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Pascua Yaqui Pueblo Community Health Improvement Plan

2016 ‒ 2020

PASCUAYAQUITRIBEHEALTHDEPARTMENTCOMMUNITYHEALTHIMPROVEMENTPLAN2016-2020

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TABLE OF CONTENTS

PASCUAYAQUITRIBEHEALTHSERVICESDIVISION 3

PROMOTINGAHEALTHYPASCUAYAQUIPUEBLO 4

PASCUAYAQUIPUEBLOCOMMUNITYHEALTHIMPROVEMENTPLAN 6

COMMUNITYHEALTHIMPROVEMENTPRIORITIES 9

WORKINGTOGETHERTOWARDAHEALTHIERPASCUAYAQUIPUEBLO 22

PASCUAYAQUITRIBEHEALTHDEPARTMENTCOMMUNITYHEALTHIMPROVEMENTPLAN2016-2020

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PASCUA YAQUI TRIBE HEALTH SERVICES DIVISION VISION–AhealthyYaqui(Hiaki)communitywhereallpeoplecanenjoyhealthandwellnessinaclean,safe environment, be protected from public health threats, and have access to high-quality andcomprehensivehealthcare.MISSIONSTATEMENT–ThemissionofthePascuaYaquiTribalHealthProgramsistoprovidethehighestpossiblestandardsofcareforthehealthandwell-beingoftribalmembersandtheirfamilieswithinallYoemecommunities.VALUES• Werespectanddignifyindividualchoices

andYoemeculturalvaluesandtraditions.• Usingaholisticwellnessapproach,we

supporthealingthemind,body,andspirit.• Weaffirmtheuseoftraditionalhealing

herbsandprayer.• Wearecommittedtothepreventionand

treatmentofdiseaseandtotherestorationofhealthinourYoemecommunities.

• WearededicatedinbringingaboutemotionalandspiritualunitywithinourYoemefamilies.

• Weencourageahealthfullifestylethroughsupportandeducationofthebenefitsofbalancednutrition,moderateexerciseandfreedomfromaddiction.

• WeacknowledgethestrengthoftheYoemecommunitiesandendeavortohonorandshareourelders’wisdomforthefutureofourchildren.

• ThroughtheserviceofourHealthPrograms,theYoemeNationshallliveinbalanceandharmonywithinthesacredcircleoflife.

PURPOSE STATEMENT –We serve Tribal Members and their families in all Yoeme Communities byprovidingandpromotinghealthservicestoachieve longevity,wellnessandhealthy lifestyles.BydoingthiswehelpourCommunityliveinbalanceandharmonywithinthesacredcircleoflife.ABOUTTHEPASCUAYAQUIHEALTHSERVICESDIVISION(PYHSD)– PYHSDofferstribalmembersandtheirdependents(regardlessofresidence),andtribalemployeesavastarrayofhealthservices.PYHSDhousesseveraldepartmentsincludingAdministrationandCommunityPrograms,ManagedCare,HealthServices,HIM,CenteredSpirit,SewaU’usim,andtheDentalCenter.Additionalprogramsinclude:• CommunityHealthNursing• CommunityHealthRepresentatives

• DiabetesProgramandWellnessCenter

• FirstThingsFirst

• HIV/AIDSPrevention• HealthyFamilies,InjuryPrevention

• InjuryPreventionandPublicHealthPreparedness

• PascuaClinicandSpecialtyClinics

• Traditional/AlternativeHealing• Women,InfantsandChildren• YouthWellnessProgram

PASCUAYAQUITRIBE-HEALTHDEPARTMENTCOMMUNITYHEALTHIMPROVEMENTPLAN2016-2020

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PROMOTING A HEALTHY PASCUA YAQUI PUEBLO

How Can We Continuously Improve Our Community Health? Community health improvement planning is a process that helps communities make decisions abouthealthbasedonaccurateandcurrentdata.Communityleaders,publichealth,andhealthcareworkerscollectandusethis informationtoensurethatprogramsandservicesaremeaningful,purposeful,andstrategic.Particularly,publichealthdepartmentsusewhat is learned from theprocess to identify thehealthneedsofthecommunityandrespondbyimplementingstrategiestomakeimprovements.Apublichealth-focused community improvement planning process often includes three components: acommunityhealthassessment,acommunityhealthimprovementplan,andanorganizationalstrategicplan.Thesearedescribedbelow:• ACommunityHealthAssessment(CHA)–acollaborativeapproachofgatheringandreviewingdata

andinformationaboutacommunity’shealthstatus.Thedataandinformationcollectedaretypicallyusedtodecideonprioritiesandtoplanactionsthatwillimprovethecommunity’shealth.

• ACommunityHealthImprovementPlan(CHIP)–acommunity-drivenplanningprocessthatusesCHAresultstoprioritizehealthconcernsandcreateaplantoaddressthem.Theplangenerallycoversafive-yearspananddescribeshowthedepartmentwillsystematicallyworktogetherwithcommunitypartnerstoaddressthemostpressinghealthneedsofthecommunity.

• AStrategicPlan–aplanthatdefineshowanorganizationintendstouseitsresourcestoachieveitsgoals.Throughacommonunderstandingofthemission,vision,goals,andobjectives,thestrategicplanprovidesaframeworkthathealthdepartmentscanusetomakedecisionsthatwillhelpitmoveforward.

