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ChildrensHospitalofNewOrleansImplementationPlan November2015CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach1|P a g e TableofContents IntroductionPage:2 CommunityDefinitionPage:3 MethodologyPage:6 CommunityHealthNeedsandImplementationPlanPage:9 CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach2|P a g e Introduction ChildrensHospitalofNewOrleansisaa247bed,notforprofitmedicalcenterofferingadvancedpediatriccareforchildrenfrombirthto21yearslocatedinNewOrleans,Louisiana,andisalsooneofanetworkof4notforprofithospitalsthroughouttheGreaterNewOrleansarea. In response to its community commitment, Childrens Hospital ofNewOrleans contractedwith TrippUmbach to facilitate acomprehensiveCommunityHealthNeedsAssessment(CHNA).ThecommunityhealthneedsassessmentwasconductedbetweenMarch2015andOctober2015(SeetheChildrensHospitalofNewOrleansCommunityHealthNeedsAssessmentforthefullreport).ThisreportisthefollowupimplementationplanthatfulfillstherequirementsoftheInternalRevenueCode501(r)(3);astatuteestablishedwithin thePatientProtectionandAffordableCareAct (ACA) requiring thatnonprofithospitalsdevelop implementation strategies toaddresstheneedsidentifiedinthecommunityhealthneedsassessmentcompletedinthreeyearintervals.Thecommunityhealthneedsassessment and implementationplanningprocessundertakenbyChildrensHospitalofNewOrleans,withprojectmanagement andconsultationbyTrippUmbach,includedextensiveinputfrompersonswhorepresentthebroadinterestsofthecommunityservedbythehospital facility, including thosewith special knowledge of public health issues. TrippUmbachworked closelywith leadership fromChildrensHospitalofNewOrleansandaprojectoversightcommittee,toaccomplishtheassessmentandimplementationplan.ThisimplementationplanincludesstrategiestoaddressthecommunityhealthprioritiesamongyouthservedbythehospitalwhichwereidentifiedandprioritizedbasedontheinputofcommunityleadersrepresentingthecommunitiesservedbyChildrensHospitalofNewOrleans.Thoseprioritiesare:1)Accesstocare;2)Carecoordination;3)Culturalcompetence;4)Earlyinterventionandprevention;and5)Behavioralhealthservices.Asanonprofithospital,ChildrensHospitalofNewOrleansintendstoprovidecaretoyouthundertheageof21regardlessoftheirinsurancestatus.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach3|P a g e CommunityDefinitionWhilecommunitycanbedefined inmanyways,forthepurposesofthisreport,theChildrensHospitalofNewOrleanscommunity isdefinedas8zipcodesincluding3parishesthatholdalargemajority(80%)oftheinpatientdischargesforthehospital(SeeTable1andFigure1).Table1:ChildrensHospitalofNewOrleansStudyAreaDefinitionZipCodesTable1.ChildrensHospitalofNewOrleansStudyAreaDefinitionZipCodesCity ZipCode Parish City ZipCode ParishCrowley 70526 AcadiaParish NewOrleans 70128 OrleansParishGonzales 70737 AscensionParish NewOrleans 70129 OrleansParishPrairieville 70769 AscensionParish NewOrleans 70130 OrleansParishDeridder 70634 BeauregardParish NewOrleans 70131 OrleansParishLakeCharles 70601 CalcasieuParish WestMonroe 71291 OuachitaParishLakeCharles 70605 CalcasieuParish BelleChasse 70037 PlaqueminesParishSulphur 70665 CalcasieuParish Arabi 70032 St.BernardParishFerriday 71334 ConcordiaParish Chalmette 70043 St.BernardParishZachary 70791 EastBatonRougeParish Meraux 70075 St.BernardParishBatonRouge 70802 EastBatonRougeParish Violet 70092 St.BernardParishBatonRouge 70805 EastBatonRougeParish Destrehan 70047 St.CharlesParishBatonRouge 70815 EastBatonRougeParish Luling 70070 St.CharlesParishBatonRouge 70816 EastBatonRougeParish SaintRose 70087 St.CharlesParishVillePlatte 70586 EvangelineParish Lutcher 70071 St.JamesParishNewIberia 70560 IberiaParish Vacherie 70090 St.JamesParishWelsh 70591 JeffersonDavisParish LAPlace 70068 St.JohntheBaptistParishMetairie 70001 JeffersonParish Reserve 70084 St.JohntheBaptistParishMetairie 70002 JeffersonParish Opelousas 70570 St.LandryParishMetairie 70003 JeffersonParish BreauxBridge 70517 St.MartinParishMetairie 70005 JeffersonParish MorganCity 70380 St.MaryParishMetairie 70006 JeffersonParish Patterson 70392 St.MaryParishGretna 70053 JeffersonParish AbitaSprings 70420 St.TammanyParishGretna 70056 JeffersonParish Bush 70431 St.TammanyParishHarvey 70058 JeffersonParish Covington 70433 St.TammanyParishCommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach4|P a g e Table1.ChildrensHospitalofNewOrleansStudyAreaDefinitionZipCodesCity ZipCode Parish City ZipCode ParishKenner 