wright county community health needs assessment plan...wright county community health collaborative...

Wright County Community Health Needs Assessment Plan

2020-2022

WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN 2020-2022 PAGE 1

TABLE OF CONTENTS EXECUTIVE SUMMARY 2-3 INTRODUCTION 3-4 COMMUNITY HEALTH VISION 4 MEMBER DESCRIPTIONS 4-6 DEMOGRAPHICS 6-7 EVALUATION OF 2017-2019 COMMUNITY HEALTH NEEDS ASSESSMENT 8-15 2020-2022 CHNA PROCESS AND TIMELINE 15-16 DATA COLLECTION AND COMPARATIVE ANALYSIS 16 2018 COMMUNITY HEALTH SURVEY RESULTS 17-18 DATA REVIEW AND ISSUE PRIORITIZATION 18 FINAL PRIORITIES 19 COMMUNITY INPUT 19-21 FINDINGS FROM KEY STAKEHOLDER GROUPS 21-22 NEEDS IDENTIFIED BUT NOT INCLUDED IN THE CHNA 22 IMPLEMENTATION PLAN 22-24 RESOURCE COMMITMENTS 24 EVALUATION OF OBJECTIVES 24 ALLINA AND CENTRACARE CENTRAL MN SYSTEM-WIDE ACTIVITIES 25-27 ACKNOWLEDGEMENTS 28 CONCLUSION 28


EXECUTIVE SUMMARY TobetterunderstandhealthissuesfacingthecommunitiesofWrightCounty,BuffaloHospital,partofAllinaHealth,CentraCare–Monticello,WrightCountyPublicHealthandWrightCountyCommunityActionpartneredtodevelopandconductaCommunityHealthNeedsAssessment(CHNA).Inearly2017,theorganizationsformedWrightCountyCommunityHealthCollaborativeinanefforttocollectandprioritizedatafromvarioussources,anddevelopajointcommunityhealthimplementationplan.Thepurposeofthecollaborativegroupistosystematicallyidentifyandanalyzehealthissuesinthecommunityandcreateaplanforhowtoaddressthem.ThegroupincludesallWrightCountyorganizationswhoareencouragedorrequiredtocompleteaCommunityHealthNeedsAssessment(CHNA).ThecollaborativeemployedtheMobilizingforActionthroughPlanningandPartnership(MAPP)frameworkwhichemphasizescollaborationofhealthcareentities,publichealthandcommunityorganizationsandiscentereduponcommunityengagement.TheCHNAutilizedavarietyofinformationsourcesandcommunityinputtoanalyzeandprioritizecommunityhealthissues.Thisinformationwasusedtodevelopthehealthimprovementactionplantoaddresstheidentifiedissues.ImportantactivitiesintheCHNAprocessareoutlinedinthisdocument,aswellasrolesandresponsibilitiesamongthepartnersinthecollaborative.TheCHNAprocesswasbasedonthepartnershipbetweenfourorganizations:BuffaloHospital,partofAllinaHealth,CentraCare–Monticello,WrightCountyPublicHealthandWrightCountyCommunityAction.MajorCHNAdecisionswerebasedonconsensusandopendialoguebetweenthepartners,aswellascommunityinput.Thecollaborativeagreedthatthedefinitionofhealthencompassesabroadrangeofconditions,notjusthealthintermsofhealthcare.Improvinghealthisnolongerabouttreatingandpreventingmedical

conditions;itistheimprovementofcompletephysical,mental,spiritualandsocialwell-being.RepresentativesfrompartneringorganizationsmetregularlyfromSeptember2017toJuly2019forprogressupdates,discussiononupcomingCHNAactivitiesandeventplanning.Allcorepartnersinthecollaborativecontributedtothecompletionoftheprocesstothebestoftheirabilityandutilizedthestrengthsandcapacityofvariousgroupmembers.ThepartnershipadoptedtheMAPPmodelforassessmentandplanning.MAPPisacommunity-drivenstrategicplanningprocessforimprovingcommunityhealth.Facilitatedbypublichealthleaders,thisframeworkhelpscommunitiesapplystrategicthinkingtoprioritizepublichealthissuesandidentifyresourcestoaddressthem.MAPPisnotanagency-focusedassessmentprocess;rather,itisaninteractiveprocessthatcanimprovetheefficiency,effectiveness,andultimatelytheperformanceoflocalpublichealthsystems.CommunityownershipisakeycomponentofMAPP.Participationfromthebroadercommunityleadstocollectivethinkingandsustainablesolutionstocomplexproblems.

MappProcessModel


Thiseffortincluded:(1)completionofaCHNAtosystematicallyidentifyandanalyzehealthprioritiesinthecommunity,and(2)developmentofaplantoaddresstheseprioritiesasacollaborativeandinpartnershipwithothers.Throughthisprocess,thecollaborativeengagedwithcommunitystakeholderstobetterunderstandthehealthneedsofthecommunitiesitserves,identifiedinternalandexternalresourcesforhealthpromotionandcreatedanimplementationplanthatleveragesthoseresourcestoimprovecommunityhealth.In2018,communitymembers,communityorganizations,publichealthandhospital/healthsystemstaffparticipatedinaprocessthatidentifiedthefollowingpriorityareasforcommunityhealthinthecommunitiesservedbythecollaborative:1) MentalHealthandWellness2) DentalCare3) SubstanceUseandAbuse

In2018-19,staffsolicitedcommunityinput,assessedexistingresourcesanddevelopedacommunityhealthimprovementplanfor2020-2022inordertoaddressthesepriorities.Thisimplementationplanincludesthefollowinggoals,eachofwhichissupportedbymultiplestrategiesandwillbeimplementedthroughavarietyofactivitiesmonitoredforprogressandoutcomesovertime.MentalHealthandWellnessgoal:Reducetherateofmentalhealthcaredelayandthenumberof“notgood”mentalhealthdaysinWrightCounty.DentalCaregoal:ReducetherateofdentalcaredelayinWrightCounty.SubstanceUseandAbusegoal:SupportlocalpreventioneffortsandadvocateforpolicychangestoaddresssubstanceabuseinWrightCounty.

INTRODUCTION WrightCountyCommunityHealthCollaborativewasformedinordertosystematicallyidentifyandanalyzehealthissuesinthecommunityandcreateaplanforhowtoaddressthem.ThegroupincludesWrightCountyorganizationswhoareencouragedorrequiredtocompleteaCommunityHealthNeedsAssessment(CHNA).TheInternalRevenueServiceprovidesguidelinesforhospitalsinthisprocessaspartofmeetingobligationsunderthePatientProtectionandAffordableCareAct,whichrequires501(c)(3)non-profithospitalstoconductanassessmentatleasteverythreeyears.EveryfiveyearsallMinnesotacommunityhealthboardsmustparticipateinassessmentandplanningtodeterminelocalpublichealthprioritiesandfocuslocalresources.WrightCountyCommunityAction(WCCA)isrequiredtocompleteaCommunityNeedsAssessmenteverythreeyearsasmandatedthroughStateandFederalfundingstreams.In2016,WrightCountyPublicHealthmadeadecisiontoalignitslocalpublichealthCHNAcyclewiththetwolargehealthcaresystemsoperatinginthecommunity–BuffaloHospital,partofAllinaHealth,andCentraCare-Monticello.WCCAwasincludedtobetterunderstandthespecifichealthneedswithinlow-incomepopulationsandenableallparticipatingorganizationstoworktogetherinconductingdatacollection,dataanalysisandprioritizationprocess.WCCAplanstoconductajointassessmenteverythreeyears.

LocalPublicHealthSystemStructure


Throughthisprocess,thecollaborativeaimsto:

•Betterunderstandthehealthstatusandneedsofthecommunitiesitservesbyconsideringthemostrecenthealthanddemographicdataaswellasgatheringdirectinputfromcommunitymembers.

•Gatherperspectivesfromindividualsrepresentingtheinterestsofthecommunity,includingthosewhohaveknowledgeorexpertiseinpublichealthandthosewhoexperiencehealthinequityorarelow-incomeand/orminoritymembersofthecommunity.

•Identifycommunityresourcesandorganizationsthatthecollaborativecanpartnerwithandsupportinthepriorityareasforthatcommunity.

•Createastrategicimplementationplanbasedoninformationgatheredthroughtheneedsassessment.

•Monitorandrevisetheplanasneededoverthenextthreeyears.

Thepurposeofthisreportistosharethecurrentassessmentofcommunityhealthneedsmostrelevanttothecommunitiesservedbythecollaborativeanditscommunityhealthimprovementplantoaddressthese2020-22needs.

WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE SERVICE AREA

COMMUNITY HEALTH VISION OnOctober25,2017almost50stakeholdersfromacrossWrightCountymettohaveaconversationaboutshapingavisionforahealthiercommunityandprovidingdirectionforthenextcommunityhealthassessmentandhealthimprovementprocess.Numerouscommunityorganizationswerepresent:mentalhealthproviders,schools,businesses,healthcareproviders,governmentofficials,communitynon-profitorganizationsandcommunitymembers.Asaresultofthiscomprehensiveworkshop,thegroupframedtheCommunityHealthVision.

