the community health needs assessment and improvement plan process in yellowstone county

The Community Health Needs Assessment and Improvement Plan Process in Yellowstone County

Engagement and Accreditation

Montana Public Health Association ConferenceOctober 1, 2014

Heather Fink and Shawn Hinz

Community Engagement

What is Community Engagement?

Community Health Improvement

The Alliance

Objectives

To introduce a Community Health Needs Assessment approach including potential strategies for engaging key collaborators and community members in the process.

To demonstrate alignment with required domains of Public Health Accreditation.

ACHI Framework for the CHNA and CHIP

Suggested 7th step:revisit and refine plan and process.

http://www.assesstoolkit.org/assesstoolkit/ACHI-CHAT-intro-slides-8-27-10.pdf

July-Sept 14Aug-Oct 13 Nov-Dec 13 Jan-Feb 14 Mar-June 14Mar-July 13

ACHI steps 1 & 2: Establish and Assess InfrastructureSurvey DesignCHNA Advisory Group PRC ContractSurvey tools finalized (HBDL)

ACHI step 3: Analyze DataResults ReturnedAlliance & HBDL review BC, RSH & SVH internal reviewCHNA Advisory Group reviewHBD Coalition review

ACHI step 4: Select PrioritiesPrioritization Process Community processInstitutional processesAlliance final adoption

ACHI step 3: Collect DataSurvey ConductedFocus Groups (PRC)Telephone (PRC)

ACHI step 5: Document and Communicate ResultsResults Released Publiclya) Press Conference (Jan)b) Internal, key groups, community, & media – results, priorities & engage

ACHI step 6: Plan for ActionCHIP Adopted (June 30)BC adopts facility planSVH adopts facility plan

COMMUNITY HEALTH NEEDS ASSESSMENT TIMELINE

CHNA= Community Health Needs Assessment PRC= Professional Research Consultants – vendorCHIP= Community Health Improvement Plan HBDL=Healthy By Design LeadershipACHI=Association of Community Health Improvement (framework for CHNA-steps referenced)

ACHI step 6: Monitor ProgressCHIP begins

ACHI step 6: Plan for ActionAuthor CHIP

step 7: Revisit and Refine plan and process

DOMAIN 1: Conduct and disseminate assessments focused on population health status and public health issues facing the community • Standard 1.1: Participate in or Conduct a Collaborative Process

Resulting in a Comprehensive Community Health Assessment• Standard 1.2: Collect and Maintain Reliable, Comparable, and Valid Data That

Provide Information on Conditions of Public Health Importance and On the Health Status of the Population

• Standard 1.3: Analyze Public Health Data to Identify Trends in Health Problems, Environmental Public Health Hazards, and Social and Economic Factors That Affect the Public’s Health

• Standard 1.4: Provide and Use the Results of Health Data Analysis to Develop Recommendations Regarding Public Health Policy, Processes, Programs, or Interventions

Assess

DOMAIN 4: Engage with the community to identify and address health problems • Standard 4.1: Engage with the Public Health

System and the Community in Identifying and Addressing Health Problems Through Collaborative Processes

• Standard 4.2: Promote the Community’s Understanding of and Support for Policies and Strategies That will Improve the Public’s Health

Community Engagement

Community Health Needs Assessment Completed every 5 years, now every 3 Sponsored by the Alliance Randomized telephone survey of 404

Yellowstone County adults Secondary Data

Public health data & vital records statistics

Focus Groups Physicians & other Health Professionals Legislators Social Service Providers Educators Employers South side neighborhood residents

Measure Opportunity forImprovement

History/CurrentStatus

Action Documentation ResponsibleStaff

Date

4.1.2Example 2 RequiredDocumentation Source ofEvidence-based practices

RiverStone Health may want toconsider how thework they currently do orcould do provides their manycommunity coalition partnerswith technical assistance, toolsand resources to provideinformation about communityengagement principles,processes, and/or models.

RiverStone Health is using the Association ofCommunity HealthImprovement (ACHI) model for CommunityEngagement. This process was also used in2010.

Present to communitymembers who haveselected priority areas andstakeholders on how the ACHI model ofcommunity engagement is usedin the development of a CHIP and othertypes of community engagement. Thecommunity members willparticipate in setting priority activities.