Whileeachcomponentisoftenconsideredaseparateactivity,theycanbedevelopedtogetheraspartofan overall process aimed at improving health outcomes. For example, the CHA reports data andinformation about a community’s health status, which stakeholders can then use to identify thecommunity’s health priorities to be addressed in the CHIP. The strategic plan addresses the healthdepartment’sinternalcapacity(e.g.policies,resourcesandstaff),aswellasitsprogramneedsinordertosupportoverallimprovementefforts,bothinternallyandinaddressingthecommunity’shealth.


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Pascua Yaqui Pueblo Community Health Assessment and Strategic Plan PascuaYaquiPuebloCommunityHealthAssessment:Collectingdataaboutanentirecommunitytakesthetime,expertise,andcooperationofmanypeople.ThePascuaYaquiTribeHealthServicesDivision(alsocalledthePYTHealthDepartment)beganconductingthefirstPascuaYaquiPuebloCHAinMay2012.ThePYTHealthDepartmentheldseveralmeetingsto:1)collectandanalyzethedata,2)gatherinputfromthecommunity,and3)reportresultstocommunitystakeholders.InApril2016,thePYTHealthDepartmentpresentedthepreliminaryCHAresultsatacommunitypartnersmeeting.Afterreviewingthefindings,communitystakeholdersidentifiedthemostimportanthealthissuesandthemesthatemergedfromtheprocess.ThehealthissuesidentifiedbycommunitystakeholdersarethebasisforthisPascuaYaquiPuebloCommunityHealthImprovementPlan.PascuaYaquiHealthDepartmentStrategicPlan:InJanuary2016,thePYTHealthDepartmentbeganastrategicplanningprocessbyconductinganenvironmentalscanoftheinternalandexternalfactorsthataffectthePYTHealthDepartment.OnMarch14-15,2016,HealthDepartmentmanagersandsupervisorsparticipated in a strategic planning session. They reviewed data from the CHA and a PYT HealthDepartmentperformanceassessment.Afterreviewingthedata,theyidentifiedthedepartment’sinternalstrengthsandareasforimprovement,aswellasexternalopportunitiesandthreats(SWOTanalysis).Theresultwasacomprehensive5-yearplanaddressingtheirperformancegoals.The Pascua Yaqui Pueblo Community Health Assessment, Strategic Plan, along with this CommunityHealth Improvement Plan,make up the Pascua Yaqui Tribe’s overall community health improvementprocess.


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PASCUA YAQUI PUEBLO COMMUNITY HEALTH IMPROVEMENT PLAN

CHIP Process

The Pascua Yaqui Pueblo Community Health Improvement Plan 2016-2020 was developed throughcollaborative efforts involving several PYT Health Department staff, health care professionals, andcommunitypartners.LiketheCHA,theCHIPfocusesspecificallyonthosePascuaYaquiTribalmembersresidinginPimaCountywhichincludesthePascuaYaquiPuebloReservation,OldPascua,BarrioLibre,andelsewherewithinTucson. TheHealthDepartmentconvenedaplanningmeeting to seek inputon theCHIP.TogetherwithcommunitypartnersandPYTHealthDepartmentstaffreviewedthefindingsofthePascuaYaquiPuebloCommunityHealthAssessment(includingthecommunitysurveyandCHANGEtoolassessment;theydiscussedcommunityhealthissuesandthemes,andtheassetsandresourcesthatcansupporthealthimprovementefforts.

Issues and Themes Shaping Pascua Yaqui Pueblo’s Health Communitypartnersidentifiedseveral issuesandthemesrelatedtothecommunity’shealth. Manyofthese issuesare interrelatedandshapethehealthof individualsandthecommunity.ThethemesandissuesthatthecommunitypartnersregardasimportantaslistedinFigure1below.Figure1.IssuesandThemes

• Theme:Addressdeterminantsofhealthandfocusonpolicies,systems,andenvironmentalchange.o Accesstocare(includingindividualswithdisabilities)o Availabilityanduseofhealthcareandservicesprovidedthroughinsuranceplanso Availabilityofeducationalopportunitieso Impactofincarcerationonindividualsandfamilieso SupportforTriballawsthataddresspublichealthissueso Familieswithinadequatehousingorhousingneeds

• Theme:Improvecommunityengagement,educationandempowermento Barrierstoseekingandreceivingcareo Knowledgeofhealthresources,alternativehealthservices,andhealthdepartmentprogramso Communicationfromthehealthdepartmenttocommunityo Educationonhealth-relatedtopicsandissues(healthliteracyandenvironmentalawareness)o Partnershipswithprovidersandstakeholders

• Theme:Traditionalhealthandvalueso Balanceofwesternandtraditionalhealing,culturallyappropriateservices,Yaquihealingo Multigenerationalfamilies

• Theme:Safercommunitiesandneighborhoodso Gangaffiliationo Illegaldrugsalesincommunityo Enforcementofanimalcontrollaws

• Theme:Strengthenfamiliesandrelationshipso Domesticviolenceo Healthyrelationships(families,youngpeople,partners,etc.)