CommunityHealthVisionAscommunitymembers,wewillcommitto:•Engagement:increasecommunityabilitytomakeahealthychoiceaneasychoiceandinspireindividuallifestylechange•Collaboration:createsuccessfulpartnershipsandbuildleadershipsupportthrougheffectivecommunication,respectandwiseuseofavailableresources•Accessibility:streamline,expandandraiseawarenessofcommunityresourcesandopportunitiestoimprovethehealthofresidents•Connection:createinclusiveandinnovativesolutionstohelpeveryonefeelsociallyconnected,safe,supportedandhappyMEMBER DESCRIPTIONS BuffaloHospital,partofAllinaHealth

BuffaloHospitalisanon-profitregionalmedicalcentercommittedtoprovidingquality,patient-centeredandcomprehensivecaretopatientsinandaroundWrightCounty.Thehospitalprovidesafullrangeofinpatient,outpatientandemergencycareservicesandmanyspecialtyservices.Ithasbeennationallyandlocallyrecognizedforitsqualityofcare—particularlyitssafetyphilosophy,CommunityBenefitpracticesandemergencycare.Buffalo


HospitalwasalsothefirsthospitalinthestateofMinnesotatobeawardedthePathwaytoExcellenceAmericanNurseCredentialingdesignationandalsoreceivedanawardfromtheMinnesotaBusinessmagazinefordevelopingwellnessprograms.ClinicsaffiliatedwithBuffaloHospitalinclude:StellisHealthclinicsinAlbertville,BuffaloandMonticelloandAllinaHealthClinicsinAnnandale,Buffalo,CokatoandSt.Michael.ThehospitalalsohasalonghistoryofworkingtoimprovethehealthofthecommunitiesitservesthroughcharitablegivingbytheBuffaloHospitalFoundationanddirectcommunityhealth-improvementprogramming.BuffaloHospitalisproudtobeselectedasa2019WatsonHealthTop100SmallCommunityHospitalinthenation.TheWatsonHealth100Hospitalsstudy,formerlytheTruvenHealthAnalytics®study,identifies100top-performinghospitalsbasedonpubliclyavailabledataandabalancedlookatclinical,operationalandfinancialmetrics.WatsonHealth100TopHospitalsleadersdemonstratethatqualitycareandoperationalefficiencycanbeachievedsimultaneously,therebydeliveringgreatervaluetotheircommunities.CentraCare–MonticelloCentraCare-MonticellodeliverscomprehensiveservicestohelpyoutakechargeofyourhealthandenjoyeachdaytothefullestincludingamodernbirthcenterwithOB/GYNsandmidwives,state-ofthe-artMonticelloCancerCenter,five-starratedCareCenter,individualizeddiabeteseducation,skilledEmergencyDepartmentandLevelIVTraumaCenter,advancedlifesupportambulanceservice,comprehensiveorthopediccare,inpatientandoutpatientsurgicalservicesandwoundcareandhyperbaricmedicineservices.Inaddition,wesupportcommunityhealthandwellnessinitiativesincludingMonticelloandBigLakeFarmers’Markets,theannualBikeRodeoandHelmetSale,SafeCommunities,JustDriveandProjectH.E.A.L.Ourdedicationtoensuringaccesstoenhancedhealthcareservicesandsupportinghealthychoicesinourcommunitydemonstratesourcommitmentto

caringforeverypatient,everyday.Becauseahealthycommunityfeelsgoodforeveryone!WrightCountyPublicHealthWrightCountyPublicHealth(WCPH),adivisionofWrightCountyHealth&HumanServices(WCHHS),hasbeenworkingtopromotehealthandsafety,preventillness,andprotectourcommunitysince1951.WrightCountyPublicHealthhasalonghistoryoflooking"upstream"toidentifytherootcausesofpoorhealthandinforming,engagingandactivatingthecommunitytoaddressthosecauses.Publichealthfocusesonthehealthneedsofthepopulationasawholeandgivesprioritytopreventingproblemsoverthetreatmentofhealthproblems.Byfocusingonthegreatestgoodforthegreatestnumberofpeople,publichealthorganizescommunityresourcestomeethealthneedsandtakespositiveactiontoaddresscommunityhealthissues.WrightCountyPublicHealth,withpartners,createsenvironmentsthatpromotewell-beingandreduceshealthdisparitiesthroughempowerment,collaborationandservice.Wehave32staffmembersledbyaPublicHealthDirectorandthreesupervisors.ServicesarebasedontheAreasofPublicHealthResponsibility:assureanadequatelocalpublichealthinfrastructure,promotehealthycommunitiesandhealthybehaviors,preventthespreadofinfectiousdisease,protectagainstenvironmentalhealthhazards,prepareforandrespondtodisastersandassurethequalityandaccessibilityofhealthservices.Weusedatatomonitorhealthstatus,engagewiththecommunitytodevelopsolutionsandtakeaction,andworkwithawiderangeofpartnerstocreatepoliciesandplansthatensurethehealthofall.WrightCountyCommunityActionWrightCountyCommunityActionisanagencyfocusedoncreatingopportunitieswherelow-incomeindividualscanthriveandbuildeconomic,


socialandcommunityassets.Ourmissionis“toworkinpartnershipwiththecommunitytoempowerresidentstoimprovetheirphysical,social,andeconomicwellbeing”.WCCAdoesthisthroughitsmyriadofprogramsandserviceswhichprovidebothcrisisinterventionandpreventioneffortsforthoseexperiencing,orareatriskoffallinginto,thescopeofpoverty.WCCAutilizesamulti-generationalapproachtoprovidingserviceswhichallowsustoserveclientsfrombirthtobeyondretirement,andprovideseachclientwithcomprehensiveagencysupportacrossallprograms,leadingtogreateroutcomes.ProgramsthatarehousedoutofouragencyincludeHeadStart,EarlyHeadStart,EnergyAssistance,Weatherization,HomebuyerTraining,ForeclosurePrevention,WIC(Women,Infants&Children),MNsureNavigation,TaxPreparation,andtheAgingAllianceprogram.OurFoodShelflocationinWaverly,MNhousesallofourfoodsecurityeffortsincludingaMobileFoodShelf,EmergencyFoodBoxNetwork,BackPackprogramandFoodRescueinitiative.ThelastfewyearshasallowedWCCAtogothrougharebirthinwhichtheagencyisnolongera“hiddengem”,ratheracornerstoneforcollaborationandinnovativesolutionstocommunityconcerns.Throughallofitsefforts,WCCAalignswellwiththeWrightCountyCommunityCollaborativevisionbyprovidingbasicneeds,preventionservicesandencouragingcommunityhealthregardlessofeconomicstanding. DEMOGRAPHICS WrightCountyislocatedinCentralMinnesota,slightlynorthwestoftheTwinCities.WrightCountycovers716squaremilesandwithapopulationof131,130isMinnesota’stenthmostpopulouscounty.Thefollowingkeyindicatorsprovideabriefoverviewoftheregion.AdditionalinformationaboutWrightCountycanbefoundthroughtheU.S.CensusBureau.

POPULATIONIndicator Result SourceMedianIncome $77,953

U.S.CensusBureau,AmericanCommunitySurvey(ACS),2013-2017,5-yearestimates

Residentsinhouseholdswithincomebelowpovertyline

5.56% USCensusBureau,AmericanCommunitySurvey.2012-16

Medianage 36.0 U.S.CensusBureau,AmericanCommunitySurvey(ACS),2012-2016,5-yearestimates

Residentsunderage18

37,455 USCensusBureau,AmericanCommunitySurvey.2012-16

Residentsage65orolder

13,855 USCensusBureau,AmericanCommunitySurvey.2012-16

ResidentswithlimitedEnglishproficiency


Foreignbornresidents



RACEANDETHNICITYU.S.CensusBureau,DecennialCensusandPopulationEstimates,2017Indicator Result SourceWhitealone 93% U.S.Census

Bureau,DecennialCensusandPopulationEstimates-2017

BlackorAfricanAmericanalone

1.4% U.S.CensusBureau,DecennialCensusandPopulationEstimates-2017

Asianalone 1.2% U.S.CensusBureau,DecennialCensusandPopulationEstimates-2017

TwoorMoreRaces

1.2% U.S.CensusBureau,DecennialCensusandPopulationEstimates-2017

HispanicorLatino 2.8% U.S.CensusBureau,DecennialCensusandPopulationEstimates-2017

WrightCountyCommunityCollaborativemembersatthevisioningevent

HEALTHINDICATORSWrightCountyCommunityHealthSurvey,2018

Indicator Result SourceDelayedordidnotgetneededmedicalcareduringpast12months

20.2% WrightCountyCommunityHealthSurvey,2018

Adultsreportingdrinkinganyalcoholinpastmonth


Adultswhoareoverweightorobese


Adultsreportingfairorpoorgeneralhealth


Delayedordidnotgetneededdentalcareduringthepast12months


Delayedordidnotgetneededmentalhealthcareduringthepast12months

12% WrightCountyCommunityHealthSurvey,2018


EVALUATION OF 2017-2019 COMMUNITY HEALTH NEEDS ASSESSMENT BuffaloHospital,partofAllinaHealthGoalone:SupportmentalwellnessinWrightCountybyidentifyingandexpandingtheofferingofcommunitymentalhealthandwellnessandaddictionresourcesandstrengtheningsocialconnectionsandrelationships.MuchoftheworkinWrightCounty*topromotementalwellnessandprovidementalhealthresourceswasdonethroughBounceBackProjectandChangetoChillprogram.ThroughBounceBackProject,BuffaloHospitalprovidedseriesofclassesinseveralareamiddleandhighschoolsandimplementedvarioustoolsandcampaignsthroughouttheyeartopromotegratitude,socialconnections,randomactsofkindness,threegoodthings,mindfulnessandself-care.Inthelasttwoyears,theprojectexpandeditsreachfromBuffalotootherpartsofNorthwestRegionbycreatingcommunityteamsinAnnandaleandCokato.ThreeexistingteamsconsistofemployeesofAllinaHealthandcommunitymembersandaretaskedtodevelop,rolloutandsupportmanycommunity-basedmentalhealthandwellnessinitiativesforpeopleofallages.Offeringsincludegroupbookreads,gamedaysformultigenerationalinteraction,socialconnectionprogramsandspeakersforcommunitygatherings.ChangetoChill(CTC)TMChangetoChillisafree,onlineAllinaHealthresourcethatprovidesstressreductiontips,lifebalancetechniquesandhealtheducationservicesforteens.Morethan30,000uniqueusersvisittheCTCwebsiteeachyear,includingteachers,teensandparents.ThroughChangetoChill,hospitalwellnessspecialistsworkedwithstudentsintheclassroomandprovidedtrain-the-trainersessionstoadults.From2017through2019,BuffalohospitalstaffprovidedChangetoChill(CTC)curriculumtomorethan2,400studentsinareaschools.

