Community Health Improvement: Progress in 2018 and Plans for 2019 - - PowerPoint PPT Presentation

Community Health Improvement: Progress in 2018 and Plans for 2019

Franklin County/North Quabbin Community Health Improvement Plan (CHIP) Network Meeting 1/29/19

Today’s Agenda: Four Parts

• 2018 Progress Review
• Health Equity Data for our region
• Community Health Assessment Update
• Your Input and Ideas!

CHIP MISSION

The Community Health Improvement Plan will:

• identify priority health needs and disparities and the

factors that contribute to them;

• build on our strengths by identifying current

resources in the community to address priority health issues;

• identify the most effective strategies for addressing

the priority health needs;

• reduce gaps and duplication in services; and
• increase our collective ability to secure resources to

improve health in our region.

CHIP VISION

All residents of Franklin County and the North Quabbin Region have the opportunity to pursue healthy lifestyles and achieve social, emotional, physical, and spiritual well- being; and to participate in shaping the systems that affect their health.

CHIP STEERING COMMITTEE

Factors that Impact Health

Another image..

PART ONE: PROGRESS IN 2018

OUR 2018 PRIORITIES

Recorder Photo

2018 CHIP Plan Progress: Clinical Care

• State Community Health Worker and Recovery Coach

Certifications… and Supervisor Training

• School Dental Program Growing
• Dental at the Emergency Department at BFMC
• Concerns: fluoride varnish in medical practices,

funding for Chronic Disease Self-Management groups, lack of access to Methadone, especially in North Quabbin.

252 Residential Treatment Beds

• 32 detox beds – Franklin Recovery Center (BHN)
• 32 CSS beds – Northern Hope (BHN)
• 16 coed detox beds for substance use and mental

health disorders – Mowry Building (BHN)*

• 32 coed diversion ATS beds – (BHN)*
• 25 beds for women – Two Rivers Recovery Center

(CHD)

• 17 residential recovery beds for men – Orange

Recovery House (ServiceNet)

• 28 coed residential recovery beds – Beacon

Programs (ServiceNet)

• 8 residential recovery beds for men – Cass Farm

(GAAMHA)

• 22 coed residential recovery beds for substance use

and mental health disorders – Naukeag at Prescot (McLean)

• 12 residental re-entry beds for men – Kimball House

(FCSO)

• 28 bed mininimum sercurity treatment center –

Franklin County Sheriff’s Office (FCSO)

12

DLM1

Slide 12 DLM1 Add GAAMHA and McLean logos

Debra McLaughlin, 12/11/2018

Number of Fatal Opioid-Related Overdoses in Franklin County/North Quabbin

For 2017-2018, additional cases are still being confirmed by the Office of the Chief Medical Examiner. 2018 data as

• f November 20, 2018, includes Athol (NWDA).

5 15 4 25 4 35 22

8 10 10 19 13 9 17 2012 2013 2014 2015 2016 2017 2018

13

2018 Progress: Social and Economic Factors

• Increase to Minimum Wage
• Paid Family and Medical Leave law
• Pregnant Worker Fairness Act
• Nurturing Families groups
• Concerns: Fair Share Amendment, Hands-Free

Cell phone law

Recorder Photo

2018 Progress: Health Behaviors

• Diabetes Prevention at YMCAs
• New Parks and Trails
• Breastfeeding Support
• School Prevention Education
• School Nutrition Project

Concerns: Tobacco (and Vaping) Cessation, Youth and Marijuana Legalization

LifeSkills: Evidence-Based Substance Use Prevention Curriculum

30 class sessions spread over 3 years of middle school All Franklin County school districts implementing 75% of local students are participating in Year 1 of the program 50% of local students are participating in Year 2 of the program 45% of local students are participating in Year 3 of the program Student pre-post-tests measuring gains in knowledge and attitudes Teen Health Survey measuring reductions in youth drug & alcohol use

Next step: PreVenture Pilot?

School Nutrition Technical Assistance Consultancy

• $10K Award from County Health Rankings and Roadmaps/Robert Wood

Johnson Foundation

• Conversations with all Food Service Directors in Franklin County/North

Quabbin

• Site visit to one school per district to observe lunch prep and service
• Report provided to each school
• Met with Superintendents December 2018

to share regional recommendations

• Selected two recommendations to cover in

January 2019 School Food Service Workshop and Networking Session

20

Recorder Photo

2018 Progress: Physical Environment

• Housing Rehab funds awarded to Orange (high

priority) and other towns.