Invitation

Agendas ofmeetings

Meeting

Minutes

PowerPointPresentationACHI model

Documentation of PriorityPlanning

Attendance Sheets

Shawn Hinz, Director andHeather Fink,Coordinator forCommunity HealthImprovement

On 5/2/2014

Action Plan

CommunityResources• The Alliance• Community Health Improvement Leadership• CHNA Advisory Group• Healthy By Design Coalition• CHIP workgroup

Points of engagement• Press Conference and Preview Meetings• CHNA Advisory Group Check-Ins• Community Forum• Content Expert Meetings• CHIP Strategy Discussions

Areas of

Opportunity

► Access to Health Services*

► Cancer*

► Chronic Kidney Disease

► Dementias, Including Alzheimer’s Disease

► Heart Disease & Stroke*

► Injury & Violence*

► Infant Health & Family Planning

► Mental Health & Mental Disorders*

► Nutrition, Physical Activity & Weight*

► Respiratory Diseases*

► Substance Abuse*

► Tobacco Use

Bold items were identified as a top concern in focus groups.

* Denotes issues identified as Areas of Opportunity in 2010 as well.

Underlined-identified in 2014 Community Forum

Identified Community Priorities

– Access to Health Services

– Mental Health & Mental Disorders, Substance Abuse

– Nutrition, Physical Activity & Weight

DOMAIN 5: Develop public health policies and plans • Standard 5.1: Serve As a Primary and Expert Resource for

Establishing and Maintaining Public Health Policies, Practices, and Capacity

• Standard 5.2: Conduct a Comprehensive Planning Process Resulting in a Tribal/State/Community Health Improvement Plan

• Standard 5.3: Develop and Implement a Health Department Organizational Strategic Plan

• Standard 5.4: Maintain an All Hazards Emergency Operations Plan

Policies and Plans

Measure Opportunity for Improvement History/Current Status Action Documentation Responsible Staff Accomplish by Date

5.2.4The required documentation includes monitoring progress in meeting performance measures and a description of the progress made on health indicators as defined in the plan.

The primary constraint for meeting this measure is related to the newness of the plan. That said, the plan and the updates could be improved if the objectives and strategies/interventions were written as SMART, and rather than simply aiming to decrease or increase a particular activity, the plan could set specific targets; for example, increase by x% from x to y, etc.

RiverStone Health conducted Community Health Needs Assessments in 2005, 2010, and 2014 in partnership with the local hospitals (The Alliance). Following each needs assessment, a plan to improve the health of the community was written using community engagement.The 2014 CHIP is currently being written and the strategies will be written as SMART objectives.

Reports of progress for the 2010 CHIP will be provided. In December 2013, a presentation to the Alliance on the health priorities and outcomes occurred comparing the results of the 2005, 2010, and 2014 Community Health Needs Assessment. Work groups were formed following the development of the 2010 CHIP and developed work plans which were updated in March 2014

7-8-13 Report of CHIP progress Meeting Minutes Attendance PowerPoint 2014 CHIP update which includes;work plans, progress, updates and revisions March 2014.

Shawn Hinz, Director andHeather Fink, Coordinator for Community Health Improvement

7-8-13 12-18-13 March 2014

Action Plan

The Alliance

Community Health ImprovementCHNA and Implementation Plan

Healthy Weight

2014-2017 Community Health Improvement Plan Priorities

Healthy Weight PriorityHealthy By Design’sCurrent Initiatives

Making the healthy choice the easy choice

Focused on Policy, Systems and Environmental

Change!

Healthy By Design Coalition Better Billings

Foundation Big Sky EDA Big Sky State Games Billings Clinic Billings Family YMCA Cancer Control Coalition Chamber of

Commerce/CVB City-County Planning

Dept. community health

advocates League of Women

Voters MET Transit McCall Development

MSU BillingsMSU Extension ServiceNorthern Plains Resource

CouncilNutrition for the FutureParks and RecPeaks to Plains DesignRiverStone Health Safe Routes to School Salvation ArmySt. Vincent Healthcare School Health Advisory

CouncilUnited Way

Community Message: 5-2-1-0

Wellness Health Equity

Built Environm

ent

Active Living Every Day

Gardeners’

MarketFood

Access

Alternative Transportatio

nWorksite Projects: BSED

Recognition

Children/Families

(partners: BAFHK, SHAC)

Priority: Healthy Weight (Brand: Healthy By Design)

Focus Areas

Workgroups

DOMAIN 10: Contribute to and apply the evidence base of public health • Standard 10.1: Identify and Use the Best