Additionally,tosupportacultureofmentalwell-beinginlocalhighschools,AllinaHealthlaunchedtheChangetoChillSchoolPartnership(CTCSP)duringthe2018–2019schoolyear.BuffaloHospitalsupportedMapleLakeHighSchoolasthefirstChangetoChillSchoolPartnershipintheNorthwestRegion.Thepartnershipincludedfocusgroupswithstudents,peermentoring,messagesforparents,train-the-trainersessionsforstaffandadesignatedspacecalleda“ChillZone”forstudentsandstafftopracticeself-care.HospitalstaffalsocontinuedtosupportBetheChange,aninternalcampaigntoeliminatestigmaaroundmentalhealthconditionsandaddictionandensurethatallpatientsreceiveconsistent,exceptionalcare.VolunteerBetheChangeChampionsattendedtrainings.Additionalresourceswereprovidedthroughmeetings,webinarsandposterstoreinforcethemessageofreducingmentalhealthstigma.BuffaloHospitalalsoprovidesfinancialsupportandin-kindsupporttocommunityleadersworkingtoimprovementalwellnessinWrightCounty.Forexample,thehospitalhasbeenthesitefortheMinnesotaDepartmentofHealthmonthlyMentalWell-BeingandResilienceLearningCommunityforWrightCounty.TentimesperyearmembersofthecommunitygathertohearlearningsfromimplementingpublichealthprojectsinMinnesota.Localgroupsthendiscussthepossibilityofusingtheselearningsinthelocalcommunitysettingandapplyingbestpracticesforadvancingtheworkaroundcommunityhealthimprovement.Annually,BuffaloHospitalprovidescharitablecontributionstobethemainsponsorforEmotionsInMotion5KinBuffalo.TheeventishostedbySAVE(SuicideAwarenessVoicesofEducation),anonprofitresourceforthoseaffectedbysuicide.BuffaloHospitalalsoco-hostedandorganizeda‘Let’sTalkAboutIt’-eventincollaborationwithSAVE.TheeventwasheldatBuffaloHighSchoolandincludedameal,resourcefair,mainspeakerandyouthandadultpanelswithlocalpeoplewho•NorthwestRegionofAllinaHealthservicearea


havebeenimpactedbysuicide.Over450peopleattendedthisevent.BuffaloHospitalcreatedapartnershipwiththeDassel-CokatoAtoZorganizationandsupportingtheeffortstoprovideresourcesforstudents/individualsgoingintothefieldofmentalhealthandwellness.Tofurtherfostercollaboration,BuffaloHospitalholdsamonthlymentalhealthcommitteemeetingconsistingofrepresentativesfromBuffaloHospital,areaclinics,lawenforcement,mentalhealthprofessionals,WrightCountyHealthandHumanServicesandthefour-countycrisisteam.Thegoalofthecommitteeistobringtogetherorganizationsworkingwithmentalhealthconcernstodevelopcounty-widecollaborativesolutions.Buffaloalsohasseveralinitiativestoincreaseaccesstomentalhealthsupportinthecommunity.Thehospitalisahostforanannualretreatforwomenintreatmentorsurvivingcancer.Theeventprovidesvarietyoftoolstohelpdealwithstressandanxiety,includingyoga,creativityprojects,laughter,healthyeating,andsocialconnections.Additionally,thehospitalhiredamentalhealthprofessionaltoworkhalftimeintheclinicandhalftimeintheemergencydepartmenttoassistwithmentalhealthneedsandprovidetimelymentalhealthresourcesforpatientswhocometotheemergencyroomincrisis.Thehospitalprovidesongoingindividualandgroupbehavioralmodificationhealthcoachingandthe‘Let’sTalkWellness’programforcommunitygroupsfreeofcharge.Topicsforgroupsessionsincludemindfulness,meditation,relaxation,musictherapy,andstressmanagementandhavebeenprovidedatworkplacesandlocalmentalhealthcounselingcentersforstaffandpatients.Finally,inMayof2018,BuffaloHospitalintroducedtelepsychiatrytothepatientsinouremergencydepartment,alongwithcontinuouspromotionofthe24/7mentalhealthandaddictionresourcephonenumberatmanyofourcommunityeventsandgatherings.

Goaltwo:ReduceormaintainthelevelofobesityandincreasephysicalactivityamongthepopulationofWrightCountythroughprogramming,activities,andpoliciesthatpromoteandsupportahealthylifestyle.OngoingclassesandresourceshavebeenprovidedbyBuffaloHospitalwellnessstafftoyouthandfamiliesthroughHealthPoweredKids(HPK),afreecommunityeducationprogramfeaturing60+lessonsandactivitiesdesignedtoempowerchildrenagesthreeto14yearstomakehealthierchoicesabouteating,exercise,keepingcleanandmanagingstress.Additionally,yogaandTaiChiclasseswereofferedatworksitesandgroupeventssuchastheConnectRetreatforwomendealingwithcancer.BuffaloHospitalalsoprovidesfinancialsupporttocommunityleadersworkinginthisarea.Forexample,thehospitalprovidescharitablecontributionsthroughtheAllinaHealthMarketBuckprogramtoimproveaccesstolocalfitnessfacilitiesandaffordablehealthyfood.Additionally,from2017through2019,BuffaloHospitalprovided$90,000ingrantsthroughtheNeighborhoodHealthConnection™(NHC)programtosupportprogramssuchasTaiChiofferings,groupfitnessclassesandacommunitybikeprogram,amongothers.NHCisacommunitygrantprogramthataimstoimprovehealthbybuildingsocialconnectionsthroughhealthyeatingandphysicalactivity.In-kindsupportisprovidedbyBuffaloHospitalemployeeswhoareactivelyinvolvedinlocalgroupssuchasLiveWrightwiththefocusonobesity,Walk/BikeCoalitionandCrowRiverFoodCouncil.Finally,NorthwestregionclinicsandwellnessstaffhavebeenanactivepartoftheAccountableHealthCommunity(AHC)model.Becausesocialconditionssuchasfoodandhousinginstabilityinhibitaccesstocareandcontributetochronicdiseasessuchasmentalhealthconditionsandobesity,AllinaHealthimplementedtheAccountableHealthCommunities(AHC)modelthroughacooperativeagreementfromtheCentersforMedicare&MedicaidServices.Careteamsin78AllinaHealthsitesscreeneligiblepatientsforfivehealth-relatedsocialneeds:


housinginstability,foodinsecurity,transportationbarriers,difficultypayingforheat,electricityorotherutilities;andconcernsaboutinterpersonalviolence.Whenpatientsidentifyneeds,thecareteamprovidesalistofcommunityresourcestailoredtotheirneeds.Somehigh-riskpatientsreceiveassistancenavigatingtheresources.Goalthree:Supportcommunityaccesstoclinicalandnon-clinicalservicesinWrightCountybyengagingprovidersandcommunitypartnersincollaborativenetworkandresourcesharing.BuffaloHospitalfocusedonthesocialdeterminantsofhealthinNorthwestRegionwithapriorityonhealthyfoodaccess.Specifically,theworkinvolvedaddressingaccesstohealthierfoodandphysicalactivityofferingsforlow-incomeandfoodinsecurepopulations.Keyactivitiesincludedsupportinglocalorganizationsalreadyworkingontheissueoffoodinsecurityandaccessthroughcharitablecontributions,creatingopportunitiesandencouragingAllinaemployeestovolunteeratlocalevents,providingclassesonnutritionandhealthyeatingandlinkingWrightCountycitizenstolocalgrowers.Additionally,BuffaloHospitalprovidedprogramsandwellnessofferingsfreeofchargeandopentoanyoneinthecommunity.TwoofthefeaturedclassesareHealthyEatingforBetterHealth,afourweekseries,andDiabetesPreventionProgram,ayearlongprogram.Bothaddressbasicnutritionandfundamentalsofhealthyeatinganddevelopingexerciseprograms.BuffaloHospitalalsoprovidedLet’sTalkWellnessseriesthatcanbecustomizedtogroupsofanysize.Thetopicsfortheseriesarechosenfromanextensivelistofoptions.WellnessCoachingisavailable,alsofreeofcharge,andtargetsbehavioralmodificationwhileprovidingongoingsupportthroughgoalsetting.AllinaHealthemployeesalsocollaboratedwithteachersforfamilydinnernightsatourlocalAlternativeLearningCenter,providedcookingdemosandgrocerystoretourstomanyindividualsandgroupsinthecommunity.BuffaloHospital

hostsandmaintainsanon-sitestrawbalegarden.Producegrowninthegardenisusedforlocalcookingdemonstrationsandnutritionandproduceeducation.Inaddition,exerciseclasseshavebeenprovidedtocommunitygroupsandworksites.CharitablecontributionswereprovidebytheAllinaHealthMarketBucksprogramtoFareForAll(FFA),localPowerofProduce(POP)programsandlocalfoodshelves.NeighborhoodHealthConnectiongrantsprovidedassistancetolocalprogramspromotinghealthyeatingandphysicalactivity.In2018,theAllinaHealthBucksprogramserved294familieswith$2,940worthofproducepurchased!The‘bucks’areusedjustlikecash,andaregivenbyAllinaHealthdoctors,caremanagersandpublichealthnursestopatientswhoarefoodinsecure.Buffaloemployeeshavealsovolunteeredover375hourswiththeFoodGroup’sFareForAllprograminWrightCountywhichhasgrowntobethelargestinthestate.FareforAllisacommunityprogramofferingfreshproduceandfrozenmeatpacksat40percentoffretailprices,or$10and$25,respectively.ConnectingthedotsisanimportantpartoftheworkBuffaloHospitaldoesinthecommunity,bothbetweencommunitypartnersandwithourpatients,employeesandcareproviders.BuffaloHospitalhostsquarterlymeetingswithcommunityleaderstoidentifyneedsandlocatemuchneededresources;facilitatesbi-monthlymeetingswithregionalAllinaHealthleaders,andattendslocalchambersandrotarygroups.Thesecommunity-drivenprogramsandinitiativesaremakingadifference.Surveydatafrom2015to2018demonstratedsignificantincreaseintheconsumptionoffruitsandvegetables,decreaseinhighbloodpressureandcholesterol,noincreaseinBMIand14percentincreaseinfoodsecurityamongallrespondents.AllthesechangesandpositiveimpactisattributedlargelytothecollaborativeeffortbetweenallcommunitypartnerstoaddressthehealthneedsinWrightCounty!


CentraCare–MonticelloIn2016,CentraCareHealthSystemsharedthetop10priorityhealthindicatorswiththeirfiveregionalhospitals.CentraCare-Monticellowasaskedtoconsidertheindicatorsandnarrowthescopeofworkfortheirstaff.Thetopfourpriorityareasthatemergedfromthisprocesswere:ObesityandInactivity,MentalWellness,PrimaryCareAccessandDistractedDriving.Staffworkedtoidentifypotentialstrategiesthatwouldaddresseachpriorityarea.Animplementationplanwasdevelopedwhichincludedgoals,activitiesrelatedtogoal,leadcontacts,anticipatedoutcomesorresultsandprogressoneachactivity.Thisimplementationplanwasdesignedtoserveasastartingpointtoguidecollectiveaction.Theplanwasroutinelymonitored,evaluated,andprogressnotedastheprocessevolved.ForObesityandInactivity,severalactivitiesfocusedoncontinuedpartnershipswithlocalschooldistrictsandcommunitypartnerstopromotehealthyeatinginitiatives,activelivingandhealthylifestylesandwellnesscommunication.Thisstrategicworkoccurredthrougheducationtoschoolstaff,SafeRoutestoSchoolplanninggrantinvolvement,communityactivitiespromotingsafebikingandfamilyengagementinactivelifestylesandinstallationofdigitalsignagerelayinghealthandwellnessinformationandevents.MentalWellnessworkfocusedonpromotingcommunityresiliency,awarenessofservices,participatingincollaborativeeffortsaroundmentalwellnessandimplementingasmallgrouphighschoolpilotprogramincorporatingresiliencytools.ThemajorityofthisstrategicworkwasaccomplishedutilizingCentraCare-Monticello’sprogramtheBounceBackProject,whosetaglineisPromotingHealthThroughHappiness.TheBounceBackProjectteamgavemultipleresiliencepresentations,hostedboothsatcommunityevents,helpedsponsorschoolrelatedserviceprojects,communitybookreads,andhostedeventsandactivitiespromotingself-care.Theteamalsopilotedasix-weekresiliencycurriculuminMonticelloHighSchool’salternativelearningprogram.Asocial