• Complete Streets Redesign of roads in local towns
• Concerns: loss of staff in Greenfield Health

Department, MassRides closure, Housing Rehab in Charlemont/Hawley/Heath, State Transit funding, need for more sober housing

Status of Complete Streets Work in Franklin County

• Policy, Plan and Funding: Sunderland,

Greenfield, Montague, Whately

• Policy and Plan: Buckland, Orange, Deerfield,

Colrain

Housing Rehabilitation Progress

• CDBG funds came to:

– Greenfield, Montague, Orange, Leverett, Sunderland, Conway, Deerfield

• 31 units rehabbed – for $840,000
• New affordable units and sober housing in

Greenfield

• Plans underway for senior housing in Sunderland
• Major impediments include regulations, building

a waitlist, and completing paperwork with applicants.

Current and Potential Sober Housing Units in Our Region

2 beds – 315 Deerfield Street, Greenfield (Greenfield Housing Authority) 8 beds – 317-319 Deerfield Street, Greenfield, (Greenfield Housing Authority) 6 beds for single women – 40-42 Cedar Street, Greenfield (SAGE/GAAMHA) 8 beds – 28 Russell Street, Greenfield (Could be acquired) 4 beds – 23 Pond Street, Greenfield (Could be acquired)

.

25

2018 Progress: CHIP Organization is Growing Up!

• Grant Funding from Baystate Health
• Membership
• Community Voices Mini-Grants

PART TWO: HEALTH EQUITY DATA FOR FRANKLIN COUNTY/NORTH QUABBIN

Health Equity

“Health equity means that everyone has a fair and just opportunity to be healthier….”

• - Robert Wood Johnson Foundation

% of population experiencing 15+ poor health days in the past month (MA)

13% 11% 10% 21% 13% 10% 5% 22% 13% 10% 8% 5% Hisp/Latinx Black?Afr Amer White <high school high school grad 1-3 yrs college college grad <$25000 $25000--$34999 $35000--$49999 $50000--$74999 $75000+ race/ethnnicity education income

MA BRFSS, 2016, https://www.mass.gov/behavioral-risk-factor-surveillance

Median household income by race/ethnicity - Franklin County

$0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000

white black/AfrAmer Hispanic/Latinx

US Census Bureau, American Community Survey, 2013-2017

MA hospitalizations per 100,000 population, by race/ethnicity

white black/Afr Amer Hisp/Lat. 50 100 150 200 250 300 350 asthma, children ages 2-17 white black/Afr Amer. Hisp/Lat. 50 100 150 200 250 300 350 long-term complications of diabetes, adults white black/Afr Amer. Hisp/Lat. 50 100 150 200 250 300 350 hypertension, adults age 18 and over

Agency for Healthcare Research and Quality, https://www.ahrq.gov/policymakers/chipra/demoeval/demostates/ma.html

Place matters!

Rural vs urban

New England

5% 8% 15% 22% 26% 29% 60% Malignant neoplasms Heart disease Cerebrovascular diseases Alzheimer's Diabetes Unintentional injuries Suicide

% rural death rates exceed urban death rates in New England

Center for Rural Health, University of North Dakota https://ruralhealth.und.edu/projects/health-reform-policy-research-center/rural-urban-mortality

Life expectancy at birth

Franklin County

73.1 86.6 65 70 75 80 85 90

414 413 405.01 405.02 407.01 410 412 411 402 403 404 409 415.02 407.02 401 408 415.01 406

Centers for Disease Control and Prevention, https://www.cdc.gov/nchs/nvss/usaleep/usaleep.html

Median household income

Franklin County

$32,582 $81,458 $0 $20,000 $40,000 $60,000 $80,000

413 414 405.02 407.01 405.01 415.02 401 412 404 407.02 408 402 411 403 410 409 406 415.01

US Census Bureau, American Community Survey, 2013-2017

Educational attainment by census tract

Franklin County

14% 61% 0% 20% 40% 60% 80%

414 405.01 405.02 407.01 413 404 401 407.02 410 402 403 412 411 415.02 408 409 415.01 406