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• Theme:Addresshealthareasgreatlyaffectingthecommunityo Chronicdiseases:Diabetes,chronicpain,cancero Infectiousdiseases:HepatitisC,sexuallytransmitteddiseases,HIV/AIDSo Riskfactors:Obesity,healthyeating,accesstohealthierfood,healthylifestyleso Substanceabuse:Drugpreventionandtreatment-Nomobilesyringeexchangeo Specialpopulations:Men’shealth,youthhealth,sexualhealth,LGBThealth

Pascua Yaqui Pueblo’s Assets and ResourcesOurcommunitiesaretrulythemostvaluableassetandresourceforimprovingourhealthstatus.Thereareseveralassetsandresources inthecommunity, includingseveralcommunityfacilities,recreationalareas,atransportationassistanceprogramandplanstoimproveroadwaysandwalkways.AcompletelistingcanbefoundinthePascuaYaquiPuebloCHA;selectresourcesaredescribedbelow.CommunityServicesandResourcesThePascuaYaquiTribehasafacilitythathousestheEducationDivisionandtheLanguageandCultureDepartment.ThebuildingincludesEducationadministrativeoffices,HiakiHighSchool,a largemeetingroom, the tribal library, the Intel clubhouse with music studio, and a traditional arts studio. OthercommunityservicesandresourcesincludeaMulti-PurposeJusticeCenter(LawEnforcementDepartment,Courts, Prosecutor’s Office, and the Attorney General’s Office), alternative programs for behavioralhealth,adulteducation,mentalhealthtreatment,andanAnimalControlShelter.Despite several community resources, many members must travel long distances to access otherimportant community services including hospital, urgent care, health clinics, the library and grocerystores. ThePascuaYaquiTribeTribalTransportationProgramaimsto improvehighway,road,bridge,parkway,ortransitfacilityprogramsorprojectsthatarelocatedon,orwhichprovideaccessto,thePascuaYaquiIndianReservation.TheTribe’srecentroadwayprojectistheextensionofIgnacioBaumearoadfrom Los Reales Road toValencia Road, and the improvements on Calle Torim. The road projectwillimproveaccess,mobilityandsafetyforvehicular,bicycle,andpedestriantraffic.RecreationalAssetsCommunityFacilityatPuebloPark:Thisareaisusedasacommunitymeetingareaandisthecenterofactivityformajorcommunitycelebrations.Itincludes:• Aerobicroom• Basketballand

volleyballcourts• Boxinggym• Commercialkitchenfor

classes

• Gymnasiums• Horsestables• Meetingrooms• Mosaicartstudio• Picnicareas• Playgrounds

• Skatepark• Swimmingpools• Walkingtrails

AssetsforCommunity-LevelChangeThroughotherPascuaYaquiHealthPrograminitiatives,theGoodHealthandWellnessinIndianCountryCoalition (Coalition)used theCHANGE (CommunityHealthAssessmentaNdGroupEvaluation)Tool toidentify community strengths (assets) and areas for improvement (needs). The Coalition examinedseveral sites to determine what is currently in place that helps create a healthier environment andcommunity-levelchange.TheCoalitionfocusedonfoursectors:1)CommunityatLarge;2)CommunityInstitution/Organization;3)HealthCare;and4)School.Foreachonthesesectors,theCoalitionsurveyedcommunitysitestoidentifyneedsandassetsintheareasofPhysicalActivity,Nutrition,Tobacco,Chronic


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DiseaseManagement,andLeadership.Theresultswereusedtoinformcommunityhealthimprovementpriorities.TheassetsforeachofthesectorsarelistedbelowinFigure3.Figure2.AssetsinFourSectors–PascuaYaquiCHANGEToolResults

Sector AssetsCommunityatLarge CommunityDevelopmentOffice

• Leadership,PhysicalActivityCommunityInstitution/Organization CasinoDelSol

• Chronic Disease Management, Leadership, Nutrition, PhysicalActivity

WorkforceInnovationandOpportunityAct(WIOA)• Chronic Disease Management, Leadership, Nutrition, Physical

Activity

HumanResources• Chronic Disease Management, Leadership, Nutrition. Physical

ActivityHealth SewaU’usim,DiabetesPreventionProgram,andDentalClinic

• Chronic Disease Management, Leadership, Nutrition, PhysicalActivity,Tobacco

School HiakiHighSchool• ChronicDiseaseManagement,Leadership,NutritionHeadStart• Chronic Disease Management, Leadership, Nutrition, Physical

Activity(Environment),TobaccoPhysicalActivity,Tobacco

Our Values for the CHIP Process ThePascuaYaquiPuebloCHIP2016-2020willserveasaguideforourcommunity-wideeffortstowardahappierandhealthierPascuaYaquiPueblo.Throughoutthecommunityhealthimprovementprocess,thePYTHeathDepartmentwillworkwithcommunity,publichealth,andhealthcareprogramstoleverageassets,resources,andskillsandtoprovidethehighestpossiblestandardsofcare.Thatis,thedepartmentwill provide services andprograms that are credible, timely, quality, effective andaccountable to thecommunity.TheHealthDepartmentiscommittedtohelpcommunitymemberslivehealthylifestylesandviewtheirhealthinaholisticway.Bypromotinghealthandwellnessusingthesevalues,thecommunityhealthimprovementprocesswillbeacomprehensive,strategic,andcommunity-wideeffort.


