P. Alexander, RT, 25 (senior program) Educational materials available Sleep Health presentation November Pulmonary support group averages 10 programs offered with 212 individuals attending in 2015 (averages 28 / session) Educational materials available Patients referred to sleep lab in Augusta 13

14 Topic Area People 2020 Substance Addresses adolescents, Abuse alcohol, prescription drug abuse Tobacco Reduce tobacco use by adults Baseline in and under were current cig smokers Reduce cigarette usage by adolescents baseline 19.5 % of adolescents in grades 9-12 smoked cigarettes in the past 30 days in Target 16.0% Increase tobacco screening and counseling 2020 goals Reduce the past year nonmedical se of prescription drugs proportion of teens never using substances Adult Maine 2010 tobacco use 22% county 26% Youth: 20% Maine 22% (MIYAS 2009) 2020 Goals: Reduce tobacco use by teens Reduce tobacco use by adults Addressed through OSA grant work plan Reduce tobacco use by adults Reduce cigarette usage by adolescents Increase tobacco screening and counseling Collaboration with Prescription RFGH pharmacy, police, Medication Misuse GSPHC substance abuse presentation 14 program coordinator and CHE RFGH will collaborate where applicable to reduce rate of high school student tobacco use of 19.6% and current smoking rate of 26.1 % (2015 CHNA Health Indicators)RFGH will Offer worksite presentations. Provide resources, communicate 1-800#, tobacco intervention trainings to healthcare professionals Offer tar Wars to youth (4 th and 5 th graders) as evidenced based tobacco prevention curriculum 1:1 Tobacco Cessation Tobacco Support group bi-monthly Addressed through OSA grant work plan GSPHC work, policy and environmental change, youth summit 2012GSPHC/RFGH recognized for work in community with local stores 1:1 Tobacco Cessation Over the past 7 years CHE has met with 60 individuals to develop a tobacco quit plan. 26 individuals have remained abstinent for >6 months (43% abstinence rate). A tobacco support group initiated - 5 participants / program with a 32% abstinence rate for a six month period or more in those contacted. (106 total) 2013: average 7/gp 2012 & 2013 RFGH recognized for RFGH met silver level Purchased new signage for entrances Addressed through OSA grant work plan SPH (formally GSPHC) work, policy and environmental change, youth summit 2014 Silver Status by Maine Tobacco Free Hospital Network for tobacco efforts 1:1 tobacco cessation on request RFGH became 100% tobacco free campus on 9/1/ early 2014 and 273 late th and 5 th graders (4 districts + 1 community school) participated in Tar Wars program CHE facilitated tobacco prevention program for 25 HS students (March, 2014 Tobacco Free presentation by CHE for Great American Smokeout November 2015 Addressed through OSA grant work plan SPH (formally GSPHC) work, policy and environmental change, youth summit 2015 Silver Status by Maine Tobacco Free Hospital Network for tobacco efforts Met 9/10 standards 1:1 tobacco cessation on request Tobacco Free presentation by CHE for Great American Smokeout November Tobacco support group 21 sessions with 102 total attendees (average 4-5 per session) 9/15: CHE reports 73/191 consults over 10 yrs have quit > 6 mos (38% abstinence rate) Take steps to create / support tobacco-free hsp environment and supporting tobacco-free lifestyles for patients, staff and the community. Topic Area People 2020 RFGH

15 Tobacco continued Vision Other outcomes See above 2012: HS program. with 6 attend See above 4th grade education Tobacco support (Tar Wars) to 210 group 24 sessions students 4 districts with 79 total 2013: 4th and 5th attendees (average graders participated in 3-4 per session) Tar wars program- 40 attendees (note: 67 out of 180 consults over 10 years have quit for 6 months or longer 37% abstinence rate for individual consults) Objectives include vision screening, eye injury, protective eyewear use RFGH health website education RFGH health website education Community Resource RFGH programming 2012 & 2013 for NB X 700 participants each yr. Healthcare Careers 2012 & 2013 for local districts approximately 44 students and 28 adults for evening program in 2012, 25 in : Literacy volunteer program planned Literacy early reading offered as topic by speech therapy at Birth and Beyond RFGH health website education Literacy volunteer program offered X2 Career exploration presentations in Madison High School 10 presentations by health care professionals to 5 students each time Career exploration presentations held at RFGH approx.50 students from 2 school districts EMS (Special Olympics) 55 RFGH health website education Advance Directives what it is / how to fill out 51 Career exploration presentations in Madison High School 10 presentations by health care professionals to 5 students each time 15