% Bachelor's degree or more

US Census Bureau, American Community Survey, 2013-2017

% occupied housing units with no vehicle available - Franklin County

23% 2% 0% 10% 20%

414 407.01 405.01 413 411 412 407.02 408 405.02 415.02 402 403 410 404 401 409 406 415.01

US Census Bureau, American Community Survey, 2013-2017

Census tract Life expectancy at birth % Bachelor's degree or more Median household income No vehicle available Greenfield (east of I91 south of downtown, & Deerfield St) 414

73.1 14%

$35,924

23%

Greenfield (downtown) 413 76.1 25%

$32,582

13% Orange (northeast and center) 405.01 76.9 14% $44,648 15% Orange (remaining town) 405.02 78.2 20% $40,682 6% Montague (Turners Falls) 407.01 78.7 23% $43,100 16% Greenfield (west of I91) 410 79.2 36% $72,500 4% Greenfield (Pierce to Silver Street) 412 79.6 39% $54,909 8% Greenfield (east of I91 north of downtown, & High St) 411 80.4 41% $68,393 8% Bernardston, Gill, Leyden 402 81.1 37% $66,764 4% Northfield 403 81.5 38% $69,028 4% Erving, Warwick, Wendell 404 81.6 28% $58,571 4% Deerfield 409 82.3 55% $78,949 3% Buckland, Shelburne 415.02 82.9 44% $53,500 5% Montague (remaining town) 407.02 83.4 32% $60,444 6% Charlemont, Colrain, Hawley, Heath, Monroe, Rowe 401 84 30% $54,308 4% Sunderland, Whately 408 84.7 53% $61,146 6% Ashfield, Conway 415.01 85.5 55%

$81,458

2% Leverett, New Salem, Shutesbury 406

86.6 61%

$80,795

2%

Health equity

“Health equity means that everyone has a fair and just opportunity to be healthier….” “…This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”

PART THREE: THE BAYSTATE FRANKLIN COMMUNITY HEALTH ASSESSMENT

What is a Community Health Assessment?

What kind of data is going into this Health Assessment?

• Department of Public Health data
• School data
• State Healthy Aging Report
• Partner reports from our region
• Health Equity data
• Focus groups
• Interviews
• You!

PART FOUR: TABLE WORK!

First Question: What are the top 3 most pressing health needs in your community?

– And who do they impact the most? People in a certain place? Of a certain age? – Table facilitators bring answers to front of room

Second Question: Choose a strategy from the 2017-2020 CHIP priority list for the Network to focus on in 2019.

Results of Table Work Questions?

Join us in 2019!

Tuesday, March 26 9-11 AM: County Health Rankings for 2019 2019 CHIP Progress Review meetings from 9-11 AM at Olver Transit Center

• Tuesday, April 30
• Tuesday, July 30
• Tuesday, November 26

Community Health Assessment: https://www.facebook.com/westernmachna/ Report Release: Summer 2019 www.frcog.org/chip

Community Health Improvement: Progress in 2018 and Plans for 2019

Franklin County/North Quabbin Community Health Improvement Plan (CHIP) Network Meeting 1/29/19

Today’s Agenda: Four Parts

• 2018 Progress Review
• Health Equity Data for our region
• Community Health Assessment Update
• Your Input and Ideas!

CHIP MISSION

The Community Health Improvement Plan will:

• identify priority health needs and disparities and the

factors that contribute to them;

• build on our strengths by identifying current

resources in the community to address priority health issues;

• identify the most effective strategies for addressing

the priority health needs;

• reduce gaps and duplication in services; and
• increase our collective ability to secure resources to

improve health in our region.

CHIP VISION

All residents of Franklin County and the North Quabbin Region have the opportunity to pursue healthy lifestyles and achieve social, emotional, physical, and spiritual well- being; and to participate in shaping the systems that affect their health.

CHIP STEERING COMMITTEE

Factors that Impact Health

Another image..

PART ONE: PROGRESS IN 2018

OUR 2018 PRIORITIES

Recorder Photo

2018 CHIP Plan Progress: Clinical Care

• State Community Health Worker and Recovery Coach

Certifications… and Supervisor Training

• School Dental Program Growing
• Dental at the Emergency Department at BFMC
• Concerns: fluoride varnish in medical practices,

funding for Chronic Disease Self-Management groups, lack of access to Methadone, especially in North Quabbin.