workerwasalsoaddedtotheteamatProjectH.E.A.L.,whichisamonthlyfreehealthscreeningofferedintwolocalcommunities,toprovideaccessandreferralinformationrelatedtomentalwellness.ActionsintheareaofPrimaryCareAccessfocusedonthecontinuedrecruitmentofprimarycareproviders,addingtwobytheendoffiscalyear2017.ProjectH.E.A.L.wasexpandedtoitssecondlocationandmidwiferyserviceswereaddedoncampus.Staffattendedseveralwellnessfairsandprovidedlunch-and-learnpresentationstopromotetheadditionoftheseprimarycareaccessopportunities.Finally,concentratedeffortstobringawarenesstoDistractedDrivingwereundertaken.ACentraCare-MonticellorepresentativejoinedtheSafeCommunitiesofWrightCountyBoard.WesponsoredandparticipatedinourlocalJustDriveDayannually.Weincreaseddistracteddrivingawarenessatlocalfarmer’smarkets,healthfairs,andexpos.Wealsoappliedforandwereawardedfundstopurchasea“drivingsimulator”toeducatestudentsandadultsaboutdistractedorimpaireddriving.WealsoapprovedaCentraCare-Monticelloemployeepolicyonsafedriving,requiringeliminationofalldistractionswhiledrivingforwork,drivingacompanyvehicle,ordrivingwhilebeingreimbursedforwork-relatedmileage.WrightCountyPublicHealthPriorityissue–ObesityTheongoingfinancialsupportprovidedbybeingagranteeoftheStatewideHealthImprovementPartnershiphasallowedWrightCountyPublicHealth(WCPH)anditscommunitypartnerstoimplementavarietyofeffortsthatpromotehealthierchoicestobendthecurveofobesity.TheLiveWrightCollaborativeisthelocalcoalitionsupportingthesecountywideefforts.StrongcommunitypartnershipshaveallowedWCPHtobecomprehensiveinthetacticstopromotehealthyeatingandactiveliving.WehaveworkedwithfarmersmarketstostartPowerofProducekids'clubs,supportedschoolstomakehealthychoicesaneasierchoiceandareinvolvedintheCrowRiver


FoodCouncil.Wehaveworkedtoincreasephysicalactivitythroughactiverecessinschools,conductingwalkablecommunityworkshopsandsaferoutestoschoolplanning.Thisworkisguidedbyevidence-basedapproachesthatfocusonpolicy,systemsandenvironmentalchanges.Goal1:IncreasehealthyeatingamongyouthandadultsIncreasetheprevalenceofadultswhoeatrecommendednumberoffruitsandvegetablesdailyfrom35%to50%byDecember31,2018.The2019MinnesotaStudentSurveyresultswerenotavailableatthetimeofthisdocumentbeingcompleted.2018SurveyFindings:41.6%Adultsreportedeatingrecommendednumberoffruitsandvegetables.Goal2:IncreaseactivelivingamongyouthandadultsIncreasetheprevalenceofadultsmeetingphysicalactivityguidelinesfrom25%to51%byDecember31,2018.(2015–5ormoredaysof30+minutesmoderateactivity).The2019MinnesotaStudentSurveyresultswerenotavailableatthetimeofthisdocumentbeingcompleted.2018SurveyFindings:27.7%ofadultsreported5-7daysof30+minutesofmoderatephysicalactivity.Priorityissue–MentalWell-BeingOverall,WCPHapproachinaddressingmentalwell-beingiscompletelydifferentfromwhatwasproposedinthe2015-2019CommunityHealthImprovementPlan(CHIP).Thechallengesforpublichealtharetoidentifyriskfactors,increaseawarenessaboutmentaldisordersandtheeffectivenessoftreatment,removethestigmaassociatedwithreceivingtreatment,eliminatehealthdisparities,andimproveaccesstomentalhealthservicesforallpersons,particularlyamongpopulationsinWrightCountythataredisproportionatelyaffected.Weworkedinthelast2yearstoincorporatementalhealthpromotionintochronicdiseasepreventionefforts,conductsurveillanceandresearchthelandscapeofservicesavailabletoimproveunderstandingandoutreacheffortstopromotementalwell-being,and

collaboratedwithpartnerstodevelopmorecomprehensivementalhealthplanstoenhancecareandeliminategaps.Theprogresswemadeasadepartmentandcommunitycannotbedescribedinstrategies,goalsorobjectivesdeveloped.TheprogresscanbemeasuredinthedifferentapproachWCPHistaking,inthediscussionstheorganizationhavehadinternallyandexternallytolearnmoreaboutmentalillnessandmentalwell-being,chartingorganization’spathforthenextCHNA,whichhasledtotheidentificationofspecificstrategiesandgoals/SMARTObjectivesforthenextimprovementplancycle.Priorityissue–UseandAbuseofAlcohol,TobaccoandOtherDrugsPeople’suseandabuseofdrugscontinuetotakeatollonourcommunities.Overthelastfiveyearswehaveseensubtleshiftsintherateofuseandsubstancesofuse.ThishasrequiredWCPHtobenimbleinplanningandimplementingtheeffortstoaddressspecificproblems;youthuseofelectroniccigarettesandthemisuseofopioidsamongouradultpopulation.Themediaattentiongiventothisissuesalsocreatesanopportunityfortheorganizationtoelevatekeymessagesandworktochangespecificpolicy,systemsandenvironmentstocurbtheaccessibilityanduseofsubstances.Goal1:Reduceduseandimpactofalcohol,tobacco,illegaldrugsandthemisuseofprescriptionmedicationsthroughworkwiththedrugpreventioncoalitionofWrightCounty—MentorshipEducationandDrugAwareness(MEADA).Increaseactivecoalitionmeetingparticipationbyatleast25percentbyDecember31,2018.(8representativesonaverageattendquarterlymeetings).Status:Wehaveincreasedmembershipsporadicallyhowever,thebiggestthingwehavedonearoundtheactivityofthecoalitionisthatitnowmeetseveryothermonth.Wedidincreasetheaveragenumberofcoalitionmembersattendingmeetingsto10ateverymeetingduring2018.ByDecember31,2018,theMEADAmembershipwillconstituteacountywiderepresentationofindividualsandorganizationswithpersonaland


professionalexperienceinAlcohol,TobaccoandOtherDrugs(ATOD)preventionanduse.Status:Forthisobjectivewehaveseenanimprovementinrepresentationwhenitcomestothepersonalandprofessionalexperience,howeverwestilllackinginthegeographiclocationsideofit.Membershipspansfieldsofworksuchas,lawenforcement,schoolstaff,hospitalstaff,treatmentproviders,drugcourt,communitymembers,publichealthofficialsandcountycommissioners.However,membershipisstilllargelyrepresentativesfromBuffaloarea,HowardLake,Monticello,CokatoandSt.Michael-Albertville.WrightCountyCommunityActionIn2017,WrightCountyCommunityActionunderwentastrategicplanningprocessutilizingcommunitystakeholderconversationsandinsight.Severalkeypriorityareasinfluencedstrategicgoals,objectives,andstrategiesthatwillleadtheagencytowardgrowthandincreasedclientoutcomes.Thefollowingprogrammaticfocusesarekeyelementsofthosestrategiesandcontributetothecommunity’shealth.FOOD INSECURITY Underthenutritionsegmentsofouragency,wesetthreestrategies:evaluatespaceneedsandopportunities,consistentlyevaluatenewopportunitiestoprovidecomprehensivenutritionservicesandimproveFoodShelfoperations.Inlate2016,wetransitionedtheFoodShelftoa‘clientchoicemodel’,whichgaveclientsgreaterfreedomtomeettheirspecificneeds.Inordertofulfillourexpandedservicecapacity,weinvolvedSecondHarvestHeartlandandotherfooddistributionservices.Wealsoexpandedourbusinesshoursto35hoursaweekbyincludinglongereveninghours.Priorto2017,ourrefrigerationinfrastructurereducedourclient’sabilityofchoiceduetolimitedspace.Bythespringof2017,wewereabletoleveragelocalgrantfundingtopurchasetwomodularcoolersandacommercialfreezer.Wehavealsomadesignificant

buildingimprovementstomaximizeservicecapacityanddrystoragespace.WealsorecognizedthatourremotelocationinWaverlyprovidedachallengetopotentialclientswithlimitedtransportation.Toaddressthisneedandgapsinthehoursofavailabilityandservice,welaunchedtheWrightCountyEmergencyFoodBox(EFB)programinthesummerof2017.Thisprogramconsistsofcontainersholdingthirty-poundsofnon-perishablefoodsatasatellitepartner.Moreimportantly,eachboxalsoprovidesspecificeducationalresources,includingthehoursandlocationsofallareafoodshelves,withtheintentionofinformingtheclientabouttheirnextstepinresolvingtheirfoodinsecurity.Hostsitesreceivetrainingonthedistributionofboththefoodandtheresources,allowingourclientstoreceivecounselingabouttheirsituation,aswellasmaterials,fromatrustedmemberofthecommunity.InSeptember2017,wecontinuedourFoodShelfprogrammingexpansionbylaunchingourMobileFoodShelfprograminordertoservehomeboundseniors.Bycollaboratingwithseniorlivingcommunities,weexpandedfoodaccessdirectlytoourclients’doorsteps.ClientsselectitemstheyneedfromamenuandhaveaccesstoavolunteerEnrollmentSpecialist.Then,dedicatedvolunteerspackanddelivertheitems.BuildingoffthesuccessoftheBackPackFoodProgram,whichlaunchedin2016forHeadStart/EarlyHeadStartfamilies,theHowardLake-Waverly-Winstedschooldistrictapproachedusinthefallof2017.Theschooldistrictrequestedweexpandouroperationstoservetheneedsoftheirlow-incomestudents.Afterextensivelogisticsplanningandexecution,weareproudthatourrelationshipcontinuestoday.Furthermore,wealsoexpandedourBackPackprogramtoserveMeeker&WrightSpecialEducationCooperative(MAWSECO).Overall,ourstrategiesandinnovativeprogramminghaveincreasedtheclientsservedbyover200%.