70062 JeffersonParish Covington 70435 St.TammanyParishKenner 70065 JeffersonParish Folsom 70437 St.TammanyParishMarrero 70072 JeffersonParish Madisonville 70447 St.TammanyParishWestwego 70094 JeffersonParish Mandeville 70448 St.TammanyParishNewOrleans 70121 JeffersonParish PearlRiver 70452 St.TammanyParishNewOrleans 70123 JeffersonParish Slidell 70458 St.TammanyParishLafayette 70501 LafayetteParish Slidell 70460 St.TammanyParishLafayette 70506 LafayetteParish Slidell 70461 St.TammanyParishLafayette 70508 LafayetteParish Mandeville 70471 St.TammanyParishYoungsville 70592 LafayetteParish Hammond 70401 TangipahoaParishThibodaux 70301 LafourcheParish Hammond 70403 TangipahoaParishCutOff 70345 LafourcheParish Amite 70422 TangipahoaParishGalliano 70354 LafourcheParish Independence 70443 TangipahoaParishLarose 70373 LafourcheParish Kentwood 70444 TangipahoaParishLockport 70374 LafourcheParish Loranger 70446 TangipahoaParishRaceland 70394 LafourcheParish Ponchatoula 70454 TangipahoaParishDenhamSprings 70726 LivingstonParish Tickfaw 70466 TangipahoaParishWalker 70785 LivingstonParish Gray 70359 TerrebonneParishNewOrleans 70113 OrleansParish Houma 70360 TerrebonneParishNewOrleans 70114 OrleansParish Houma 70363 TerrebonneParishNewOrleans 70115 OrleansParish Houma 70364 TerrebonneParishNewOrleans 70116 OrleansParish Leesville 71446 VernonParishNewOrleans 70117 OrleansParish Angie 70426 WashingtonParishNewOrleans 70118 OrleansParish Bogalusa 70427 WashingtonParishNewOrleans 70119 OrleansParish Franklinton 70438 WashingtonParishNewOrleans 70122 OrleansParish MississippiNewOrleans 70124 OrleansParish Kiln 39556 HancockCountyNewOrleans 70125 OrleansParish Gulfport 39503 HarrisonCountyNewOrleans 70126 OrleansParish Carriere 39426 PearlRiverCountyNewOrleans 70127 OrleansParish Picayune 39466 PearlRiverCountyCommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach5|P a g e Figure1.MapofChildrensHospitalofNewOrleansStudyAreaCommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach6|P a g e MethodologyTrippUmbachfacilitatedandmanagedanimplementationplanningprocessonbehalfofChildrensHospitalofNewOrleans,resultinginthedevelopmentofan implementationstrategyandplantoaddresstheneeds identified intheircommunityhealthneedsassessmentcompletedin2015(i.e.,accesstohealthservices;resourceawarenessandhealthliteracy;accesstohealthyoptions;andbehaviorsthatimpacthealth).Keyelementsoftheimplementationplanningprocessincluded: ImplementationStrategyProcessPlanning:AmeetingwasfacilitatedbytheconsultantsandtheCHNAoversightcommitteeconsistingofleadershipfromChildrensHospitalofNewOrleans. CommunityHealthNeedsAssessmentReview:TrippUmbach facilitatedabriefoverviewofCommunityHealthNeedsAssessmentfindings to hospital leaders and facilitated adiscussionprocessduring ameetingheldonOctober 7, 2015.Hospital leaders thenparticipatedinadiscussiontodeterminewhichofthepreviouslyidentifiedcommunityhelathprioritiescouldbeandwhichcouldnotbeaddressedbyChildrensHospitalofNewOrleans.Onceneedswereselected;hospitalleadershipwereaskedtoproviderationalefortheneedsthatthehospitalcouldnotmeet. InventoryofInternalHospitalResources:Anonlinesurveywasdevelopedbasedontheunderlyingfactors identifiedasdrivingthesignificanthealthneedsintheChildrensHospitalofNewOrleansCommunityHealthNeedsAssessment.Thesurveywasreviewedandadministered by hospital leadership to key staff of the hospitalwhich completed the survey. The internal survey identifiedwhatprogramsandservicesareofferedatChildrensHospitalofNewOrleansthatmeetsignificantcommunityhealthneeds. CommitteeReviewofEvidenceBasedPracticesandPlanDevelopment:TrippUmbachfacilitatedareviewofstrategyandevidencebasedpracticesamonghospitalleadersduringameetingheldonOctober20,2015.Basedonthepracticespreviouslyprovided,hospitalleadershipreviewedanddiscussedthestrategyandsubsequentactionstepsneededtoimplementbestpracticestobegintoaddressthehealthneedsidentifiedintheservicearea.Hospitalleadersalignedneedswithbestpracticemodelsandavailableresources,definedactionsteps,timelines,andpotentialpartnersforeachneedtodeveloptheaccompanyingimplementationplan.