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COMMUNITY HEALTH IMPROVEMENT PRIORITIES During the CHIP planningmeeting, community partners and staff went through a consensus-buildingprocesstoselectpriorityhealthareas.Attendeesworkedinsmallgroupsbasedontheirareaofexpertiseand interest to brainstorm goals, objectives, and activities aimed at improving the health of thecommunityforeachstrategicpriority.Belowyouwillfindatableforeachofthesixcommunityhealthimprovementprioritiesthatemerged(calledStrategicPrioritiesinthetablesstartingonthepagebelow).Eachtableincludesthegoals,performanceobjectives,strategies,andalistofrelatednationalobjectivesthatalignwiththisplan’sobjectives.Thetablesalsoprovideinformationonwhichdepartment,groupororganizationisresponsibleforeachobjective,andliststhepartnersthattheywillworkwithtocompletespecifiedactivities.Note:ThroughouttheStrategicPrioritytables,thereaderwillfindtheabbreviations:DEVandTBD.Theirmeaningsaredescribedhere.

DEV Developmental:Objectives, baseline or target information forwhich there are nocurrentdatafor,butwillbecollectedaspartofthecommunityhealthimprovementprocess. Basedon thedata, thePublicHealthAccreditationTeammayrevise theapproach.

TBD Tobedetermined:Targetdateforactivitywillbedeterminedbytheorganizationordepartmentleadingtheobjective.

Alignment with Federal Health Improvement Priorities ThePascuaYaquiPuebloCHIPobjectivesalignwithnationalobjectivesidentifiedinHealthyPeople2020.HealthyPeople2020isa listof10-yeargoalsandtargetsforachievingbetterhealthacrossthenationprovidedbytheU.S.DepartmentofHealthandHumanServices.Thislistisupdatedeverytenyears.Overthelastthreedecades,theHealthyPeopleinitiativehasestablishedbenchmarksandmonitoredprogressovertime.Specificareasofalignmentforeachstrategicpriorityarenotedinthestrategicprioritytablesbelow.


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STRATEGICPRIORITY:CoordinationofCare

GOAL1:Integrateandenhanceofmedical,behavioral,socialandeconomicservicesandprograms.

PERFORMANCEMEASURESHowWeWillKnowWeareMakingaDifferenceIndicators Baseline Target Source Frequency

Numberofemergencyroomvisits DEV Decreaseof2%peryear

Banner,Carondelet,TMC(YoemeHealthPlan)

Annually

Numberofannualphysicalsvisits DEV Increaseof2%peryear

ElRioPrimaryCare(YoemeHealthPlan)

Annually

BACKGROUNDStakeholders:• Healthdepartment,Education,IT,PrimaryCareProvidersPolicy,Systems,EnvironmentalChanges:ChangeOrganizationalNormsandInfluencePolicy:• TribalCouncilsupportandinvolvement;HealthDepartmentStrategicPrioritySocialDeterminantsofHealth:• Income;Availabilityofhealthservices(underutilizehealthcoverageoptions)AlignmentwithHealthyPeople2020:• Improveaccesstocomprehensive,qualityhealthcareservices.

OBJECTIVE1.1:By12/31/2017,decreasevisitstotheemergencyroomby2%annually.Lead:CommunityHealthNursing(CHN)ProgramPolicyChange(Y/N):NACTIONPLANStrategy/Activity Target

DateTargetorResult Partners ProgressNotes

Strategy:Gatherdataandinformationtoassessthescopeofemergencyroom(ER)overuse.Convenequarterlypublichealth/healthcarestakeholdermeetings.

ONGOINGbeginning10/2016

Quarterlymeetings ElRio,YoemeHealthPlan

DeterminebaselineinformationforERvisits.

12/2016 ERreportonusagebymonth,year,andpatienttype

IdentifytargetgroupwhooverusetheER.

12/2016 Targetgroupidentification

CHN,Primarycareproviders;Clinic

Strategy:Provideconsistentcoordinationandcasemanagementfollow-through.Createadescriptionofprogramsandresourcesforlowincomeandrepeatpatients.

3/2017 Programresourceavailableforpatients

Provideconsistentcoordinationandcasemanagementfollow-through.(e.g.connectiontoprimarycare,behavioralhealth,addressingindividualissues)

3/2017 DecreasedpercentageofpatientsthatoverusetheER

CHN


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OBJECTIVE1.2:By12/31/2018,increaseannualphysicalsby2%annually.Lead:YoemeHealthPlan,HealthInformationManagement(HIM)PolicyChange(Y/N):NACTIONPLANStrategy/Activity Target


Strategy:Createarecallsystemandmediacampaignencouragingannualphysicals.Determinebaselineinformationforannualphysicals

2/2017 Reportoffindingsbasedon2016data

YoemeHealthPlan

Createplantotargetspecificgroupofpatientswitharemindersystem

6/2017 Completedplan

Sendremindersforindividualsdueforannualphysicals.

7/2017 Postcardssenttotargetedpatients

YoemeHealthPlan

Developpublicserviceannouncementsandothereducationmaterialstoinformthecommunityabouttheimportanceofandavailabilityofpreventionservicesandannualphysicals.