Available Evidence for Making Informed Public Health Practice Decisions

• Standard 10.2: Promote Understanding and Use of Research Results, Evaluations, and Evidence-based Practices With Appropriate Audiences

Evidence Based Practice

Healthy By Design

Workgroup WorkplanExample

Complete streets are designed and operated to enable safe access for all users. Pedestrians, bicyclists, motorists, and public transportation users of all ages and abilities are able to safely move along and across a complete street.*

* Source: National Complete Streets Coalition www.completestreets.org

Zimmerman Trail near Poly Drive

“Complete Streets” passed unanimously by City Council. Adopted by Billings

August 22, 2011

Report on 2014…Average of 150-200 customers each weekAverage of 12 sellers weeklyMoved to South ParkSNAP, Debit, Credit

Gardeners’ Market

Active Living Every Day Classes

Address identified physical activity barriers and opportunities.

Action Plan Measure Opportunity for

ImprovementHistory/Current Status Action Documentation Responsible

StaffAccomplish by

Date 10.1.1Example 2 Required Documentation Source of Evidence-based practices

To seek out and utilize evidence-based or promising practices that are aligned with the 10 Essential Public Health Services

The Healthy By Design Coalition is led by RiverStone Health, and Alliance partners Billings Clinic and St. Vincent Healthcare. There are 5 active workgroups: Healthy Weight, Worksite Wellness, Health Equity, Built Environment, and Recognition Program that all embrace 5210 messaging. 5 fruits/vegetables, 2 hours or less of screen time, 1 hour of physical activity per day, and 0 sugary beverages. This 5210 messaging is centered around our work to decrease obesity and chronic disease (a priority of our current CHIP) and evidenced by the success of the “Let’s Go Maine” program and referenced in many CDC resource lists. See below

To assure consistent messaging of the 5210 model a train the trainer program will be developed and implemented to include sanitarians, and immunization staff. Identify target audiences for future 5210 trainings

InvitationPowerPointsAttendance Training Materials Emails/minutes

Melissa and Dasheema Melissa and Dasheema

5/15/2014 5/15/2014

Let’s Go Maine, Hawaii Initiative for Childhood Obesity Research and Education, Healthy By Design.

Healthy Weight Collaborative Project

Community Message

www.healthybydesignyellowstone.org

Healthy By Design

Alliance and Community Health Improvement Leadership

Mental Health/Substance

Abuse

Access to Care

Healthy Weight

Community Health Improvement Staff

Community Health Needs Assessment

Community Health Improvement Plan

Priorities

Com

munity

• Strategy team meeting 8/27/14: Heather Fink, Nathan Stahley, Kristin Lundgren, TommiLee Harper, Libby Carter

• Proposed co-chairs: Libby Carter, DPHHS and Barbara Mettler, Mental Health Center (to be approached by Kristin)

• Common strategies of focus:– Increase capacity for trauma informed care– Support advocacy efforts for co-occurring treatment and family treatment– Identify mental health and substance abuse related resources (integrate trauma

informed certification)• Actions:

– Outline strategy plan, aligned with DESTRESS grant– Finalize chairs– Hiring for grant coordinator– Identify opportunity to connect/collaborate with Tobacco and

Substance Abuse Coalitions– Pursue potential interns to support

Priority: Mental Health/ Substance

• Finalizing Alliance organizations strategy team representatives

• Determine meeting time and date• Review CHNA, CHIP, strategies• Recognize current efforts underway• Determine priority strategies and potential

opportunities– Meeting scheduled in October– Determine where Healthy Weight Plans fit

Priority: Clinical/Access

Alliance and Community Health Improvement Leadership

Mental Health/Substance

Abuse

Access to Care

Healthy Weight

Community Health Improvement Staff

Community Health Needs Assessment

Community Health Improvement Plan

Priorities

Com

munity

WHO?

Backbone Structures

Who does the work?• Collaborative• Nonprofit organization• Dedicated staff

Collective Impact

Making a difference

THANK YOU

Shawn HinzVice President, Public Health Services

RiverStone Healthshawn.hin@riverstonehealth.org

406-247-3365

Heather FinkCommunity Health Improvement Manager

On behalf of the Alliance: Billings Clinic, RiverStone Health, St. Vincent Healthcareheather@healthybydesignyellowstone.org

406-247-3272