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach7|P a g e Final ImplementationPlanningReport: A finalreportwasdevelopedthatdetailsthe implementationplanthehospitalwillusetoaddressthecommunityhealthpriorities identifiedbytheChildrensHospitalofNewOrleansCommunityHealthNeedsAssessmentwhichincludes: Objectives Anticipatedimpact Targetpopulation Plannedactionsteps Plannedresourcecommitment Collaboratingorganizations Evaluationmethodsandmetrics CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach8|P a g e CommunityHealthNeedsandImplementationPlanCommunityHealthNeedsImplementationPlanningMeetingQualitativeand informationaldatawerepresentedduringameetingheldonOctober7,2015withChildrensHospitalofNewOrleansleadershipwiththepurposeofselectingsignificantcommunityhealthneedsforhospitalimplementationplanning.TrippUmbachpresentedtheresultsoftheCHNAandusedthesefindingstoengagethehospitalleadersinagroupdiscussionrelatedtotheneedsthatChildrensHospitalofNewOrleanswouldaddressinimplementationplanning.Thehospitalleaderswereaskedtodiscussaplanforhealthimprovementintheircommunity,andselecttheneedsthattheyfeltthehospitalcouldaddressandassistthecommunityinresolving,andthosethattheyfeltthehospitalwouldnotbewellpositionedtoresolve.Duringtheprocess,hospitalleadersdeterminedthattheywerecapableofmeetingeachofthecommunityhealthprioritiesidentifiedintheir2015CHNA.Asaresult,hospitalleadersbelievethefollowinghealthneedsarethosetowhichChildrensHospitalofNewOrleansisbestpositionedtodedicateresourcestoaddresswithintheircommunity.1. AccesstoCare2. CareCoordination3. CulturalCompetence4. EarlyInterventionandPrevention5. BehavioralHealthServicesTrippUmbachcompletedanindependentreviewofexistingdata,indepthinterviewswithcommunitystakeholdersrepresentingacrosssectionofagencies,anddetailedinputprovidedbysurveyrespondents,whichresultedinasummaryofthecommunityhelathprioritiesintheChildrensHospitalofNewOrleanscommunityandtheimplementationstrategydevelopedtoaddressthoseneeds:CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach9|P a g e KEYCOMMUNITYHEALTHPRIORITY#1:INCREASINGACCESSTOHEALTHCAREUnderlyingfactorsidentifiedbysecondarydataandprimaryinputfromcommunityleaders,communitystakeholders,andresidentsurveyrespondents:1. Therearegreaterbarrierstoaccessinghealthcareinareaswiththepoorestsocioeconomicstatus2. Providertopopulationratiosthatarenotadequateenoughtomeettheneed.Increasingaccesstohealthservicesforyouthisidentifiedasthenumberonecommunityhealthprioritybycommunityleaders.AccesstohealthcareisanongoinghealthneedinmanyareasacrosstheU.S.Leadersdiscussedtheneedtoincreaseaccesstohealthservicesforyouthandtheirfamiliesasatopcommunityhealthpriority.Communityleadersfocusedtheirdiscussionsprimarilyonthelimitedaccessyouthhave tohealthservices inareaswherepovertyratesarehigh,the limitednumberofproviders,andrestrictiveregulationsthatimpedeserviceprovision.Socioeconomicstatuscreatesbarrierstoaccessinghealthcare(e.g.,lackofhealthinsuranceforundocumentedyouth,limitedserviceslocatedinareaswithhigherratesofpoverty,etc.),whichtypicallyhaveanegativeimpactonthehealthofresidents.Often,thereisahighcorrelation between poor health outcomes, consumption of healthcare resources, and the geographic areaswhere socioeconomicindicators (i.e., income, insurance,employment,education,etc.)are thepoorest. In theneedsassessments completedbyChildrensHospitalofNewOrleans in2013, community stakeholdersand focusgroupparticipants identifiedaccess tohealth careandmedicalservices(i.e.,primary,preventive,andmental)asaneedinthehospitalservicearea.WhileChildrensHospitalofNewOrleans,ahospitalintheLCMCHealthSystem,providesaccesstoaffordablehealthcareforyouth21yearsoldandyoungerinnumerousways,theneedtoimproveaccesswasidentifiedthroughthemostrecentcommunityhealthneedsassessment.RecognizingthatChildrensHospitalofNewOrleansisnottheonlymedicalresourceinthehospitalsservicearea,hospitalleadership developed the following threeyear strategy to further align the resources of the hospitalwith the health needs of thecommunity:CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach10|P a g e NEED:AccesstoCareUNDERLYINGFACTORS:Limitedaccessyouthhavetohealthservicesinareaswherepovertyratesarehigh,thelimitednumberofproviders,andrestrictiveregulationsthatimpedeserviceprovisionANTICIPATEDIMPACT:ProvideaccesstoyouthseekingcareatChildrensHospitalofNewOrleansthatmaynototherwisehaveaccesstohealthservicesObjective TargetPopulationPlannedAnnualActivity