1/2018 Bi-Monthlyannouncements

PYTRadio,YaquiTimes,CHN,DiabetesProgram,SewaU’usim

YaquiRadioinformative/educationalshowsfeaturingpatientsbeingscreenedortalkingabouttheirannualphysical.

3/2018 Bi-Monthlyannouncements

KPYTRadio


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StrategicPriority:CommunityEducation,EmpowermentandEngagement

GOAL2:Increasetheavailabilityandaccessibilitytohealtheducationinformationandactivities.


Numberofhealtheducationmaterialsproducedanddisseminated

0resourcesin2016 5resourcesby2020

MaterialsandCommunicationsLog

Annually

Numberoffirst-timeandreturningcommunitygardenvolunteers

DEV 50volunteersannually

CommunityGardenVolunteerRoster

Annually

BACKGROUNDStakeholders:• PoliceDepartment,FireDepartment,CenteredSpirit,Education,SewaU’usim,Elders,LanguageandCulture,CHNPolicy,Systems,EnvironmentalChanges:Fosteringcoordinationandnetworksincommunityhealth:• IncorporatingcommunitygardenintothephysicalenvironmentSocialDeterminantsofHealth:• HealthliteracyAlignmentwithHealthyPeople2020:• IncreasetheproportionofpreschoolEarlyHeadStartandHeadStartprogramsthatprovidehealtheducationto

preventhealthproblems• Increasetheproportionofelementary,middle,andseniorhighschoolsthatprovidecomprehensiveschoolhealth

educationtopreventhealthproblems

OBJECTIVE2.1:Annuallyfrom2016-2020,createanddeliverhealtheducationmaterialsonatleast1leadinghealthissue.Lead:SewaU’usimPolicyChange(Y/N):N

ACTIONPLANStrategy/Activity Target


Strategy:MobilizethecommunitytoadvocateforpreventionandeducateonTribalhealthissuesFormacross-cutting,communitystakeholdersworkgroup

1/2017 Listofworkgroupparticipants

GoodHealthandWellnessinIndianCountryCoalition

Coordinateyouth,elderandLanguageandCultureinvolvementintheworkgroupandtoprovideinputonhealtheducationmaterials

3/2017 #ofyouthandelderswhoparticipate;#ofmeetingswithLanguageandCulture

Education,LanguageandCulture,SeniorCenter


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WelcomeCenterworkerswillcoordinateallhealtheventscalendar

7/2017 Monthlyannouncements

WelcomeCenter

Implementmonthlyhealthcampaignsaligningwithnationalandlocalhealthinitiatives:• Updatecommunityposterwith

infoonthethehealthissueofthemonth

• Issueswillincludeasthma,STD’s,airquality,andothers

9/2017 Scheduleofmonthlyhealthcampaigns

YoemeHealthPlan,CHN,SewaU’usim

ImplementhealthyeatingcurriculumatHeadStartandHiakiHighSchool

8/2018 Schedule;#ofyouthwhoattendtheworkshops

HeadStartandHiakiHighSchool,DiabetesProgram

Gatherinformationannuallyanddocument‘bestpractices’onprovidingcommunityhealtheducation.

ONGOINGthrough10/2019

Bestpracticesdocument

GrantsProgramManager

OBJECTIVE2.2:Annuallyfrom2017-2020,recruit50ofvolunteersforthecommunitygarden.Lead:SewaU’usimPolicyChange(Y/N):YACTIONPLANStrategy/Activity Target


Strategy:Supporttheexistingcommunityeffortandbolsteritsvisibilityinthecommunity.Raiseawarenessofthecommunitygardenthroughothercommunityevents

3/2017 Attendanceatcommunityevent

GHWC

Recruitgroupstoparticipateinvolunteergroup(children’sgroup,elders,diabetesprogram)

4/2017 Diversityofparticipants

GHWC,DiabetesProgram,HeadStart,YouthPrograms

Provideincentivesforfirst-timevolunteers

5/2017 #offirst-timevolunteerswhoparticipateatleast2timeswithinyear

Provideincentivesforlong-termvolunteers

5/2017 #ofvolunteerswhoparticipatefor1yearorlonger


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STRATEGICPRIORITY:SubstanceAbuse

GOAL3:Preventandtreataddictiontoharmfulsubstancesandbehaviors.


Numberofpeersupportandcoachingprogramsestablished

0programsin2016 1peersupportandcoachingprogram

CenteredSpirit(CSP)

Every2years

Numberofprescriptiondruguseagendasdeveloped

0agendasin2016 1agendaby2019

HealthAdministration

Every2years

BACKGROUNDStakeholders:• CenteredSpiritProgram(CSP)Policy,Systems,EnvironmentalChanges:ChangeOrganizationalNormsandInfluencePolicy:• TribalCouncilsupportandinvolvement;AgendawillinfluencepolicychangeSocialDeterminantsofHealth:• SocialsupportAlignmentwithHealthyPeople2020:• IncreasethenumberofTribalhealthservicesprovidingpopulation-basedprimarypreventionservicesaddressing

substanceabuse

OBJECTIVE3.1:By12/31/2020,pilotatleastonepeersupportandcoachingprogramtoempowerandpromoteindividualstoliveahealthyandbalancedlife.Lead:CenteredSpiritProgram(CSP)PolicyChange(Y/N):NACTIONPLANStrategy/Activity Target


