Adventist HealthCare Behavioral Health & Wellness Services Community Health Needs Assessment Implementation Strategy. Adopted May 15, 2017

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Adventist HealthCare Behavioral Health & Wellness Services 2017-2019 Community Health Needs Assessment Implementation Strategy Adopted May 15, 2017

Implementation Strategy Development & Adoption Adventist HealthCare Behavioral Health & Wellness Services 2017-2019 Community Health Needs Assessment (CHNA) was reviewed and approved by the Adventist HealthCare Board of Trustees in November of 2016. Based on the findings, as well as input from the community, Adventist HealthCare Behavioral Health & Wellness Services Presidents Council prioritized the needs identified in the CHNA in order to guide the development of an Implementation Strategy. The following factors were considered in completing the prioritization process: Incidence and Prevalence: How big of a problem is the need in the community? Presence and Magnitude of Disparities: Are some populations disproportionately burdened? Change over Time: Has the need improved, worsened, or seen no change in recent years? Alignment with County Priority Areas: Is the health area aligned with Montgomery County s priority areas? Community Input: Based on the primary survey data, Healthy Montgomery Community Conversations, and input from the Center for Health Equity and Wellness Advisory Board, what are the most significant areas of need as identified by the community? Existing Resources, Expertise, and Partnerships: Does the hospital have resources, existing programing, expertise, or existing/potential partnerships that can be leveraged to effectively address the need? Gaps and Resources in the Community: Are there existing resources sufficiently addressing the need or are additional resources needed? Where specifically do the gaps lie? Potential for Measurable and Achievable Outcomes: Are there relevant outcome measures? Will it be possible to make an impact? The final prioritized list of needs for Adventist HealthCare Behavioral Health & Wellness Services 2017-2019 Community Health Needs Assessment is as follows: 1. Mental Health 2. Substance Abuse 3. Housing 4. Suicide 5. Education 6. Dual Diagnosis 7. Food Access 8. Dementia / Alzheimer s 9. Domestic Violence 10. Tobacco Based on the prioritization process, Adventist HealthCare Behavioral Health & Wellness Services has elected to focus its initiatives on mental health and substance abuse for adolescents and adults.

Implementation Strategy Overview: Mental Health & Substance Abuse Identified Need Primary data collected as part of Adventist HealthCare Behavioral Health and Wellness Services CHNA ranked stress/living in a high pressure area and mental health in the top 10 among 26 identified community health concerns. Stress/living in a high pressure area was ranked 3 rd, while mental health was ranked 10 th. In Montgomery County, 14.4% of the adult population self-reported a diagnosis of depression. Hispanics (19.2%), Blacks (17.7%), and females (18.2%) were most disproportionately affected. Among Montgomery County youths, 10.7% of 12-17 year olds had a major depressive episode in 2013; 72% of which suffered severe impairment as a result. Although State Health Improvement Process (SHIP) and Healthy People 2020 (HP2020) targets for suicide are being met in both Montgomery and Prince George s Counties, whites have the highest rates in both counties and do not meet the SHIP target in Prince George s County. ER utilization for mental health disorders, as well as for addictions related conditions, has been on a steady upward trend in both Montgomery and Prince George s Counties. In Montgomery County the highest rates are seen among blacks, while in Prince George s County the highest rates are seen among whites. In both Montgomery and Prince George s Counties, the drug induced death rate has recently increased. In both counties, the rates are highest among whites. In Prince George s, while the county overall meets SHIP and HP2020 targets, whites meet neither target. In Montgomery County, 7% of the population has reported illicit drug use. The highest rates are seen among 12-17 year olds (9.5%). Goal Increase awareness around mental health and substance abuse issues, needs and resources; and reduce stigmas around accessing mental health and substance abuse services. Strategy 1: Providing Support and Education around Mental Health and Substance Abuse for Adolescents Overview & Activities Adventist HealthCare Behavioral Health & Wellness Services will provide mental health and substance abuse resources for adolescents and families in partnership with Montgomery County Schools. This will include providing education and support around symptoms to look out for, prevention, treatment and care options, coping strategies, and available community resources. Additionally, this program will facilitate a safe space for questions and discussion. Objectives Hold quarterly educational support group sessions at Montgomery County Schools for students and/or their families Increase participants knowledge around available mental health and substance abuse resources Increase participants self-efficacy in accessing available mental health and substance abuse resources Collaborative Partners Montgomery County Public Schools Committed Resources Staff time and funds for planning, implementing, and evaluating educational support groups

Strategy 2: Providing Support and Education around Mental Health and Substance Abuse for Community Members (Adolescents & Adults) Overview & Activities Adventist HealthCare Behavioral Health & Wellness Services will provide educational support groups for community members regarding mental health and substance abuse. Support group topics will include areas such as symptoms to look out for, prevention, treatment and care options, and coping strategies. A large focus of the groups will also be on increasing awareness of, and access to community resources, in order to help demystify the mental health and substance abuse care continuum no matter the stage of care. Sessions will be held outside of the Behavioral Health hospital to increase access and comfort for attendees. Objectives Hold monthly educational support group sessions for community members Increase participants knowledge around available mental health and substance abuse resources Increase participants self-efficacy in accessing available mental health and substance abuse resources Committed Resources Staff time and funds for planning, implementing and evaluating educational support groups Other Areas of Need Not Directly Addressed by Behavioral Health & Wellness Services BH&WS does not directly address the areas of need included in the table below through ongoing education or programing. However, these areas may be addressed through the Adventist HealthCare Community Partnership Fund which aims to provide funding for community organizations working to address needs identified in our community health needs assessment. BH&WS as a part of Adventist HealthCare is committed to providing financial support to improve the health and wellbeing of our community through the Community Partnership Fund. The Adventist HealthCare Community Partnership fund provides funding for 501(c)(3) non-profit organizations whose activities align with our mission and the following funding objectives: HEALTH AND WELLNESS: Support community health services, education, and prevention and wellness programs PARTNERSHIPS: Leverage partnerships to address socioeconomic disadvantages that affect health CAPACITY BUILDING: Improve community health through collaborative partnerships, economic and workforce development, and advocacy When reviewing applications, the priorities for the Community Partnership Fund include: Activities that address a priority area of need identified in our hospitals Community Health Needs Assessments Activities that target populations in Adventist HealthCare s service area that are socially and economically disadvantaged or medically underserved Activities that align with Adventist HealthCare s community-based mission Activities that have a measurable impact on the community being served Area of Need Suicide, Dual-Diagnosis, Dementia/Alzheimer s, Domestic Violence, and Tobacco Social Determinants: Education, Housing, Food Access Rationale BH&WS does not currently provide ongoing community outreach or programs specific to suicide, dual-diagnosis, dementia/alzheimer s, domestic violence, or tobacco due to limited resources, and a focus on areas that were identified as higher priority during the CHNA prioritization process.