Timeframe/MeasuresPotentialResourcesProvideaccesstomedicalandpreventivehealthservicesavailabletoyouthinthehospitalserviceareaYouth021servedbyCHNOYear13:1. ExpandaccesstomedicalandpreventivecaretopatientswithinthecommunityA. ExpandprimarycareB. Expandspecialtycare2. ProvidepreventativeservicescontributingtooverallhealthimprovementofpediatriccommunityincludingimmunizationsA. GNOImmunizationProgram(seeAppendixAforcompletedescriptionofprogram)B. AmbulatoryClinicalandNutritionalSupporttosupporthealthyeatingandlifestyle(seeAppendixAforcompletedescriptionofprogram).3. ProvideahealthinsurancecoverageoptionforthosefamiliesnotabletoobtainanotherwisesufficientinsuranceplanA. ChildrensHealthcareAssistanceProgram(CHAP)assistsinprovidingmedicalcaretoourfacilitytouninsuredorunderinsuredpatients(seeAppendixAforcompletedescriptionofprogram).Year13:1Growthinoutpatientvolumeandspecialty2ANumberofImmunizationsgiven3A#ofpatientsand$committed3B#ofYouthassistedYear13:Resources:Thismightincludebudget,stafftime,materials,durablegoods,etc.1AStafftime,committedspace,costofclinicoperations,etc.1BUnfundedspecialtycare,stafftime,equipment,etc.2AOperationalcost,stafftime,supplies,etc.3AOperationalcost,budgettocovercare,etc.3BOperationalcost,stafftime,etc.4Stafftime,costoftransportationwhenprovided,etc.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach11|P a g e NEED:AccesstoCareUNDERLYINGFACTORS:Limitedaccessyouthhavetohealthservicesinareaswherepovertyratesarehigh,thelimitednumberofproviders,andrestrictiveregulationsthatimpedeserviceprovisionANTICIPATEDIMPACT:ProvideaccesstoyouthseekingcareatChildrensHospitalofNewOrleansthatmaynototherwisehaveaccesstohealthservicesObjective TargetPopulationPlannedAnnualActivity Timeframe/MeasuresPotentialResourcesB. OfferaMedicaidenrolleronsitetoassistfamiliesinapplyingforMedicaid.PotentialPartners:FamilyServiceofGreaterNewOrleansOffice/Westbank,LouisianaMedicaid/JeffersonParishWestBank,LouisianaMedicaid/PlaqueminesParish,LouisianaMedicaid/St.CharlesParish,LouisianaMedicaid/St.JohnParish,DaughtersofCharity/Metairie,CityofNOHealthDepartment/SchoolbasedDentalVan,CohenSchoolBasedHealthCenter,LSUHSCDSchoolBasedHealthCenter/AtScienceandMath,DaughtersofCharity/St.Cecilia,DaughtersofCharity/CarrolltonOneBunchHookUpLLC,CheatamMedicalTransit,HappyDayTransportationService,AOneTransportationLLC,PunctualTransportationLLC,NewOrleansRegionalTransitAuthority,CrawfordTransitService,BirdsTransportationLLC,JustaroundtheCity,GreenLightTransportation CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach12|P a g e KEYCOMMUNITYHEALTHNEED#2:NEEDFORCARECOORDINATIONUnderlyingfactorsidentifiedbysecondarydataandprimaryinputfromcommunityleaders,communitystakeholdersandresidentsurveyrespondents:1. Needforcarecoordination.2. Limitedaccesstohealthcareasaresultoftransportationissues.Leadersrecognizedthatcarecoordinationwillcontinuetoimprovewiththegrowthoftechnologyandengagementofpediatricprovidersandcommunitybasedorganizations(e.g.,thehealthinformationexchange,electronicmedicalrecords,etc.).However,leadersrecognizedthatcarecoordinationinpresenttimesisnotalwaysfunctioninginthemosteffectivewayforyouth.Leadersfocuseddiscussionsaroundtheneedfororganized,ongoingcarecoordinationforyouththatincludesinputfromallrelevantparties(e.g.,parents,religiousaffiliates,teachers,nurses,counselors,etc.).WhileChildrensHospitalofNewOrleans,ahospitalintheLCMCHealthSystem,providesprogramsandserviceswhichaimstoincreasecarecoordination,theneedtoimprovecarecoordinationwasidentifiedthroughthemostrecentcommunityhealthneedsassessment.RecognizingthatChildrensHospitalofNewOrleans isnottheonlymedicalresource inthehospitalsservicearea,hospital leadershipdevelopedthefollowingthreeyearstrategytofurtheraligntheresourcesofthehospitalwiththehealthneedsofthecommunity: CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach13|P a g e NEED:CareCoordinationUNDERLYINGFACTORS:Needfororganized,ongoingcarecoordinationforyouththatincludesinputfromallrelevantparties(e.g.,parents,religiousaffiliates,teachers,nurses,counselors,etc.)ANTICIPATEDIMPACT:ProvidecarecoordinationtoyouthseekingcareatChildrensHospitalofNewOrleansObjective TargetPopulationPlannedAnnualActivity Timeframe/MeasuresPotentialResourcesProvideservicesthateffectivelyassistcaregiversincoordinatinghealthcareservicesforyouthwhenseekingcareatCHNOYouth021servedbyCHNOregardlessofabilitytopayYear13:1. ProvideeducationalinformationaboutwhatservicesareavailableinthecommunityA. MaintainrelationshipwithofficeofpublichealthviaChildrensSpecialHealthServices(CSHS)toprovidearesourcecenterlocatedonsiteB. MaintainrelationshipwithStateBoardofEducationwithourVentilatorAssistedCareProgram(VACP)toeducateschoolhealthprofessionals2. ProvideeducationalinformationabouthealthmanagementandhealthybehaviorsA. Thediabetesandhealthylifestylesclinicofferseducationalinformationtofamiliesofyouthdiagnosedwithdiabetes.3. ImplementorganizationwideElectronicHealthRecordsystem4. Provideeducationtothepatient/familytoensureasafeandhealthyenvironmentforthepediatricventilatedpatientinthehome.Year13:1ABMaintainrelationship2AD#ofyouthreceivingservicesattheDiabetesandhealthylifestylesclinicandWebhits.3ImplementbySummer20174AVACPdocumentationYear13:Resources:Thismightincludebudget,stafftime,materials,durablegoods,etc.Webdevelopmentbudget,stafftime(i.e.,casemanagersandsocialworkers),dedicatedspace,costofimplementingEMR,printingcosts,etc.