252 Residential Treatment Beds

• 32 detox beds – Franklin Recovery Center (BHN)
• 32 CSS beds – Northern Hope (BHN)
• 16 coed detox beds for substance use and mental

health disorders – Mowry Building (BHN)*

• 32 coed diversion ATS beds – (BHN)*
• 25 beds for women – Two Rivers Recovery Center

(CHD)

• 17 residential recovery beds for men – Orange

Recovery House (ServiceNet)

• 28 coed residential recovery beds – Beacon

Programs (ServiceNet)

• 8 residential recovery beds for men – Cass Farm

(GAAMHA)

• 22 coed residential recovery beds for substance use

and mental health disorders – Naukeag at Prescot (McLean)

• 12 residental re-entry beds for men – Kimball House

(FCSO)

• 28 bed mininimum sercurity treatment center –

Franklin County Sheriff’s Office (FCSO)

12

DLM1

Slide 12 DLM1 Add GAAMHA and McLean logos

Debra McLaughlin, 12/11/2018

Number of Fatal Opioid-Related Overdoses in Franklin County/North Quabbin

For 2017-2018, additional cases are still being confirmed by the Office of the Chief Medical Examiner. 2018 data as

• f November 20, 2018, includes Athol (NWDA).

5 15 4 25 4 35 22

8 10 10 19 13 9 17 2012 2013 2014 2015 2016 2017 2018

13

2018 Progress: Social and Economic Factors

• Increase to Minimum Wage
• Paid Family and Medical Leave law
• Pregnant Worker Fairness Act
• Nurturing Families groups
• Concerns: Fair Share Amendment, Hands-Free

Cell phone law

Recorder Photo

2018 Progress: Health Behaviors

• Diabetes Prevention at YMCAs
• New Parks and Trails
• Breastfeeding Support
• School Prevention Education
• School Nutrition Project

Concerns: Tobacco (and Vaping) Cessation, Youth and Marijuana Legalization

LifeSkills: Evidence-Based Substance Use Prevention Curriculum

30 class sessions spread over 3 years of middle school All Franklin County school districts implementing 75% of local students are participating in Year 1 of the program 50% of local students are participating in Year 2 of the program 45% of local students are participating in Year 3 of the program Student pre-post-tests measuring gains in knowledge and attitudes Teen Health Survey measuring reductions in youth drug & alcohol use

Next step: PreVenture Pilot?

School Nutrition Technical Assistance Consultancy

• $10K Award from County Health Rankings and Roadmaps/Robert Wood

Johnson Foundation

• Conversations with all Food Service Directors in Franklin County/North

Quabbin

• Site visit to one school per district to observe lunch prep and service
• Report provided to each school
• Met with Superintendents December 2018

to share regional recommendations

• Selected two recommendations to cover in

January 2019 School Food Service Workshop and Networking Session

20

Recorder Photo

2018 Progress: Physical Environment

• Housing Rehab funds awarded to Orange (high

priority) and other towns.

• Complete Streets Redesign of roads in local towns
• Concerns: loss of staff in Greenfield Health

Department, MassRides closure, Housing Rehab in Charlemont/Hawley/Heath, State Transit funding, need for more sober housing

Status of Complete Streets Work in Franklin County

• Policy, Plan and Funding: Sunderland,

Greenfield, Montague, Whately

• Policy and Plan: Buckland, Orange, Deerfield,

Colrain

Housing Rehabilitation Progress

• CDBG funds came to:

– Greenfield, Montague, Orange, Leverett, Sunderland, Conway, Deerfield

• 31 units rehabbed – for $840,000
• New affordable units and sober housing in

Greenfield

• Plans underway for senior housing in Sunderland
• Major impediments include regulations, building

a waitlist, and completing paperwork with applicants.

Current and Potential Sober Housing Units in Our Region

2 beds – 315 Deerfield Street, Greenfield (Greenfield Housing Authority) 8 beds – 317-319 Deerfield Street, Greenfield, (Greenfield Housing Authority) 6 beds for single women – 40-42 Cedar Street, Greenfield (SAGE/GAAMHA) 8 beds – 28 Russell Street, Greenfield (Could be acquired) 4 beds – 23 Pond Street, Greenfield (Could be acquired)

.

25

2018 Progress: CHIP Organization is Growing Up!

• Grant Funding from Baystate Health
• Membership
• Community Voices Mini-Grants

PART TWO: HEALTH EQUITY DATA FOR FRANKLIN COUNTY/NORTH QUABBIN

Health Equity

“Health equity means that everyone has a fair and just opportunity to be healthier….”