Strategy:Developapeersupportandcoachingprogramonhealthylivingpractices.Researchexistingprogramsandpotentialfundingsources

9/2016 Identifyprogrammodel

Adaptprogramandtrainingmaterials

TBD Modeladaptation

Conduct2pilotprogramstoassesseffectivenessandobtainfeedback

TBD 2pilotsandevaluationresults

Finalizetheprogrambasedonpilottrainingresults

TBD Finalprogram

Train2stafftoimplement12-weekpeercoachingprogram

TBD Trainedstaff

Identifyandrecruitindividuals/groupsinPascuaYaquithatwillbenefit

ONGOING(Beginning8/2017)

Numberofparticipants

CHN,CHR


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OBJECTIVE3.2:By12/31/2019,developaPYTagendaforaddressingprescriptiondrug-relatedharmsinthecommunity.Lead:HealthPolicyandProceduresPolicyChange(Y/N):YACTIONPLANStrategy/Activity Target


Strategy:Developprescriptiondrugmisusestrategythataddressesthecomplexissuesincludingpain,addiction,mentalhealth,co-morbiditiesEstablishaprescriptiondrugmisusetaskforce

6/2018 Multi-sectorteam CenteredSpirit;Lawenforcement;CHN;EnvironmentalHealth;ElRio;PHABTeam

Conductresearchoranassessmenttodeterminetheextentofprescriptiondrugmisuseanditsharmtoindividuals,familiesandthecommunity

9/2018 Descriptionofneedsandrisks

Identifyopportunitiesforprevention,education,treatmentandenforcementstrategies

3/2019 Prioritiesareastoaddress

Proposerecommendationswithmilestones

9/2019 Report

Implementtherecommendationswithcontributionfromstakeholders(e.g.drugtakebackprograms,peersupportgroups,alternativestopainmedications)

ONGOING(Beginning3/2020)

Coordinatedefforttopreventprescriptiondrugmisuse


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STRATEGICPRIORITY:ChronicDisease

GOAL4:Promotehealthybehaviorsandlifestyles,andreduceriskofchronicdiseasesthroughpreventionandeffectivemanagementofpre-existingconditions.


Numberofhealthyfoodpoliciesadopted

DEV DEV GHWCSurvey Every2years

Childhoodobesityrate• Percentageofchildren5-18

whoareoverweightorobese

DEV 5%reductionin2020

ElRio Annually

PercentageofPYHSDstaffutilizingEmployeeWellnessPolicy

DEV 20%increaseby2020

PYHSDSurvey Every2years

Percentincreaseincancerscreenings(Seemultipleindicatorsbelow)

• Breastcancerscreenings DEV DEV ElRio Annually

• Cervicalcancerscreenings DEV DEV ElRio Annually

• Tobaccousescreenings DEV DEV ElRio Annually

• Oralcancerscreenings DEV DEV ElRio Annually

• Prostatecancerscreenings DEV DEV ElRio Annually

Background

Stakeholders:• Forimplementation–Healthprogram:Nursing,HIV/AIDS,Diabetes• Foroutreachandengagement–Casino,KPYTRadio,Powwow,HealthServicesDivisionPolicy,Systems,EnvironmentalChanges:• Accesstohealthyfood;Healthyfoodsonmenu;EmployeeWellnessPolicySocialDeterminantsofHealth:• Income,povertyandfoodsecurity• Otherdeterminants:BuiltenvironmentandchronicdiseaseriskfactorsAlignmentwithHealthyPeople2020:• Increasetheproportionofworksitesthatofferanemployeehealthpromotionprogramtotheiremployees• IncreasethenumberofTribalhealthservicesprovidingpopulation-basedprimarypreventionservicesaddressing

chronicdisease• Increasetheproportionofschoolsthatoffernutritiousfoodsandbeveragesoutsideofschoolmeals


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OBJECTIVE4.1:By9/30/2017,increaseuseofthePYTEmployeeWellnessProgramby20%.Lead:HealthAdminPolicyChange(Y/N):YACTIONPLANStrategy/Activity Target


IdentifypercentofemployeesusingtheEmployeeWellnessProgram

10/2016 Surveyresults

Informemployeesofpolicyandencouragethemtoutilize

1/2017 Increasedawareness

Provideincentivestoindividualsutilizingtheprogram

6/2017 Increaseduse On-reservationfacilitiesthatstaffcanuse(WellnessCenter,StressManagement,Nutrition)

Obtainworkerinputonpolicyandupdateifneeded

9/2017 Feedbackandengagement

OBJECTIVE4.2:By9/30/2018,increasethenumberofhealthyfoodpoliciesinschoolsandworksites.(DEV)Lead:GHWCPolicyChange(Y/N):YACTIONPLANStrategy/Activity Target


Strategy:Advocateforandsupportprogramsandpoliciesthatencouragehealthyeating,andimprovedaccesstofruitsandvegetablesSurveyschoolsandworksitestodetermineexistingpolicies

TBD Examplesofpolicies

Reviewinformationonchallengesandbarrierstohealthyfoods

TBD Summary

SupportfreshproduceprogramsbypurchasingfoodfortheGoodHealthandWellnessSaladBar

TBD MonthlySoupandSaladBaropentothecommunity

Farmers,GWHC,Cafeteria

Advocateforapolicythatrequireshealthyfoodoptionsatschoolevents

TBD Proposedpolicy HealthAdmin

AdvocateforaPYTHealthServicesDivisionpolicythatencourageshealthyfoodoptionsbeservedatsponsoredeventsandhealthfacilities