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach14|P a g e NEED:CareCoordinationUNDERLYINGFACTORS:Needfororganized,ongoingcarecoordinationforyouththatincludesinputfromallrelevantparties(e.g.,parents,religiousaffiliates,teachers,nurses,counselors,etc.)ANTICIPATEDIMPACT:ProvidecarecoordinationtoyouthseekingcareatChildrensHospitalofNewOrleans5. CentralizeresourcestoprovidestreamlinedandcoordinatedcaretopatientsA. CallCenterB. TransferCenter5AIncrease#ofPhysiciansandClinicusingCallCenterforscheduling5BOpentheTransferCenterinearly2015PotentialPartners:OfficeofPublicHealth,Communitybasedpediatricproviders,andWebdevelopers/providers. CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach15|P a g e KEYCOMMUNITYHEALTHNEED#3NEEDTOIMPROVECULTURALCOMPETENCEUnderlyingfactorsidentifiedbysecondarydataandprimaryinputfromcommunityleaders,communitystakeholdersandresidentsurveyrespondents:1. Presenceofbarriersrelatedtoliteracy,awarenessandlanguage2. NeedtoincreaseculturallysensitiveclinicalcareandeducationaloutreachtovulnerablepopulationsImprovingculturalcompetencewasidentifiedasatophealthpriorityfortheChildrensHospitalofNewOrleansservicearea.Communityleaders focused their discussions primarily on the need for bilingual providers, and treatment options that are culturally sensitive.community leadersdiscussed the cultural competenceand linguistic challenges thatplaya role inprovidingeffective treatment thatpatientsandtheirparentscanunderstandandcomplywith.ThereisaneedforculturallycompetentcareinthehospitalaswellasinthecommunityforLatinoandVietnameseresidentsincludingprovidinginformationinthelanguageandvariousdialectsresidentsspeak..WhileChildrensHospitalofNewOrleans,ahospital intheLCMCHealthSystem,providesserviceswhichareculturallycompetent,theneed to improveculturalcompetencewas identified through themost recentcommunityhealthneedsassessment.Recognizing thatChildrensHospitalofNewOrleans isnot theonlymedical resource in thehospitals servicearea,hospital leadershipdeveloped thefollowingthreeyearstrategytofurtheraligntheresourcesofthehospitalwiththehealthneedsofthecommunity: CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach16|P a g e NEED:CulturalCompetenceUNDERLYINGFACTORS:theneedforbilingualproviders,andtreatmentoptionsthatareculturallysensitive.ANTICIPATEDIMPACT:Providehealthservicesandinformationtoyouthandtheirfamiliesthatisculturallysensitive.Objective TargetPopulationPlannedAnnualActivity Timeframe/MeasuresPotentialResourcesEnsureeffectivecommunicationwithpatientsandtheirfamiliesthroughculturallysensitivecommunicationsandeducation.Youth021servedbyCHNOwithvaryingculturalbackgrounds(i.e.,Latino,Vietnamese,etc.)andresidentswithlimitedEnglishskillsYear13:1. CHNOwillscreenpatientsduringadmissionfortheirlanguageofpreferenceandprovideappropriatetranslationservicesforpatientsthatpreferalanguageotherthanEnglish.A. OfferalanguagelinefortranslationB. Basedonresourcesandavailability,offerbilingualstafftoassistwithtranslation.C. OffereducationandoutreachinavarietyoflanguagesD. EnsurecomprehensionofmedicaldocumentsforpatientswithlimitedEnglishspeakingskills.2. CHNOwillstrivetoofferculturallysensitivecaretopatients.A. Offerchaplainservicestoprovideoversightandcoordinationforreligiouspreferencesandpracticesforavarietyofaffiliations.Year13:1AD#ofusesofthetranslationline(costandlanguages),#ofclasses/educationaloutreacheffortsprovidedinalanguageotherthanEnglish.2Anumberofchaplainsonstaff,andbudgetYear13:Resources:Thismightincludebudget,stafftime,materials,durablegoods,etc.Stafftime,costoflanguageline,costofdocumenttranslationandprintingPotentialPartners:CommunitybasedchaplainsCommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach17|P a g e