Berks County 2016 Community Health Needs Assessment Summit Meeting April 7, 2016
What is a CHNA? “A systematic process involving the community to identify and analyze community health needs and assets in order to prioritize needs and to plan and act upon unmet community health needs. ” Source: Catholic Health Association
Market Study or Needs Assessment? M arket S tudy N eeds A ssessment Primary and secondary research Primary and secondary research Determine consumer needs Determine consumer wants and needs Determine what competition offers Determine how and if needs are being met Determine gaps in services Determine what there is a market for Determine what and how much Determine where nonprofit people or third parties are willing to organization may best meet its pay (i.e., what will be purchased); mission by addressing community need, without expectation of reimbursement or payment Client is the community Client is the organization Data is public Data is proprietary Source: ParenteBeard, HAP – 12.8.11
Background • Patient Protection and Affordable Care Act mandate; • Tax-exempt hospitals must perform CHNA once every three years, to include: • R eport (publically available) including, community and public health input; • Implementation strategy; • Report on IRS Form 990: • How addressing needs identified; • If not addressing them, why not; • $50,000 fine per hospital per year, potential revoke of tax-exempt status
Collaborative Effort Mary Hahn Desha Dickson Vice President of Strategy and Director of Community Business Development Health and Engagement Heidi Williamson Pat Giles Mary Kargbo Vice President for Programs and Executive Vice President/ Chief Executive Officer Initiatives Chief Impact Officer
Collaborative Effort (Cont’d) Community Advisory Committee: ◦ Represent the broad interests of the community; ◦ Provide comment as to survey methods and focus of assessment; ◦ Give input into list of key interviews and focus group selection; ◦ Provide feedback as to survey findings; ◦ Help prioritize Summit feedback; ◦ Work together with hospitals for implementation plan to align community benefit with identified needs.
CHNA Process RFP For Consulting Services Consultant Selected: ◦ Holleran Consulting ◦ Franklin & Marshall College (Center for Opinion Research) Data Collection Needs Assessment, Public Roll-Out of Findings Prioritization of Recommendations Implementation Plans Board Approval (each hospital) Public Posting FINAL DEADLINE: Fall 2016
Berks County 2013 Community Health Needs Assessment Review
Berks County CHNA 2013: Survey Findings Berks County health reflects national • trends in health status and access to care; Overall, residents are in good health • and have good access to care; Poor access to primary and • preventive care results in poorer health status and higher rates of mortality for population sub-groups in Berks County; City of Reading residents are in • poorer health and are more likely to face barriers to care, as are certain subpopulations.
Berks County CHNA 2013: Recommendations – Consultant Report Increase Access to Care: ◦ Increase capacity of existing providers (specifically for uninsured and underinsured and through establishing Berks County Health Department); ◦ Improve ability of providers to serve low income, Black, undocumented, and Latino populations: Expanding culturally appropriate services; Expanding health education efforts that address cultural barriers to care; Expanding outreach; Enhance Personal Health Behaviors: ◦ Increase programs and interventions
Berks County CHNA 2013: Priorities Preventive Care: ◦ Obesity ◦ Dental Prenatal Care Specialty Care: ◦ Behavioral ◦ Other (Sub-specialists) All done with CULTURAL COMPETENCY and all involve ACCESS TO CARE issues
Berks County CHNA 2013: Addressing the Priorities Prenatal Care: Centering Pregnancy Program Mary Hahn Vice President of Strategy and Business Development
Berks County CHNA 2013: Prenatal Care (Where We Began) Berks County and City of Reading Statistics Year Preterm Births Low Birth Weight (<37 weeks) (<2,500 grams) 2005-2008/9 7.7% (8.8% in City of Reading) 2010-2012 6.3% 7.4% (9.7% in City of Reading) (9.8% in City of Reading)