Alwaysworkingtoreduceouroverheadthroughthriftydesign,inthewinterof2018WCCAenteredintoaFoodRescuepartnershipwithalocalgrocer.Thisprogramwillengagevolunteersingivingbacktothecommunity,furthercreatingcapacitywithinouragency,providepartnertaxincentivesandoverallreducingediblewastefromourlocalgrocers.HEAD START/EARLY HEAD START Asapartoffederalperformancestandards,HeadStart(HS)andEarlyHeadStart(EHS)mustconductaNeedsAssessmenteveryfiveyearsalongsideanannualself-assessment.Thisallowsprogramleadershiptomonitorprogressontheirgoals.Currentkeygoalsoftheprogramincludeimprovingthequalityofprogramming,increasingfamilyoutcomesandstrengtheningschooldistrictpartnerships.In2017,HSwasabletoextendthehoursofprogrammingforalimitednumberofcenters.Twomorecenterswillbefollowingextendedhoursinthe2019–2020schoolyear.Byincreasinghoursofoperation,wearemeetingtheneedsoffamilyschedules,aswellasengagingthechildreninanimprovededucationalstructureandcurriculum.Toimprovethequalityofprogrammingandstaffdevelopment,HS/EHSalsoimplementedReflectiveSupervision.Thisprocessallowsteacherstoreflectondifficultsituationstheyencounterinahealthyandproductiveway.Thisincreasestheteachers'mentalwell-beingtoincreaseservicetothechildrenintheircare.Furthermore,ourincreasedpartnershipswithmentalhealthprovidershavemovedusfromanobservation-basedassessmenttoaninteractiveevaluation.Alsoin2017,theprogrampilotedanewstaffpositioncalledFamilyAdvocateinordertoprovidealiaisonbetweentheclassroomandcaregivers.Thisrolesupportstheentirefamilybyprovidinghomevisits,referrals,andincreasedconversationaroundgoalswithparentsandcaregivers.Duetothepilot’ssuccesssinceimplementingthismodel,weincreasedcapacityforFamilyAdvocatesand

nowemploysfourpositionstosupportvariouscentersthroughoutthecounty.Thisconcentratedeffortona2Gen/WholeFamilyapproachhasledtogreaterfamilyoutcomes.WCCAcollaboratesextensivelywiththeMonticelloSchoolDistrictinWrightCounty.TherearefourclassroomsinMonticelloSchoolwhereHSfundedanddistrictfundedchildslotsareinthesamerooms.Theseclassroomsarereferredtoas“blended”becauseobserverswouldnotbeabletotellwhichchildrenwerefundedbyHS,andwhichchildrenwereinthedistrictfundedpreschoolprogram.Thismodelhelpsimprovesocialconnectednessamongstchildrenofvaryingeconomicclasses.AGING ALLIANCE Duringthe2017strategicplanningprocess,WCCAspecificallycalledoutthefollowingstrategiesfortheAgingAllianceprogram:(1)ImplementservicesthatmeettheneedsofagingadultsinWrightCounty,(2)EvaluatehowWCCAprogramscanhelpagingadultslivelongerintheirownhomesand(3)Fosterstrongpartnershipswiththecounty,healthcarefacilities,andlocalnonprofitorganizations.WCCA’sAgingAlliancelaunchedin2018andfocusesonprovidingservicesforolderadultswiththeintentionofhelpingthemlivelongerintheirownhomes.TheprogrampremieredinearlyspringbyprovidingAssistedTransportation,whichremovesthebarrierofaccesstobasicneedssuchasgrocerystores,medicalappointments,pharmacyrunsandsocialservicesappointments.TheprogramgrewrapidlythroughouttheyearwiththehelpofaqualifiedandpassionateDispatcher,whotakesspecialcaretoconnectthevolunteerdriverwiththerightclient.Thisattentiontodetailallowstheprogramtohaveanadditionalelementofsocialandemotionalsupportasthedriversandclientsspendhoursontheroadtogethersharingcompanyandreducingtheriskofseniorisolation.By2018,WCCAlaunchedhomemaker/housekeepingserviceswiththemissionofallowingolderresidentstobeabletolive


inasafeandhealthyenvironmentandreducetheriskofslips,fallsandaccidentswhilemaintainingtheirhome.Thesuccessofthesetwoservices,partneredbythecounty’sgreatneedforsenior-focusedservices,allowedtheagencytobeawardedaLiveWellatHomegrantthroughMinnesotaDepartmentofHumanServicesalongsideTitleIIIfundingthroughCentralMNCouncilonAging.Soonafter,theagencywasabletolaunchcoreservicesalongsidetheirhousekeepingprogramandbegincoordinatedeffortstoreduceseniorisolationthroughsocialeventsandvolunteerism.ByMay2019,WCCAwasserving16seniorsonaweeklyorbiweeklybasisthroughitshousekeepingandchoreprogramandover72seniorswithAssistedTransportation.ApipelineofclientsdemonstratestheincreasingneedfortheseservicesthroughoutWrightCounty.ThispipelinewillcontinuetogrowasBabyBoomerscontinuetoagefurtherintoretirement.

2020-2022 CHNA PROCESS AND TIMELINE TheWrightCountyCommunityHealthCollaborativedesignedaprocessthatengagedcommunitystakeholdersthroughoutandincludedbothreviewofexistingsecondarydataandcollectionofprimarydatathroughlocalsurvey,ElectronicMedicalRecords(EMR)dataanalysis,communitydialoguesandfocusgroups.Staffofeachorganizationprovidedleadershipfortheprocessdesignedtoidentifyuniqueneedsanddeveloplocalizedactionplans,whilealsoidentifyingcommonthemesforactioncommunity-wide.OrganizingandPartnershipDevelopment:August–September2017

a. EstablishtheCoreCommittee:BuffaloHospital,partofAllinaHealth,CentraCare–Monticello,WrightCountyPublicHealthandWrightCountyCommunityActionrepresentatives.

b. DeveloptheMAPPSteeringCommittee:representativesfromnon-profitorganizations,healthcare,schools,diverseculturalcommunities,businesses/chambersofcommerce,lawenforcement,cityandcountyofficials,subjectmatterexperts,andotherleadersinthecommunity.Thisgroupwillserveanimportantroleascommunityrepresentativesandissueexperts.TheMAPPCommitteewillbeconvenedduringseveralkeyphasesoftheCHNAprocess;includingvisioning,datareview,andhealthissueprioritization.CommunityBenefitAdvisoryCouncil(CBAC)willserveasabasegroupfortheMAPPSteeringCommittee.

Visioning:October–December2017

a. HoldaVisionandValuessessionwiththeMAPPSteeringCommittee,facilitatedbytheCoreCommitteeandexternalfacilitator.ThiswillproduceasharedVisionandValueswhichwillguidetheworkofthecollaborative.Thisisalsoanopportunitytoincreasevisibilityofthepartnership,buildrelationships,andadvocatefortheimportanceofimprovingcommunityhealth.

b. DraftVisionandValuesstatementsfromtheVisioningsessionandsharewiththeMAPPSteeringCommittee.CollectfeedbackandfinalizeVisionandValuesstatementbytheendofDecember2017.

DataGatheringandAnalysis:October2017-December2018

a. DevelopanddeploylocalWrightCountyPublicHealthsurvey–developandrevisesurveyApril-May2018,sendsurveyinAugust2018,dataanalysisNovember-December2018

b. LocalPublicHealthSystemAssessment–January1,2017-December312017

c. ForcesofChangeAssessmentandAssetsdiscussion–May7,2018

d. Gatherpubliclyavailabledatathatcaninformhealthissueprioritizationandplanning–October2017-August2018


e. WrightCountyPublicHealth:HealthEquityDataAnalysis–October2017-April2018

f. GatherlocalhealthindicatorsthroughElectronicMedicalRecords(BuffaloHospital,partofAllinaHealthandCentraCare–Monticello)–April–August2018

g. WrightCountyCommunityActionCommunityNeedsAssessment–January–August2018

h. Gathercommunityanecdotaldata(WrightCountyFair)–July18-22,2018

PrioritizeHealthIssues:August2018-January2019

a. ConveneMAPPCommitteeinadatareviewsessionandstartprioritizationofhealthissues–August13,2018

b. Gathercommunityinputthroughdialoguesandfocusgroupsinthecommunity

c. Analyzedatatoidentifythetop3prioritiestobecomethefocusoffutureCHNAplanningwork.

DevelopActionPlans:January-May2019a. Collaborativeproducesjointaction

(implementationplan)focusingontop3chosenprioritiesandjointtactics/activitiestoaddressthosepriorities.

b. ConductCommunityActionSummittoshareresultsofCommunityNeedsAssessmentanddevelopthetacticstoaddresssocialdeterminantsofhealth–May30,2019

c. Metwithlocalcoalitions,advisorygroupsandtaskforcestoalignactivitiesandbuildrelationshipswithcommunitypartners.

ImplementationandMonitoringofActionPlans:2020–2022

a. Celebratesuccesses-finalMAPPCommitteemeetingand/orcommunicationtoreviewactionplansandcelebrateaccomplishmentsthusfar.

b. Beginimplementationof2020-2022plans.c. Regularmeetingstofurther

implementationandmonitorprogress.

DATA COLLECTION AND COMPARATIVE ANALYSIS WrightCountyCommunityCollaborativeutilizedavarietyofinformationanddatasourcesalongwithgatheringcommunityinputtoanalyzeandprioritizecommunityhealthissues.Thedatasourcesincluded:•MinnesotaStudentSurvey•USCensusBureau(demographicdata)•FeedingAmerica(foodinsecurity)•USDepartmentofEducation•CDCandUSDepartmentofHealthandHumanServicesdata•USDepartmentofAgriculturestatistics•USDepartmentofLabor•CountyHealthRankings•USDepartmentofHealthandHumanServices•DartmouthCollegeInstituteforHealthPolicyandClinicalPractice(chronicconditionsdata)•ElectronicMedicalRecords(EMR)datafromlocalhealthcareproviders•Datagatheredfromlocalfocusgroups,communitydialogues,visioningandcommunityeventsThechallengesofanalyzingthedatafromabovementionedsourcesincludedlackofconsistencyininterpretationofthedata,applicabilityofthedatainrelationtothehealthissuesthecountywasfacing,timerelatedconcerns(inmanycases,mostrecentdataavailablewastwoorthreeyearsold)andmostimportant,lackofunbiased,consistent,measurableinformationcollecteddirectlyfromthecommunitythecollaborativegroupserved.Inearly2015,theideaofconductingalocal,currenthealthsurveywasintroducedbyWrightCountyPublicHealth.Withthesupportoflocalhealthcaresystems(BuffaloHospital,partofAllinaHealth,andCentraCareHealth—Monticello),thesurveywasadministeredtoWrightCountyresidentsin2015,andagainin2018,whenWrightCountyCommunityActionjoinedthecollaborative.