TBD Proposedpolicy HealthAdmin


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OBJECTIVE4.3:By9/30/2019,reducethechildhoodobesityrateby5%ormore.(DEV)Lead:DiabetesProgramPolicyChange(Y/N):YACTIONPLANStrategy/Activity Target


Strategy:IncreaseaccesstoopportunitiesforphysicalactivitiesforkidsAdvocateforandsupportprogramsandpoliciesthatencouragephysicalactivity,anddecreasingBMI

TBD Proposedpolicytotriballeadership

Educateparentsofchildren’sprogramswithresourcesthatpromoteactiveplayandphysicalactivity

TBD Healtheducationmaterials

HeadStart,BoysandGirls,SewaU’usim

Developopportunitiesforcommunitygroupsandbusinesstosponsorphysicalactivitiesforchildren

TBD Increasednumberofphysicalactivities

CommunityCenter

OBJECTIVE4.4:By12/31/2020,increasescreeningsofcancerscreeningsby5%.(DEV)Lead:CommunityHealthNursing(CHN)PolicyChange(Y/N):NACTIONPLANStrategy/Activity Target


Strategy:Supporthealthcareproviders,CHRs,nurses,HIVandDentalprogramsexpandtheirreachandreferrals.Workwithhealthprogramstoidentifyscreeningsprovidedandresourcesforpatients

9/2016 Descriptionofavailableservices

Reviewpatientrecordstosendoutremindersforscreeningstheyareduefor

TBD Remindersystem YoemeHealthPlan,CHN,andManagedCare

Workwithhealthcareproviderstoaddresschallengesandbarrierstheyfacewhenreferpatientsforscreenings

TBD Increasedopportunitiesforscreenings


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STRATEGICPRIORITY:InfectiousDisease

GOAL5:Raiseawarenessofemergencypreparednessandsexualhealthservices.


Numberofchlamydiaandgonorrheascreenings

DEV DEV ElRio Monthlyreportsofscreeningsandreferralsfortreatment

NumberofHIVandHepatitisC(HepC)screeningsprovidedbyNewBeginnings,HIV/AIDSProgram

0HIVscreenings20HepCscreenings

15HIVscreenings25HepCscreenings2017-2020

NewBeginnings,HIV/AIDSProgram

Semiannualreportsofcompletedscreeningsandreferralsfortreatment

Numberofprogramsforsexualhealth

0in2016 1by2020 HIV/AIDSProgram Every2years

NumberofworkshopsandoutreachonPublicHealthEmergencyPreparednessatcommunity-wideevents

1in2016 1 TribalPHEPprogram

Annually

NumberofreportablediseasemonitoredandtrackedinEpiInfo

0 10 TribalPHEP,HealthAdmin,CHN

Monthly

NumberofHealthcareworkerstrainedinhealthemergencypreparednessplanning

0 10 TribalPHEPprogram,CHN,FEMA,

Every2years

Background

Stakeholders:• SewaU’usim,HIV/AIDSDepartment,CSP,ElRio,DiabetesProgramPolicy,Systems,EnvironmentalChanges:• Potentialpolicychangearoundmandatoryinfectiousdiseasescreeningatintakeorprotocolsforofferinginfectious

diseasescreeningsSocialDeterminantsofHealth:• AccesstohealthcareAlignmentwithHealthyPeople2020:• Promotehealthysexualbehaviors,strengthencommunitycapacity,andincreaseaccesstoqualityservicestoprevent

sexuallytransmitteddiseases(STDs)andtheircomplications.

OBJECTIVE5.1:By12/31/2017,increasethenumberofSTDs,HIV,andHepatitisCscreenings.(DEV)Lead:HIV/AIDSProgramPolicyChange(Y/N):YACTIONPLAN


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Strategy/Activity TargetDate

TargetorResult Partners ProgressNotes

Strategy:CollaboratewithPYHSDprogramstoincreasecommunityawarenessoftheimportanceofSTD,HIV,andHepatitisCscreening.Coordinatecommunityeducationeventswhichdiscusstheimportanceofscreening

6/2017 Scheduleofcommunityevents

HIV/AIDSProgramincollaborationwithallPYHSDprograms

Utilizesocialmediatoshareinformationaboutscreenings

6/2017 Monthlysocialmediacampaigns

HIV/AIDSProgram,HealthAdministration

ProducemonthlyPSAs 10/2016 PSAschedule HIV/AIDSProgram,Radio

CreateavideoaboutscreeningtoplayintheWelcomeCenter

6/2018 Completedvideo HIV/AIDSProgram,LanguageandCulture

Strategy:ImprovecurrentSTD,HIV,andHepatitisCscreeningprotocolsandproceduresUpdateprotocolsandproceduresasneededtoeliminatebarrierstoseekingscreenings

1/2017 Updatedprotocolsandprocedures

OBJECTIVE5.2:By12/31/2019,re-establishasexualhealthprogramforhighriskgroups.Lead:HIV/AIDSProgramPolicyChange(Y/N):N