• - Robert Wood Johnson Foundation

% of population experiencing 15+ poor health days in the past month (MA)

13% 11% 10% 21% 13% 10% 5% 22% 13% 10% 8% 5% Hisp/Latinx Black?Afr Amer White <high school high school grad 1-3 yrs college college grad <$25000 $25000--$34999 $35000--$49999 $50000--$74999 $75000+ race/ethnnicity education income

MA BRFSS, 2016, https://www.mass.gov/behavioral-risk-factor-surveillance

Median household income by race/ethnicity - Franklin County

$0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000

white black/AfrAmer Hispanic/Latinx

US Census Bureau, American Community Survey, 2013-2017

MA hospitalizations per 100,000 population, by race/ethnicity

white black/Afr Amer Hisp/Lat. 50 100 150 200 250 300 350 asthma, children ages 2-17 white black/Afr Amer. Hisp/Lat. 50 100 150 200 250 300 350 long-term complications of diabetes, adults white black/Afr Amer. Hisp/Lat. 50 100 150 200 250 300 350 hypertension, adults age 18 and over

Agency for Healthcare Research and Quality, https://www.ahrq.gov/policymakers/chipra/demoeval/demostates/ma.html

Place matters!

Rural vs urban

New England

5% 8% 15% 22% 26% 29% 60% Malignant neoplasms Heart disease Cerebrovascular diseases Alzheimer's Diabetes Unintentional injuries Suicide

% rural death rates exceed urban death rates in New England

Center for Rural Health, University of North Dakota https://ruralhealth.und.edu/projects/health-reform-policy-research-center/rural-urban-mortality

Life expectancy at birth

Franklin County

73.1 86.6 65 70 75 80 85 90

414 413 405.01 405.02 407.01 410 412 411 402 403 404 409 415.02 407.02 401 408 415.01 406

Centers for Disease Control and Prevention, https://www.cdc.gov/nchs/nvss/usaleep/usaleep.html

Median household income

Franklin County

$32,582 $81,458 $0 $20,000 $40,000 $60,000 $80,000

413 414 405.02 407.01 405.01 415.02 401 412 404 407.02 408 402 411 403 410 409 406 415.01

US Census Bureau, American Community Survey, 2013-2017

Educational attainment by census tract

Franklin County

14% 61% 0% 20% 40% 60% 80%

414 405.01 405.02 407.01 413 404 401 407.02 410 402 403 412 411 415.02 408 409 415.01 406

% Bachelor's degree or more

US Census Bureau, American Community Survey, 2013-2017

% occupied housing units with no vehicle available - Franklin County

23% 2% 0% 10% 20%

414 407.01 405.01 413 411 412 407.02 408 405.02 415.02 402 403 410 404 401 409 406 415.01

US Census Bureau, American Community Survey, 2013-2017

Census tract Life expectancy at birth % Bachelor's degree or more Median household income No vehicle available Greenfield (east of I91 south of downtown, & Deerfield St) 414

73.1 14%

$35,924

23%

Greenfield (downtown) 413 76.1 25%

$32,582

13% Orange (northeast and center) 405.01 76.9 14% $44,648 15% Orange (remaining town) 405.02 78.2 20% $40,682 6% Montague (Turners Falls) 407.01 78.7 23% $43,100 16% Greenfield (west of I91) 410 79.2 36% $72,500 4% Greenfield (Pierce to Silver Street) 412 79.6 39% $54,909 8% Greenfield (east of I91 north of downtown, & High St) 411 80.4 41% $68,393 8% Bernardston, Gill, Leyden 402 81.1 37% $66,764 4% Northfield 403 81.5 38% $69,028 4% Erving, Warwick, Wendell 404 81.6 28% $58,571 4% Deerfield 409 82.3 55% $78,949 3% Buckland, Shelburne 415.02 82.9 44% $53,500 5% Montague (remaining town) 407.02 83.4 32% $60,444 6% Charlemont, Colrain, Hawley, Heath, Monroe, Rowe 401 84 30% $54,308 4% Sunderland, Whately 408 84.7 53% $61,146 6% Ashfield, Conway 415.01 85.5 55%

$81,458

2% Leverett, New Salem, Shutesbury 406

86.6 61%

$80,795

2%

Health equity

“Health equity means that everyone has a fair and just opportunity to be healthier….” “…This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”

PART THREE: THE BAYSTATE FRANKLIN COMMUNITY HEALTH ASSESSMENT

What is a Community Health Assessment?