KEYCOMMUNITYHEALTHNEED#4NEEDTOIMPROVEEARLYINTERVENTIONANDPREVENTIONUnderlyingfactorsidentifiedbysecondarydataandprimaryinputfromcommunityleaders,communitystakeholdersandresidentsurveyrespondents:1. Lackofawarenessaboutsymptomsandneedforearlyintervention(parentsandproviders)and2. Lackofawarenessaboutwhatservicesareisavailable(parentsandproviders)Communityleadersdiscussedtheneedforearlyinterventionandpreventionasatophealthpriority.Communityleadersfocusedtheirdiscussionsprimarilyonthelackofprovidersandlimitedawarenessofparentsandprovidersregardingtheneedforservicesaswellastheresourcesthatareavailableinlocalcommunities.WhileChildrensHospitalofNewOrleans,ahospitalintheLCMCHealthSystem,providesearlyinterventionandpreventionservices,theneed to improveculturalcompetencewas identified through themost recentcommunityhealthneedsassessment.Recognizing thatChildrensHospitalofNewOrleans isnot theonlymedical resource in thehospitals servicearea,hospital leadershipdeveloped thefollowingthreeyearstrategytofurtheraligntheresourcesofthehospitalwiththehealthneedsofthecommunity: CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach18|P a g e NEED:EarlyInterventionandPreventionUNDERLYINGFACTORS:ANTICIPATEDIMPACT:ImproveearlydetectionandresponseaswellasaccesstopreventivecarerelatedtohealthissuesforyouthObjective TargetPopulationPlannedAnnualActivity Timeframe/MeasuresPotentialResourcesProvideearlyinterventionandpreventivehealthservicesinthecommunitiesservedbyCHNOYouth021servedbyCHNOregardlessofabilitytopayYear13:1. Ensureprovidersareawareofthemostuptodatepreventivepracticesanddetectionmethodsbyprovidingoutreachandeducationtolocalproviders.2. Offergeneralandspecialpediatriccarewhichincludesservicestofacilitateearlyinterventionwithanyhealthissuesoutsideoftypicalchilddevelopmentincludingreferrals(seeAppendixAforprogramdescriptions).A. ChildAbuseCareCenterB. DialysisandTransplantCenterC. DevelopmentaldelayclinicsD. Healthylifestylesclinic3. ProvideparentswiththeeducationandsupportnecessarytofacilitateearlyinterventionandpreventivecareforyouthservedbyCHNO(seeAppendixAforprogramdescriptions).A. TheParentingCenteratChildrensHospitalYear13:1Documentoutreachtoproviders2ADDocumentthe#ofyouthservedbyeacharea3ABDocumentthe#ofparentsservedandpresentationsgiven4ABDocumentthe#ofyouthservedbyeachareaYear13:Resources:Thismightincludebudget,stafftime,materials,durablegoods,etc.Stafftime,dedicatedspace,durablegoods,funding,etc.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach19|P a g e NEED:EarlyInterventionandPreventionUNDERLYINGFACTORS:ANTICIPATEDIMPACT:ImproveearlydetectionandresponseaswellasaccesstopreventivecarerelatedtohealthissuesforyouthB. Cancercommunityoutreacheducation4. Providepatientswithinformationaboutandaccesstohealthyoptions(seeAppendixAforprogramdescriptions).A. AmbulatoryClinicalandNutritionalSupportB. MiracleLeagueofGreaterNewOrleansPotentialPartners:FamiliesHelpingFamilies,CovenantHouse,MarchofDimes,AmericanCancerSocietyNewOrleansOffice,Boys&GirlsClubofSoutheastLouisiana,BaptistCommunityMinistries,CatholicCharities,andBoyScoutsofAmericaSoutheastLouisianaCouncil.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach20|P a g e KEYCOMMUNITYHEALTHNEED#5NEEDTOIMPROVEBEHAVIORALHEALTHSERVICESUnderlyingfactorsidentifiedbysecondarydataandprimaryinputfromcommunityleaders,communitystakeholdersandresidentsurveyrespondents:1. Therearenotenoughproviderstomeetthedemandandthespectrumofservicesavailableinmostareasisnotcomprehensiveenoughtotreatindividualneeds.Communityleadersatthecommunityforumidentifiedtheneedtoaddressbehavioralhealthneedsasatophealthpriority.Communityleaders, stakeholders,and survey respondentsagree thatbehavioralhealthand substanceabuse isa tophealthpriority.Discussionsfocusedprimarilyonthelimitednumberofprovidersthatarenotadequateenoughtomeetthegrowingdemand.AccordingtotheNewOrleansCityHealthDepartment,NewOrleansresidentscarryaheavyburdenfrommentalhealth,substanceabuse,andotherbehavioralhealthissues.Whilethisisnotdirectlyrelatedtoyouth,itisindicativeofapopulationswithgrowingbehavioralhealthconcerns.Muchofthedatavailablefocusesonadultbehavioralhealthmeasures,thoughstakeholdersand leaders indicatedthattherearesimilar issuesamongyouthinthestudyarea.WhileChildrensHospitalofNewOrleans,ahospitalintheLCMCHealthSystem,providesearlyinterventionandpreventionservices,theneed to improve access to behavioral health serviceswas identified through themost recent community health needs assessment.RecognizingthatChildrensHospitalofNewOrleans isnottheonlymedicalresource inthehospitalsservicearea,hospital