Berks County CHNA 2013: Prenatal Care (Centering Program Overview) Centering Pregnancy Program: ◦ Group setting, including self-monitoring and extended time with provider; ◦ 3 components: health assessment, education, and support; Program started in 2013 (Piloted in 2012); 6-8 ongoing groups at any given time; Groups are facilitated by a CNM, OB Community Health Worker (CHW), & OB Navigator; English & Spanish groups: ◦ Bilingual CHW assists the Spanish groups with interpretation
Berks County CHNA 2013: Prenatal Care (Centering Program Overview) PSH-St. Joseph Downtown Reading Campus OB Patient Demographics Ethnicity African American 15% Payer Mix Private Insured 5% Asian 0% Medical Assistance 90% Caucasian 10% Latina 75% Uninsured 5% Native American 0% Other 0% Other 0% Target Population: ◦ Patients receiving low risk prenatal care at PSHSJ Downtown Reading Campus; ◦ Prenatal patients who desire to see a Certified Nurse Midwife (CNM) throughout their pregnancy; ◦ Coordinated care for high risk patients who see physicians throughout their pregnancy but also desire the group model;
Berks County CHNA 2013: Prenatal Care (Health Outcomes) Participants’ pregnancy outcome data is recorded & trended: Centering Pregnancy vs. Routine Care Deliveries at PSHSJ: Jan – Dec 2015 Preterm Low Birth T otal # of Deliveries Weight Babies Deliveries (<9.6%) (<7.8%) Centering 98 3 (3.1%) 2 (2.0%) Pregnancy Routine Care 597 59 (9.9%) 57 (9.5%) T otal 695 62 (8.9%) 59 (8.5%)
Berks County CHNA 2013: Prenatal Care (Program Successes) Over 300 women have participated since 2012 ◦ Currently have 51 enrolled in groups; Increase of enrollment by 28 percent in 12 months; Exceeding goals for Health Outcomes FY2015; 3 rd consecutive year providing Centering Pregnancy at Reading High School; Plan to begin groups at Mary’s Shelter in Spring 2016; 2015 HAP’s “Community Champion” Award; Fully Certified as Approved Centering Pregnancy site by Centering Healthcare Institute.
Berks County CHNA 2013: Prenatal Care (Centering Program Overview) Centering Pregnancy Program Target population: ◦ Patients receiving low risk prenatal care RHS’s Women Health Center; ◦ Prenatal patients who desire to see a Certified Nurse Midwife (CNM) throughout their pregnancy; Program started in January 2015; 4 ongoing groups at any given time; Groups are facilitated by a CNM at 5 th Street Conference Room; English groups, Spanish instruction available Summer 2016
Berks County CHNA 2013: Addressing the Priorities Preventive Care (Dental): Oral Health Task Force Heidi Williamson Vice President for Programs and Initiatives
Berks County CHNA 2013: Preventive Care (Dental) -Where We Began 30 percent of Berks County adults did not • see a dentist in the previous year; In the City of Reading, 43 percent of adults had not seen a dentist in the previous year; Those percentages were higher than in 2008.
Berks County CHNA 2013: Preventive Care (Dental) - Oral Health Task Force
Berks County CHNA 2013: Preventive Care (Dental) - Oral Health Task Force • Attracted nearly $100,000 in funding from the DentaQuest Foundation; Expanded to include organizations like the local libraries, Berks Encore, the Hispanic Center, and Olivet Boys and Girls Club; Conducted additional on-the-ground research.
Berks County CHNA 2013: Preventive Care (Dental) - What’s Next? • Carole Snyder leads the task force; Additional funding from DentaQuest to engage community members who are less likely to have insurance and visit a dentist; Continue to engage medical and dental professionals to share information that leads to better outcomes for all patients.
Berks County CHNA 2013: Addressing the Priorities Access to Care: Berks Community Health Center (BCHC) Mary Kargbo Chief Executive Officer
Berks County CHNA 2013: Access to Care (BCHC) -Where We Began Access to care was one of the major aspects of the 2013 CHNA report as indicated in the following findings: ◦ 44 percent of survey respondents identified the cost of healthcare, including insurance coverage, co ‐ pays, and deductibles, as the most common health concerns; ◦ 12 percent of adults (or about 37,000 individuals) reported that there was a time in the previous year when they needed health care, but did not receive it due to the cost; ◦ Among the uninsured in Berks County, one ‐ quarter (24.8 percent) visited an emergency room for care in the previous year due to a lack of health insurance; BCHC Board Members adopted the 2013 CHNA report findings in its entirety;
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