What kind of data is going into this Health Assessment?

• Department of Public Health data
• School data
• State Healthy Aging Report
• Partner reports from our region
• Health Equity data
• Focus groups
• Interviews
• You!

PART FOUR: TABLE WORK!

First Question: What are the top 3 most pressing health needs in your community?

– And who do they impact the most? People in a certain place? Of a certain age? – Table facilitators bring answers to front of room

Second Question: Choose a strategy from the 2017-2020 CHIP priority list for the Network to focus on in 2019.

Results of Table Work Questions?

Join us in 2019!

Tuesday, March 26 9-11 AM: County Health Rankings for 2019 2019 CHIP Progress Review meetings from 9-11 AM at Olver Transit Center

• Tuesday, April 30
• Tuesday, July 30
• Tuesday, November 26

Community Health Assessment: https://www.facebook.com/westernmachna/ Report Release: Summer 2019 www.frcog.org/chip

Community Health Improvement: Progress in 2018 and Plans for 2019

Franklin County/North Quabbin Community Health Improvement Plan (CHIP) Network Meeting 1/29/19

Today’s Agenda: Four Parts

• 2018 Progress Review
• Health Equity Data for our region
• Community Health Assessment Update
• Your Input and Ideas!

CHIP MISSION

The Community Health Improvement Plan will:

• identify priority health needs and disparities and the

factors that contribute to them;

• build on our strengths by identifying current

resources in the community to address priority health issues;

• identify the most effective strategies for addressing

the priority health needs;

• reduce gaps and duplication in services; and
• increase our collective ability to secure resources to

improve health in our region.

CHIP VISION

All residents of Franklin County and the North Quabbin Region have the opportunity to pursue healthy lifestyles and achieve social, emotional, physical, and spiritual well- being; and to participate in shaping the systems that affect their health.

CHIP STEERING COMMITTEE

Factors that Impact Health

Another image..

PART ONE: PROGRESS IN 2018

OUR 2018 PRIORITIES

Recorder Photo

2018 CHIP Plan Progress: Clinical Care

• State Community Health Worker and Recovery Coach

Certifications… and Supervisor Training

• School Dental Program Growing
• Dental at the Emergency Department at BFMC
• Concerns: fluoride varnish in medical practices,

funding for Chronic Disease Self-Management groups, lack of access to Methadone, especially in North Quabbin.

252 Residential Treatment Beds

• 32 detox beds – Franklin Recovery Center (BHN)
• 32 CSS beds – Northern Hope (BHN)
• 16 coed detox beds for substance use and mental

health disorders – Mowry Building (BHN)*

• 32 coed diversion ATS beds – (BHN)*
• 25 beds for women – Two Rivers Recovery Center

(CHD)

• 17 residential recovery beds for men – Orange

Recovery House (ServiceNet)

• 28 coed residential recovery beds – Beacon

Programs (ServiceNet)

• 8 residential recovery beds for men – Cass Farm

(GAAMHA)

• 22 coed residential recovery beds for substance use

and mental health disorders – Naukeag at Prescot (McLean)

• 12 residental re-entry beds for men – Kimball House

(FCSO)

• 28 bed mininimum sercurity treatment center –

Franklin County Sheriff’s Office (FCSO)

12

DLM1

Slide 12 DLM1 Add GAAMHA and McLean logos

Debra McLaughlin, 12/11/2018

Number of Fatal Opioid-Related Overdoses in Franklin County/North Quabbin

For 2017-2018, additional cases are still being confirmed by the Office of the Chief Medical Examiner. 2018 data as

• f November 20, 2018, includes Athol (NWDA).