2018 COMMUNITY HEALTH SURVEY RESULTS BACKGROUND: -Thepapersurveywasmailedto8,000people;1,600ineachofthefivecommissionerdistricts.-Probabilitysample;byaddressandadultwithmostrecentbirthday.-Twocopiesofsurveysentwithpostcardreminderinbetween.-In2015,thesurveyhad2089completions–26.1%responserate.-In2018,thesurveyhad2039completions-25.5%responserate.-Datastatisticallyweightedtoaccountforsampledesignanddifferentialresponsebygenderandage.-FundingforthesurveywasreceivedfromMinnesotaDepartmentofHealth(SHIPprogram),CentraCare–MonticelloandBuffaloHospital,partofAllinaHealth.Duetolimitedfunding,in2018thesurveywasshortenedfromsixtofourpages.However,thequestionsusedforcomparativeanalysiswerenotchangedtohelpensureconsistencyandcomparability.TOP 5 HEALTH ISSUES FACING WRIGHT COUNTY Topfiveissuesidentifiedinthe2018surveyarethesameasthoseidentifiedin2015-People’sattitudesareshiftingtoseriousproblemasresponsesfortop5issuesfacingWrightCounty

2018 Moderate/Serious Problem 1. Distracted Driving 83% 2. Obesity 66% 3. Lack of Physical Activity 65% 4. Illegal drug use among teens 63% 5. Illegal drug use among adults 59%

Obesity According to height and weight status that respondents provided in their survey, it

shows that 29% are considered obese. The overweight and/or obese survey respondents represent 2 in 3 adults. - 42% reported consuming 5 or more servings of fruits/vegetables day yesterday - 28% reported 30 minutes or more of moderate exercise 5-7 days per week

Utilization of Health Care

during past 12 months and

“Foregone Care”

20% delayed or did not get needed Medical Care - Most common reason: Not serious enough (48%) 24% delayed or did not get needed Dental Care - Most common reason: Cost too much (59%) 12% delayed or did not get needed Mental Health Care - Most common reason: Not serious enough (41%)

General Health

Status and Behaviors

- 93% of adults report their health as good/very good/excellent - 11% of adults report being smokers - 73% of adults report any alcohol use in the past 30 days - 27% report ever being told by a doctor that they had any mental health problem - 33% reported at least one day of not good mental health in the past 30 days - 16% of adults reported that they worried about food running out during the past 12 months


Better 2015 2018Highbloodpressure/hypertension

26.3% 23.9%

Highcholesterolortriglycerides

28.9% 27.6%

0notgoodphysicalhealthdaysinthelast30days

58.1% 66.4%

0notgoodmentalhealthdaysinthelast30days

64.4% 67.2%

0servingsvegetablesyesterday

14.5% 11.0%

0servingsfruit/fruitjuiceyesterday

17.4% 15.3%

0servingsfruits/vegetablesyesterday

6.5% 3.7%

5+servingsfruits/vegetablesyesterday

35.8% 41.6%

“Never”worriedaboutfoodrunningoutduringthepast12months

70.3% 84.4%

Participateinanyphysicalactivityduringthepast30days

82.9% 86.0%

Moderateexercise5-7daysperweek

25.0% 27.7%

Vigorousexercise3-7daysperweek

25.7% 30.6%

Currentcigarettesmoking 11.5% 10.6%

Anyalcoholdrinkinginpast30days

76.3% 72.8%

Worse 2015 2018Asthma 9.6% 12.0%

Anxietyorpanicattacks 15.9% 18.0%

Delayeddentalcareduringthepast12months

19.9% 23.7%

Currentsmokerswhotriedtoquitduringthepast12months

48.2% 44.9%

Driverswhomakeoransweraphonecall“often”whiledriving

18.1% 20.8%

Distracted Driving People feel that distracted driving is a problem/an issue in their community, yet many continue to acknowledge they engage in distracting activities while driving; - 42% report reading or sending texts (often and sometimes) - 85% report making or answering a phone call (often and sometimes) - 44% report they eat, shave or put on make-up, do other activities (often and sometimes)


DATA REVIEW AND ISSUE PRIORITIZATION Approximately150stakeholdersrepresentingbroadinterestsofthecommunityand40communityorganizationsparticipatedinkeyinformantinterviewsand/orattendedatleastoneofseveralmeetingsbetweenOctober2017andMarch2019toreviewanddiscusstheabovedataandhelpidentifythreepriorityhealthissues.Agenciesrepresentedatthesemeetingsinclude:AllinaHealthClinicsBuffalo-Hanover-MontroseSchoolDistrictBuffaloHospitalFoundationBuffaloHospital,partofAllinaHealthBuffaloRotaryCatholicCharitiesCentraCareClinicCentraCareHealth-MonticelloCentralMNCouncilOnAgingCentralMNMentalHealthCenterCommunitymembersCrisisNurseryCrowRiverFoodCouncilDassel-CokatoEarlyChildhoodEducationDBT®andEMDR®SpecialistsForgottenHarvestFamilyYouthCommunityConnectionsHowardLake-Winsted-WaverlySchoolDistrictIntegriprintPrintingLoveINCMinnesotaDepartmentofHealthMarionO'Neill,MNHouseofRepresentativesMonticelloHelpCenterRiversofHopeSafeCommunitiesofWrightCountySolutionsCounselingSTRIVETherapyTimberBayVirginiaPiperCancerInstitute,BuffaloHospitalWrightCountySheriff'sOfficeWrightChoiceWrightCountyCommissionerWrightCountyCommunityActionWrightCountyHealthandHumanServicesWrightCountyHistoricalSocietyWrightCountyPublicHealthWrightCountyPublicHealthTaskForceWrightCountyAreaUnitedWayYouth First

ThereviewprocessincludedaformalprioritizationtoolknownastheHanlonmethod,whichincludesrankinghealthprioritiesbasedonthreeprimarycriteria:thesizeoftheproblem,includingprojectionoffuturetrends;theseriousnessoftheproblem,includingdisparatehealthburdenswithinthepopulation;andtheeffectivenessandfeasibilityofinterventionsonthepartofhealthcare.

FINAL PRIORITIES Throughthisprocess,threeprioritieswereidentifiedforactionin2020-2022:1.MentalHealthandWellness2.DentalCare3.SubstanceUseandAbuseCOMMUNITY INPUT InformalconversationsovercoffeeiswhereourjourneystartedandwasultimatelynurturedbyatwodaytrainingopportunityinMayof2017onMobilizingforActionthroughPlanningandPartnership(MAPP).AllorganizationsinvolvedintheWrightCountyCommunityHealthCollaborativewereabletoattend.ShortlyafterthistraininginoneofourmeetingweallagreeduponthatitmadesensetousetheMAPPmodelandcommittedtoeachotherwewereinthisjourneytogether.

MAPPPrioritizationMeeting


AgroupofhealthprofessionalsinWrightCountyareworkingtogethertorolloutanewapproachtohowweassesshealthinourcommunitiesandimplementacommunitydrivenprocessforimprovinghealth.RepresentativesfromAllinaHealth—BuffaloHospital,CentraCare-Monticello,WrightCountyCommunityActionandWrightCountyPublicHealthbeganmeetinginthesummerof2016,tosetthestageforcompletionofacommunitywidehealthassessmentandhealthimprovementprocesstobecompletedbythesummerof2019.Developingahealthycommunitydoesnotjusthappen;itrequiresaconsciousandcarefulapproach.ThemodelwehavechosentouseisMAPP;NationalAssociationofCountyandCityHealthOfficials(NACCHO)statesthat“thisframeworkhelpscommunitiesprioritizepublichealthissues,identifyresourcesforaddressingthemandtakeactiontoimproveconditionsthatsupporthealthyliving.MAPPisgenerallyledbyoneormoreorganizationsandiscompletedwiththeinputandparticipationofmanyorganizationsandtheindividualswhowork,learn,liveandplayinthecommunity.”OnOctober25,2017,thecollaborativeconductedaCommunityVisioningevent.ThegoaloftheeventwastohelpadvancecollaborativeworkontheCommunityHealthNeedsAssessmentinWrightCountybyidentifyinggaps,challenges,creatingpotentialpartnershipsanddevelopingacommunityvision.Fiftyrepresentativesfromvariouscommunityorganizationsandgroupsattendedtheeventandhelpedthecollaborativeframethecommunityhealthvisionandcreatecommonunderstandingofwhatahealthiercommunitywouldlooklikeinyearstocome.

MAPPPrioritizationMeeting

October 25, 2017 -MAPP Kick-off and

Community Visioning Event

May 7, 2018 –Forces of Change and Community

Assets Discussion/Activity

August 13, 2018 –Narrow Scope of Priority Health Issues (Hanlon)


CommunityConversation–May7,2018Aspartoftheoverallassessmentprocess,thecollaborativeconductedaconversationwithcommunitypartnerstosharedataonspecifictopics,facilitatesmallgroupdiscussionandgatherinputthatwouldfurtherdefinepotentialpriorityhealthissues.Datawasgatheredfromavarietyofsourcesandsharedwiththelargegroupbeforebreakingintosmallergroups.ThecollaborativecoregroupmembersfacilitatedForcesofChangeAssessmentamongtheattendees.ForcesofChangeAssessmentidentifiesalltheforces,associatedopportunitiesandthreatsthatcanaffect,eithernoworinthefuture,thecommunityandlocalpublichealthsystem.AreasincludedinForcesofChangediscussion:EconomicTechnologicalSocialEnvironmentalQuestionposedwitheachoneoftheforcesdiscussed:Howdoesthisforceofchangeposeathreatoropportunitytothehealthofourcommunity?ThecollaborativealsoassessedCommunityAssetsasstrengthsinthecommunitythegroupcollectivelyserves.Thegroupgatheredinputfromtheparticipantsonthefollowingareas:

• Skills,TalentsandExperienceofCommunityMembers

• NeighborhoodAssociationsandotherSocialGroups

• SenseofHistory• CommunityPride• CommunityReputation

NarrowscopeofcommunitypriorityissuesOnAugust13,2018,thecollaborativeconductedatargetedprioritizationsessioninvolvingCommunityBenefitAdvisoryCouncil(CBAC)andWrightCountyTaskForcememberstobetterunderstandwhichissuesarerisingtothetopas

majorhealthconcernsinWrightCounty.ThesessionutilizedtheHanlonmethod.DevelopedbyJ.J.Hanlon,theHanlonMethodforPrioritizingHealthProblemsisawell-respectedtechniquewhichobjectivelytakesintoconsiderationexplicitlydefinedcriteriaandfeasibilityfactors.Thoughacomplexmethod,theHanlonMethodisadvantageouswhenthedesiredoutcomeisanobjectivelistofhealthprioritiesbasedonbaselinedataandnumericalvalues.Hanlonhelpsprioritizetheissuesintermsoftheidentifiedareas,yetstillemphasizesthatfeasibilityshouldbeconsideredwhenchoosingwhatareatotackle.Theprevalence(sizeofproblem)andseverity(seriousnesstothoseimpacted)helptoensurethatarangeofissuesisexploredwhenprioritizing,butthethirdelementoffeasibilityreallydeterminesthepaththatmakesthemostsense.Asaresultoftheprioritizationsession,thecollaborativearrivedat10tophealthprioritiesfacingthepopulationofWrightCounty. FINDINGS FROM KEY STAKEHOLDER GROUPS Aftercollectingextensivefeedbackandconductingcommunityconversationsanddialogues,thecollaborativearrivedattop10priorities,whichwerethenreviewedbyeachorganizations’stakeholdergroups.Eachgroupconsistedofkeystakeholders,includingseniorleadersandmanagers.Allfourgroupsfocusedondefiningwhathealthprioritiesarethemostrelevanttothepopulationeachorganizationserves,andhowthepopulationisaffectedbythegapsidentifiedintheCHNAprocess.EachgrouparrivedattheirownprioritizedlistofhealthissuesfacingWrightCounty.Thelistswerethencombinedbythecoregroupandissueswereagainprioritizedbasedontherankingsfromindividualorganizations.Thecoregroupfocusedontheissuesfacingthemajorityofthepopulationservedandtheseverityandmagnitudeofthehealth


concerns.Thecollaborativechosethetopthreeprioritiesbasedontruecommunityneed,versusjusttheabilitytoprovideinterventions.Thecollaborativebelievesthatpartofthesolutionisstartingtheconversationaroundthetopicsthathavenotyetbeenaddressed,andengagingcommunitypartnersandotherorganizationstoassistinimplementationplanninganddevelopmentoftactics/activitiestoaddressthosepriorities.NEEDS IDENTIFIED BUT NOT INCLUDED IN THE CHNA: GoingintotheHanlonPrioritizationonAugust13th,2018,thecoregrouphadalistof20identifiedhealthissuesthatneededtobediscussedandarrangedaccordingtotheweightofitssize,seriousnessandeffectiveness.Afterallthehealthissueswereranked,thecoregrouprealizedtherewereseveralidentifiedissuesthatcouldbecombinedwithtoppriorities.Forexample,SuicideAwarenessandPreventioncanbecombinedwithoneofthetopprioritiesofMentalHealthandWellness.OtherissuesthatwereidentifiedincludedStress,LackofPhysicalActivityandSocialConnectedness/Isolation.Whilethecoregroupunderstandsthatalloftheseissuesareimportantandneedconcentratedeffortsinordertoresolve,theywillbeconsciouslydiscussedandnaturallyaddressedinthestrategiesandtacticseachorganizationcreates.WhiletopicssuchasdistracteddrivingrankedasahighneedinWrightCounty,therearecurrentlymanygroupsalreadyworkingonthisissueandactivelypursuinginterventionsaroundthisconcern(SafeCommunitiesofWrightCounty,Highway55coalition,Highway12coalitionandI94WestChamberofCommerce).Someoftheprioritiesidentifiedin2017–2019ImplementationPlanarestillrelevanttotheworkofthecollaborative(foodinsecurity,obesity,physicalactivity,accesstocare).Thecollaborativemadesignificantstridesinaddressingthoseprioritiesandwillcontinuetosupporttheefforts

aroundtheseinitiativesthroughcurrentworkflowsandservicemodels.

IMPLEMENTATION PLAN Afterconfirmingthetopthreeprioritiesandgatheringcommunityideasforaction,WrightCountyCommunityHealthCollaborativedevelopedanimplementationplanbasedontheinput.Thisplanoutlinesthesetofactionsthatthecollaborativewilltaketorespondtotheidentifiedcommunityneeds.Followingthecommunitydialoguesandfocusgroups,acoregroupofstafffromfourorganizationsparticipatingincollaborationworkedthroughemail,phoneandin-personmeetingstoreviewanddiscussthedataandtodraftgoalsandstrategiesforthe2020-2022implementationplan.ThethreeprioritiesandtheirrespectivegoalsandstrategieswerecommunicatedtoCommunityBenefitAdvisoryCouncil,hospitalboardsandleadershipgroupsintheparticipativeorganizations,aswellasanyotherinterestedcommunitymembers.Actionsessionswerethenconvenedtodevelopspecificobjectivesandevidence-basedactivitiestosupporteachofthegoalsduringthethree-yearimplementationphase.Thefollowingimplementationplanisathree-yearplandepictingtheoverallworkthatthecollaborativewillconducttoaddressthepriorityareas.Existingresourcestoaddresseachissuearealsolistedsoastoreduceduplicationandidentifypossiblepartners.Detailedobjectivesincludingtimelinesandmeasuresofsuccesswillbedevelopedindetailbytheworkgroupsthatwillconveneoverthecourseoftheimplementationperiod.Themembersofthecollaborativewillmaintainorganizationspecificworkplansandcommittoworkingasagrouponatleastonecollectiveimpacttacticforeachidentifiedpriorityoverthecourseoftheimplementationperiod.Sharedcollectiveimpacttacticswillhavemeasurableoutcomesand


involvemutuallyreinforcingactivitieswiththebackbonesupportofparticipatingorganizations.Thecollaborativeiscommittedtocontinuouscommunicationoverthecourseofimplementationperiodtoimplementcollectiveimpacttactics.Priority1:MentalHealthandWellnessResources:Currently,manypartnersexistinthecommunitythathaveexpertiseinandworktosupportmentalhealthinitiatives,suchascommunitymentalhealthproviders,clinics,BounceBackProject,MentalHealthAdvisoryCouncil,CommunityAdultMentalHealthInitiative,CentralMNMentalHealth.Goal:Reducetherateofmentalhealthcaredelayandthenumberof“notgood”mentalhealthdaysinWrightCountyStrategies:

• Strategy1:Addressallaspectsofthementalwellnesscontinuum,includingwell-beingmaintenance,preventionofdiseaseandintervention

• Strategy2:Increasesocialconnectednessandcombatisolation

• Strategy3:Educationaroundmentalillnessasamedicalcondition

• Strategy4:Increaseawarenessaboutsuiciderelatedissues–suicideprevention

Collectiveimpacttactic:Implementcoordinatedawarenesscampaigneducatingthecommunityaboutmentalillnessasamedicalcondition.Priority2:DentalCareResources:Currently,manypartnersexistinthecommunitythathaveexpertiseinandworktosupportmentalhealthinitiatives,suchas33dentalclinicsinWrightCounty,Children’sDentalService,OperationGrace,AppleTreeDental,GiveKidsaSmileandDentalHealthWorkGroup–partofthePublicHealthTaskForce.

Goal:ReducetherateofdentalcaredelayinWrightCountyStrategies:

• Strategy1:Increaseaccesstodentalcareforallwiththefocusonunderservedpopulation

• Strategy2:Educatethecommunityabouttheimportanceofregulardentalcare

Collectiveimpacttactic:EachorganizationinvolvedinWrightCountyCommunityHealthCollaborativewillhaveanactiveparticipantintheDentalHealthWorkGroup–partofthePublicHealthTaskForcetohelpadvancetheworkarounddentalcareaccessinWrightCounty.Priority3:SubstanceUseandAbuseResources:Currently,manypartnersexistinthecommunitythathaveexpertiseinandworktosupportpreventionofsubstanceuseandabuse,suchasMentorshipEducationandDrugAwareness(MEADA)CoalitionofWrightCounty,OpioidActionTeam,DrugCourt,treatmentandrecoveryservices.Goal:SupportlocalpreventioneffortsandadvocateforpolicychangestoaddresssubstanceabuseinWrightCountyStrategies:

• Strategy1:Reducestigmarelatedtodiagnosisandtreatmentofaddictionsandsubstanceabusedisorders,andthepossibleconnectiontomentalhealthconditions

• Strategy2:Provideeducationandaddresstobaccoande-ciguseandaccess

• Strategy3:Identifyandcreatebetterlinkagetoappropriateavailableresources

Collectiveimpacttactic:Engageinpolicy,systemandenvironmentalchangesthatreduceaccesstoe-cigarettesamongyouthandadults.


Themembersofthecollaborativearecommittedtoworkinginalignmentwithcommunitycoalitions,taskforceoradvisoryboardswhoseworkisalreadyfocusedonthesepriorityhealthissues(MentorshipEducationandDrugAwareness(MEADA)CoalitionofWrightCounty,MentalHealthAdvisoryCommitteeandDentalHealthWorkGroup–partofthePublicHealthTaskForce).Thecollaborativewillworktosupportcurrentinterventioneffortsandpreventduplicationwhilebuildingneworstrengtheningexistingrelationshipsacrossthecommunity.Thecollaborativebelievescoordinatedapproachwillhavethegreatestimpactonaddressingthesepriorityhealthissues.RESOURCE COMMITMENTS WrightCountyCommunityHealthCollaborative,throughitsmemberorganizations,willcommitresourcesduring2020-2022toensureeffectiveimplementationofitsplannedactivitiestomeetthegoalsandobjectivesidentified.Resourcesmayincludespecificprogramsandservices,charitablecontributionsandemployeevolunteerismofferedbyindividualorganizationsandstafftimedevotedtoadvancingcollectivework.Althougheachorganizationparticipatinginthecollaborativewillcommittoits’ownsetoftacticsandactivities(appropriatelyalignedwiththemissionanddefinedorganizationalpurposeofeachmemberofthecollaborative),thegroupwillcollectivelyworkonatleastonecommontactic/activityundereachofthreedefinedprioritiesandcommittomeasurableoutcomesforthosetacticsattheendofthethreeyearimplementationcycle.Thegroupwillmeetin-person,viaphoneorweb-basedservicesonaregularbasis(nolessthanmonthly)totrackprogress,identifygapsandworktowardssuccessfulresolutionoftheidentifiedchallenges.

EVALUATION OF OBJECTIVES Throughouttheimplementationphase,specificmetricswillbetrackedtodocumentprogresstowardmeetinggoalsandobjectivesandmakeadjustmentstotheimplementationplanasneeded.Specificevaluationplanswillbeestablishedorcontinuedforprogramsandinitiativesasappropriate.Monitoringofpopulation-levelmetricsandsystem-widemetricswillalsoprovidecontextforthehealthstatusofthecommunitiesWrightCountyCommunityCollaborativeservesandtheworkofthecollaborativegroupoverall.SomeoftheevaluationsourcesincludebutnotlimitedtotheMinnesotastudentsurvey,localWrightCountysurvey(comparativedatawillbeanalyzed;thecollaborativewillstrivetodeploynewsurveyin2021),treatmentadmissions,ElectronicMedicalRecord(EMR)data,numberofpeoplereachedthrougheducationaleffortsandcommunitypresentations.