leadershipdevelopedthefollowingthreeyearstrategytofurtheraligntheresourcesofthehospitalwiththehealthneedsofthecommunity:CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach21|P a g e NEED:BehavioralHealthServicesUNDERLYINGFACTORS:LimitednumberofprovidersthatarenotadequateenoughtomeetthegrowingdemandANTICIPATEDIMPACT:ProvideaccesstopediatricbehavioralhealthservicesinthehospitalserviceareaObjective TargetPopulationPlannedAnnualActivity Timeframe/MeasuresPotentialResourcesOfferbehavioralhealthservicestoyouthinthehospitalserviceareaYouth021servedbyCHNOregardlessofabilitytopayYear13:1. Provideinpatientandoutpatientbehavioralhealthservices(seeAppendixAforprogramdescriptions)A. RapidTreatmentProgramB. TheChildandAdolescentBehavioralHealthCenterC. AudreyHepburnCARECenterD. AutismCenter2. Providecarecoordinationforpatientsreceivingbehavioralhealthservices.A. Provideinformationandconnectiontocommunityresourcesasneededtopatientsandfamiliesthroughthesocialservicesdepartment.Year13:1ADDocumentthenumberofpatientservedineachprogram2ADocumentthenumberofreferralsmadeYear13:Resources:Thismightincludebudget,stafftime,materials,durablegoods,etc.Stafftime,dedicatedspace,funding,etc.PotentialPartners:KingsleyHouse,CovenantHouse,CatholicCharities/Metairie,CatholicCharitiesArchiocesesofNewOrleans,DaughtersofCharity/Carrollton,LSUHSCDSchoolBasedHealthCenter/atEleanorMcMain,MercyFamilyCenter,JewishFamilyServices,CelebrationHopeCenter,TheGuidanceCenter,JeffersonParishHumanServicesAuthority,FamilyServicesofGreaterNewOrleans,MetropolitanHumanServicesDistrict,EnhancedDestinyServicesInc,andIntegratedBehavioralHealthLLC.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach22|P a g e APPENDIXAProgramDescriptionsChildrensHospitalofNewOrleansNovember,2015CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach23|P a g e GNO Immunization Program The Centers for Disease Control recommends thatwhen children are uptodatewith theirvaccinationstheyareprotectedagainst16seriouschildhooddiseasesandwidespreaddiseaseoutbreaksaremore likelytobeprevented.Thisisnotonlybeneficialfortheindividualchild,butforthecommunityasawhole,whichmakesimmunizationsoneofthemostcosteffectivewaystomaintaincommunityhealth.Foreverydollarspentonvaccinations,thecaregiversaves$18directlyand$9indirectly(i.e.,preventionofworklossbythecaregiverandlostearningsfromdisability).Therefore,theGreaterNew Orleans Immunization Network (GNOIN) and the School Kids Immunization Program (SKIP) objective is to improveimmunizationratesofchildrenlivinginthegreaterNewOrleansareatoanidealrateof90%.VaccinesareprovidedtoGNOINforfreethroughtheLouisianaOfficeofPublicHealthaspartofthefederallyfundedVaccinesforChildrenprogram(VFC).ChildrensHospitalcurrentlypartnerswithfourareahospitalsthatdeliverbabiesEastJeffersonGeneralHospital,OchsnerClinicFoundation,TouroInfirmary,andWestJeffersonMedicalCentertosupporttheeffortsoftheimmunizationbus. ChildrensHealthcareAssistanceProgram (CHAP) ChildrensHealthcareAssistanceProgram (CHAP)providesphysician andhospitalservicesatnocosttochildrenwhosefamilyincomeistoohightoqualifyforMedicaid,butwhoselackofresourceslimittheiraccesstoqualityhealthcare. Ambulatory Clinical and Nutritional Support The outpatient Registered Dietitian provides nutritional assessments, helpsdeterminenutritiondiagnoses,determinesand implementsnutrition interventionsand thenmonitorsandevaluatespatientsprogressinanoutpatientsetting.Nutritioneducationfordiseasepreventionandnutritioncounselingforchronicconditionsareessentialcomponentsofacomprehensivehealthcareprogram.MedicalNutritionTherapyimprovespatientoutcomesandqualityoflife,anditlowershealthcarecosts.AndbecausemanynutritionalanddietaryservicesarenotcoveredunderLouisianaMedicaid,thereisaneedtoprovidethemtotheindigentpopulation.RegisteredDietitiansareanintegralpartofthehealthcareteamformanyoutpatientclinics,astheyhelptoinitiateandmanagetherapeuticdiets. RapidTreatmentProgramTheRapidTreatmentProgramopenedin2008,asanoutpatientmentalhealthtriageclinicdesignedtoprovideanexpeditedresponsetopatients.Thegoalofthisprogramistoprovideculturallysensitive,timelimitedassessmentand treatment intervention services to childrenprimarily suffering fromPostTraumaticStressDisorder,depressivedisorders,anxietydisorders,schoolavoidance/phobia,sleepdisorders(notassessedtobeCentralNervousSystemdependent),andAttentionDeficitHyperactivityDisorder.Manyschoolsprovideverylimited,ifany,mentalhealthandpsychologicaltreatmentoptions.Thecombinationoftherapidtreatmentandinpatientadolescentbehavioralhealthprogramsprovidetreatmentoptionstochildrendealingwithstressassociatedwithschoolortheirpersonallives.