ACTIONPLANStrategy/Activity Target


Strategy:Re-establishpreviousHIVpreventionandeducationprogram(InCommunitySpiritProgram)toreachhighriskgroups.ObtainTribalLeadershipsupporttodeveloppreventionprogram

10/2017 DecisionMemofromHealthOversightCommittee

TribalCouncil

Seekfundinginternallyorthroughexternalgrants

10/2017 Fundingsecured GrantsProgramManager,HIV/AIDSProgram

Identifytargetpopulations 1/2018 Populationidentifiedinworkplan

HIV/AIDSProgram

AdaptInCommunitySpiritprogramtoincorporatelanguageandculturalelementsintothelessons

5/2018 Adaptedprogram LanguageandCulture

Recruitandtrainstafftodeliverprogram

6/2018 Trainedstaff

Pilotsexualhealthsessionswith2highriskgroups

8/2018 Feedbackonprogram

Identifyongoingfundingsupportforprogramsforfinancialsustainability

1/2019 Sustainablefundingforprogramcosts

GrantsProgramManager


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OBJECTIVE5.3:By12/31/2017,increasethenumberofworkshopsandoutreacheffortsinthecommunityonPublicHealthpreparedness.Lead:TribalHealthPHEPPolicyChange(Y/N):NACTIONPLANStrategy/Activity TargetDate TargetorResult Partners ProgressNotesStrategy:Createacommunity-widecampaignabouttheimportanceofpreparedness.RaiseawarenessofPublicHealthpreparednessbypromotingthetopicatcommunityevents

12/2017 1eventannually PYTRadiostation,AZDept.ofPHEPtaskforce,FEMA,CHN

DevelopPSAonPHEP 12/2017 QuarterlyPSA PYTRadio,YaquiTimes

DevelopanddisseminateflyersonPHEP

12/2017 Semi-annually PYTintranetannouncementpage,Communityboard,YaquiTimes

OBJECTIVE5.4:By12/31/2017,increasethenumberofreportablediseasesmonitoredandtrackedinEpiInfo.Lead:TribalHealthPHEPPolicyChange(Y/N):NACTIONPLANStrategy/Activity TargetDate TargetorResult Partners ProgressNotes

Strategy:Improveinternaldatasystemsfornotifiablediseases.Assesscurrentreportablediseaseandtrackingsystem

10/2016 Summary CHN,ElRioClinic,HIM,HealthAdmin

Identifyandapprovereportablediseaselisttomonitorandtrack

12/2016 DecisionMemo HealthAdmin,CHN

CompleteEpiInfoTraining 1/2017 Certificate HealthAdmin,ITCATEC

MonitorandtrackreportablediseasesinEpiInfo

6/2017 MonthlyReportfromEpiInfo

HealthAdmin

OBJECTIVE5.5:By12/31/2017,increasethenumberofstafftrainedinhealthemergencypreparedness.Lead:TribalHealthPHEPPolicyChange(Y/N):YACTIONPLANStrategy/Activity TargetDate TargetorResult Partners ProgressNotesStrategy:ImprovePYSHDstaffawarenessandinvolvementinpreparednessplanning.Identifypercentageofhealthstafftrainedinhealthemergencypreparednessandplanning(EPP)

01/2017 Surveyresults HealthAdmin,CHN

InformhealthstaffontheimportanceofhealthEPP

7/2017 Increasedawareness

HealthAdmin,CHN

SchedulehealthEPPtraining 9/2017 TrainingSchedule

HealthAdmin,AZPHEP,FEMA

PASCUAYAQUITRIBE-HEALTHDEPARTMENTCOMMUNITYHEALTHIMPROVEMENTPLAN2016-2020PUBLICHEALTHPERFORMANCE

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WORKING TOGETHER TOWARD A HEALTHIER PASCUA YAQUI PUEBLO BoththePascuaYaquiPuebloCommunityHealthAssessmentandCommunityHealthImprovementPlanarepartofalargerefforttowardmakingimprovementsinthecommunity’shealth.Incollaborationwiththecommunitypartners,thePublicHealthAccreditationTeamwillbegintoimplementCHIPstrategiesandactivitiesbeginninginfallof2016.Throughthecommunityhealthimprovementefforts,wewillbemaking strides toward our vision for the community’s health,which is “all TribalMembers and theirfamiliesinallYoemeCommunitieshavethehighestpossiblestandardsofcare,areempoweredtomanagetheirownhealthandengageinhealthylifestyles,andliveinbalanceandharmonywithinthesacredcircleof life.” Achievingthisvisionwillrequirepartnershipinallthestrategicpriorities,andinallareasthatshapeourcommunity’sheath.ThePublicHealthAccreditationTeamwillperiodicallymonitorprogressoverthenextfiveyears(plannedfor2017and2019),withanindepthreviewoftheobjectivesandthesupportingdatatomakeanynecessaryadjustmentstotheCHIP.TheHealthDepartmentiscommittedtocontinualhealthimprovementandwillcontinuetoleverageourbestassets–ourcommunity,culture,andtraditions.Together,wewillworktowardahealthierPascuaYaquiPuebloforallTribalmembersandtheirfamiliesinallYoemecommunities.

pascua yaqui pueblo community health improvement plan … chip 2016.pdfpascua yaqui tribe health...

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