MAPPCommunityPartners


Toalignwiththeirsystemandotherpartners,AllinaHealthandCentraCarewillpursuehealthprioritiesandactivitiesinadditiontothosedescribedintheWrightCountyCommunityHealthCollaborativeimplementationplan. ALLINA HEALTH SYSTEMWIDE ACTIVITIES TosupportlocalCHNAefforts,AllinaHealthidentifiescommunityhealthneedsconsistentacrossitsentiresystemandsystemwideinitiativeswithwhichtoaddresstheseneeds.Bydevelopingsystemwideinitiatives,AllinaHealthensuresefficientuseofresourcesacrossitsserviceareaandprovideshospitalswithprogramstheycanadapttomeettheircommunity’suniqueneeds.Thus,aspartofdevelopingitsimplementationplan,BuffaloHospitalstaffmetinFebruaryandApril2019withleadersfromeachofAllinaHealth’sninecommunityengagementregionstodiscusstheresultsofeachhospital’sdatareview,prioritizationandcommunityinputprocesses.Together,theyidentifiedmentalhealth,including substanceuse,asapriorityneedinallAllinaHealthgeographies.Additionally,allcommunitiesidentifiedsocialdeterminantsofhealth,particularlyaccesstohealthyfoodandstablehousing,askeyfactorscontributingtohealth.ObesitycausedbyphysicalinactivityandpoornutritionwasidentifiedasapriorityneedinmostAllinaHealthcommunities.Basedonthisprocess,AllinaHealthwillpursuethefollowingsystem-wideprioritiesin2020-2022:•Mentalhealthandsubstanceuse•Socialdeterminantsofhealth•Healthyeatingandactiveliving BelowarethesystemwidegoalsandstrategiesthatBuffaloHospitalwillpursue.ThoughobesitywasnotidentifiedasapriorityintheWrightCounty,BuffalowilladdressAllinaHealth’shealthyeatingandactivelivingprioritythroughitssocialdeterminantsofhealth-work,particularlyincreasingaccesstohealthyfood.Whenimplementingactivities,considerationisgiventohowtheseactivitiescanbestsupporthistorically

underservedcommunitiesandreducehealthdisparities.MentalhealthandsubstanceuseGoal1:IncreaseresilienceandhealthycopingskillsinourcommunitiesGoal2:Reducebarrierstomentalhealthandsubstanceuseservicesforpeopleinourcommunities.Strategies:

• Increaseresilienceamongschool-ageyouth.

• Increasesocialconnectednessandcommunityresilienceefforts.

• Decreasestigmaassociatedwithseekinghelpformentalhealthandsubstanceuseconditions,withaparticularfocusontheexperiencesofracialandethnicminoritiesandotherhistoricallyunderservedcommunities.

• Increasesupportofpolicyandadvocacyeffortsaimedatimprovingaccesstoadolescentmentalhealthandsubstanceuseservices.

Activities:

• OfferChangetoChillprogramminginatleastoneWrightCountyhighschooleachyearandcontinuetosupportcurrentChangetoChillschoolsasrequested.

• EnhanceandpromoteHealthPoweredKidsmentalhealthandwellnessprogrammingtoWrightCountyschools.

• Supportgrassrootscommunity-basedeffortsaroundresilience,includingsocial-connectedness.

• EnhancementalhealthandsubstanceusestigmaeliminationprogrammingintheChangetoChillprogram.

• Promotestigmaeliminationeducationandmessaging,particularlyinMayandOctober.

• Supportandadvocateforpoliciesaimedatincreasingnumberofandaccessibilitytomentalhealthandsubstanceuseservices.


SocialDeterminantsofHealthGoal:ReducesocialbarrierstohealthforAllinaHealthpatientsandcommunities.Strategies:• Implementasustainable,effectivemodeltosystematicallyidentifyandsupportpatientsinaddressingtheirhealth-relatedsocialneeds.

• Implementasustainablenetworkoftrustedcommunitypartnerswhoareabletosupportourpatientsinaddressingtheirhealth-relatedsocialneeds.

• Increasesupportofpolicyandadvocacyeffortsaimedatimprovingsocialconditionsrelatedtohealth.

• Improveaccesstohealthyfoodinourcommunities.

Activities:• Supportthesuccessfulimplementationand

evaluationoftheAccountableHealthCommunitiesmodelatparticipatingsites.

• ChampiondevelopmentofandsupporttransitiontoanAllinaHealthsystem-widestrategyandcaremodeltoidentifyandaddressthehealth-relatedsocialneedsofourpatients.

• Implementaprocesstoidentifykeycommunitypartnersandsupporttheirsustainabilitythroughfinancialcontributions,explorationofreimbursementmodels,employeevolunteerismandpolicyadvocacy.

• InpartnershipwithAllinaHealthandcommunitystakeholders,designandimplementaprocesstofacilitatetrackedreferralstoconnectpatientstocommunityresources.

• Participateinandsupportcommunitycoalitionsaimedatimprovingaccesstotransportation,housingandfood,includingconnectingAllinaHealthresources,expertiseanddatatothesegroupsasappropriate.

• Workwithcommunityorganizationstoimproveaccesstohealthyfoodinthecommunitiesweservethroughgrant-making,charitablecontributions,employeevolunteeropportunitiesandinnovativecommunitypartnerships.

CENTRACARE CENTRAL MINNESOTA SYSTEMWIDE ACTIVITIES Toincreasesuccessinmeetingtheneedsofthecommunity,thepublichealthagenciesinthecountiesofBenton,Sherburne,andStearns,alongwithCentraCareinthosecounties(includingSt.CloudHospital,CCH-Melrose,CCH-Paynesville,andCCH-SaukCentre),havedevelopedapartnershipcalledtheCentralMNAlliance.WiththeformationoftheCentralMNAlliance,theCHNAprocessandprioritizationofcommunityhealthissuesisbroadlyfocusedoncommunityissuesratherthanthetraditionaldiseaseconditionsthehospitalspreviouslyfocusedon.Thenewframeworkreliesonamixtureofnational,state,andlocaldata.TheCentralMNAllianceagreedtoutilizetheMAPP(MobilizingforActionthroughPlanningandPartnerships)processtoconducttheCommunityHealthNeedsAssessmentandpreparetheImplementationStrategy.ThepartnershipagreedtofollowthehospitalIRSrequirementofa3-yeartimeframe.OnApril24,2018,thefirstmeetingwasheldoftheCentralMNAlliance.ThemembersofthispartnershipincludeBentonCountyHumanServices,PublicHealth;CentraCare,PopulationHealth;SherburneCountyHealthandHumanServices,PublicHealth;andStearnsCountyHumanServices,PublicHealthDivision.Theserelationshipshavebeenbuildingovertimeandasaresult,amoreformalstructureofthiscommunitypartnershipwasdeveloped.Tothatend,allagencieshadstaffattendMay2017trainingontheMAPP(MobilizingforActionthroughPlanningandPartnerships)processthatwassponsoredbyNACCHO(NationalAssociationofCountyandCityHealthOfficials).SeveralmeetingswereheldbetweenMay2017andApril24,2018tocreateaunifiedCommunityHealthNeedsAssessmentandImplementationStrategy.TheworkofeachofthefourMAPPAssessmentsub-groupsresultedinfourlistsof10communitypriorities.TheCoreSupportTeamtalkedwiththeiragencystafftoidentifyanythemesorcommonalitiesamongstthefourlists.Theythencametogetherandwentthroughafacilitated


processusingtheCentralMNAllianceVisionasaguidetofinalizeatop10list.AdecisionwasmadetofocusonthetoptwoprioritiesfortheImplementationStrategyfor2019-2022.Althoughtheprioritiesthreethroughtenwillnotspecificallybeaddressedthroughactionplanningormeasurement,therearewaysmanyoftheseprioritiesarebeingaddressedeitherwithinthetoptwoprioritiesorthecommunity.Inthefuture,thegroupwillassessthecapacitytoexpandthenumberofprioritiesbeingaddressedandmeasured.

THECENTRALMNALLIANCEPRIORITIES Priority Examples1 Building

FamiliesIndividual/familyintervention,childwell-being,parentingskills

2 MentalHealth Awareness,access,well-being,addiction

3 EncouragingSocialConnection

Acrosstheagespectrum,socialconnections,communityintervention

4 AdverseChildhoodExperiences(ACEs)

Awareness,cultural,preventativemeasures,leadingtochronicdisease

5 Tobacco/NicotineUse

E-cigarettes,addiction

6 HealthCare Access,cost7 RiskyYouth

BehaviorEducation,trafficking,mentalhealth,safety,homelessness,alcohol/tobacco/otherdrugs

8 FinancialStress

Livingwage,unemployment,affordableliving

9 Trauma Acrossthelifespan10 Educating

PolicyMakersandKeyCommunityStakeholders

Educatingonemergingissuesinthecommunity


ACKNOWLEDGEMENTS WrightCountyCommunityHealthCollaborativewouldliketothankmanypartnerswhomadethisassessmentandplanpossible:•Individualcommunitymemberswhoofferedtheirtimeandvaluableinsights;•Partnerorganizationsthatmettoreviewandprioritizedataanddevelopimplementationplansandtheindividualswhocontributedtheirexpertiseandexperiencetoensureathoroughandeffectiveoutcome;•Memberorganization’sstaffwhoprovidedknowledge,skillsandleadershiptobringtheassessmentandplantofruition;•MembersoftheCHNAsteeringteam,representingthetwohospitals,publichealthdepartmentandcommunityactionorganizationallservingthepopulationofWrightCounty.

WrightCountyCommunityHealthCollaborative

members

CONCLUSION WrightCountyCommunityHealthCollaborativewillworkdiligentlytoaddresstheidentifiedneedsprioritizedinthisprocessbytakingactiononthegoalsandobjectivesoutlinedinthisplan.Forquestionsaboutthisplanorimplementationprogress,pleasecontactamemberoftheCHNAcoresteeringteam:JannaNetterfield,BuffaloHospital,partofAllinaHealth–[email protected],BuffaloHospital,partofAllinaHealth–[email protected],WrightCountyPublicHealth–[email protected],WrightCountyPublicHealth-Sarah.Grosshuesch@co.wright.mn.usMelissaPribyl,CentraCare–[email protected],WrightCountyCommunityAction-AKortisses@wccaweb.comCandiceZimmermann,[email protected]

wright county community health needs assessment plan...wright county community health collaborative...

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