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach24|P a g e AdolescentBehavioralHealthTheChildandAdolescentBehavioralHealthCenter isa34bed inpatientpsychiatricprogramlocatedatChildrensHospitalsCalhounCampus.Thegoalof treatment is to stabilize thepatientspsychiatric symptomsandprovideevaluationandmedication adjustment.Wealsoprovideeducationalgroups toenhancepositive copingandproblemsolvingskills. AudreyHepburn CARE Center TheAudreyHepburn CARE (ChildrenAt Risk Evaluation) Center is a comprehensive forensicmedicine center providing pediatric forensicmedicine evaluations to aid in the proper recognition, intervention, protection,preventionandcareofmaltreatedchildren,includingcasesdealingwithphysicalabuse,neglectandsexualabuse.Lastyear,ourAudreyHepburnCARECenterevaluatedmorethan1,000childrenwhohadbeenabusedand/orneglected.Advancedtechnologyandproceduresareutilizedforthephysicalexamination,documentationofdiagnosedmaltreatmentandcollectionofevidence.Inaddition toprovidingclinicalexcellence in forensicmedicine, theCARECenter isactive in treatment,consultation,prevention,trainingandeducation,andresearch.TheCARECenterprovidesinformationandpresentationstoparentsandthecommunityonchildabuseandinjuryprevention.Thecenteralsoadvocateslegislationandpoliciesthatensuretheprotectionofatriskchildren. AutismCenterThepurposeofTheAutismCenteratChildrensHospitalistoimprovethequalityoflifeforchildrenwithAutismSpectrumDisorders(ASD)andtheirfamilies.Inordertoaccomplishthisgoal,TheAutismCenterprovidescomprehensive,evidencebasedassessmentandtreatmentforchildrenwithAutismSpectrumDisorders.AlthoughclinicalcareistheprimarymissionofTheAutismCenteratChildrensHospital,thecenteralsoservesasatrainingfacilityforprovidersandengagesininnovativeresearchendeavorstopromoteunderstandingaboutAutismSpectrumDisordersandtheirimpactonfamilies.Theprogramisgearedforchildrenandadolescents221yearsofagewhoaresuspectedofhavingAutismSpectrumDisorders(evaluation)andyouthwhohavebeenpreviouslydiagnosedwithASDs(treatment). The Parenting Center The Parenting Center at Childrens Hospital provides a place where parents, through the help ofprofessionally trained staff, candevelop competenceand confidence in rearing children.TheCenter servesasaneducationalresourcecenterwhereparentscanlearnaboutchilddevelopmentandrelatedskills;asupportcenterwhereparentscandiscussconcernswithotherparentsandstaffwhiletheirchildrenenjoythecompanyofotherchildren;andareferralcenterwhereparentscanreceivedirectiontoappropriatecommunityresources.TheParentingCenteroffersavarietyofprogramsthataddressthenormaldevelopmentalproblemsandissuesfacingtoday'sparents.CommunityHealthNeedsAssessmentChildrensHospitalOfNewOrleans TrippUmbach25|P a g e Safe Kids Safe Kids Louisiana is a part of Safe KidsWorldwide, a global organization dedicated to protecting kids fromunintentionalinjuries,thenumberonecauseofdeathtochildrenintheUnitedStates.SafeKidsfocusesonthreeareastopreventunintentionalinjuriesinchildren:thehome,carsandroad,sportsandplay.SafeKidsLouisianausescommunityhealthfairsastheprimarymechanismtoreachfamiliesatthelocalandregionallevel,providingeducationalmaterialsuchascarseatsafety,healthyeatingtips,andtoysafety. MiracleLeagueThemissionoftheMiracleLeagueofGreaterNewOrleansistopromotethehealthandwellbeingofchildrenwithdisabilities,provideopportunities forablebodiedchildren to learnaboutand interactwithchildrenwithdisabilities,anddevelopcommunityawarenessandsupportforthechildathletewithdisabilitiesthroughorganizedsports leagues.TheMiracleLeagueisdesignedtoservekidswhocannotbeaccommodatedbyestablishedbaseballandsoccerleaguesduetothespecialneedsof theirdisabilities.Thevisionof theMiracleLeague is toprovideanydisabledchild,regardlessof their levelofdisability, theopportunitytoplayleaguesportsandenjoytheemotionalandphysicalbenefitsofbeingpartofateamsport. OrleansParishSchoolBoardTeacheratChildrensInadditiontopatienttreatmentandmedicalservices,wehaveworkedwiththeOrleansParishSchoolBoardtohaveaspecialeducationteacheronsiteonaparttimebasis.Childrensprovidesofficespaceandsuppliesandthemainresponsibilityoftheteacherwhileoncampusistositwiththepatientstomakesuretheydonotfalltoofarbehindintheirscholasticduties.Thisallowsforasmoothertransitionwhenapatientisdischargedandreturnstoschool.

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