5 15 4 25 4 35 22

8 10 10 19 13 9 17 2012 2013 2014 2015 2016 2017 2018

13

2018 Progress: Social and Economic Factors

• Increase to Minimum Wage
• Paid Family and Medical Leave law
• Pregnant Worker Fairness Act
• Nurturing Families groups
• Concerns: Fair Share Amendment, Hands-Free

Cell phone law

Recorder Photo

2018 Progress: Health Behaviors

• Diabetes Prevention at YMCAs
• New Parks and Trails
• Breastfeeding Support
• School Prevention Education
• School Nutrition Project

Concerns: Tobacco (and Vaping) Cessation, Youth and Marijuana Legalization

LifeSkills: Evidence-Based Substance Use Prevention Curriculum

30 class sessions spread over 3 years of middle school All Franklin County school districts implementing 75% of local students are participating in Year 1 of the program 50% of local students are participating in Year 2 of the program 45% of local students are participating in Year 3 of the program Student pre-post-tests measuring gains in knowledge and attitudes Teen Health Survey measuring reductions in youth drug & alcohol use

Next step: PreVenture Pilot?

School Nutrition Technical Assistance Consultancy

• $10K Award from County Health Rankings and Roadmaps/Robert Wood

Johnson Foundation

• Conversations with all Food Service Directors in Franklin County/North

Quabbin

• Site visit to one school per district to observe lunch prep and service
• Report provided to each school
• Met with Superintendents December 2018

to share regional recommendations

• Selected two recommendations to cover in

January 2019 School Food Service Workshop and Networking Session

20

Recorder Photo

2018 Progress: Physical Environment

• Housing Rehab funds awarded to Orange (high

priority) and other towns.

• Complete Streets Redesign of roads in local towns
• Concerns: loss of staff in Greenfield Health

Department, MassRides closure, Housing Rehab in Charlemont/Hawley/Heath, State Transit funding, need for more sober housing

Status of Complete Streets Work in Franklin County

• Policy, Plan and Funding: Sunderland,

Greenfield, Montague, Whately

• Policy and Plan: Buckland, Orange, Deerfield,

Colrain

Housing Rehabilitation Progress

• CDBG funds came to:

– Greenfield, Montague, Orange, Leverett, Sunderland, Conway, Deerfield

• 31 units rehabbed – for $840,000
• New affordable units and sober housing in

Greenfield

• Plans underway for senior housing in Sunderland
• Major impediments include regulations, building

a waitlist, and completing paperwork with applicants.

Current and Potential Sober Housing Units in Our Region

2 beds – 315 Deerfield Street, Greenfield (Greenfield Housing Authority) 8 beds – 317-319 Deerfield Street, Greenfield, (Greenfield Housing Authority) 6 beds for single women – 40-42 Cedar Street, Greenfield (SAGE/GAAMHA) 8 beds – 28 Russell Street, Greenfield (Could be acquired) 4 beds – 23 Pond Street, Greenfield (Could be acquired)

.

25

2018 Progress: CHIP Organization is Growing Up!

• Grant Funding from Baystate Health
• Membership
• Community Voices Mini-Grants

PART TWO: HEALTH EQUITY DATA FOR FRANKLIN COUNTY/NORTH QUABBIN

Health Equity

“Health equity means that everyone has a fair and just opportunity to be healthier….”

• - Robert Wood Johnson Foundation

% of population experiencing 15+ poor health days in the past month (MA)

13% 11% 10% 21% 13% 10% 5% 22% 13% 10% 8% 5% Hisp/Latinx Black?Afr Amer White <high school high school grad 1-3 yrs college college grad <$25000 $25000--$34999 $35000--$49999 $50000--$74999 $75000+ race/ethnnicity education income

MA BRFSS, 2016, https://www.mass.gov/behavioral-risk-factor-surveillance

Median household income by race/ethnicity - Franklin County

$0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000

white black/AfrAmer Hispanic/Latinx

US Census Bureau, American Community Survey, 2013-2017

MA hospitalizations per 100,000 population, by race/ethnicity

white black/Afr Amer Hisp/Lat. 50 100 150 200 250 300 350 asthma, children ages 2-17 white black/Afr Amer. Hisp/Lat. 50 100 150 200 250 300 350 long-term complications of diabetes, adults white black/Afr Amer. Hisp/Lat. 50 100 150 200 250 300 350 hypertension, adults age 18 and over

Agency for Healthcare Research and Quality, https://www.ahrq.gov/policymakers/chipra/demoeval/demostates/ma.html

Place matters!

Rural vs urban

New England

5% 8% 15% 22% 26% 29% 60% Malignant neoplasms Heart disease Cerebrovascular diseases Alzheimer's Diabetes Unintentional injuries Suicide

% rural death rates exceed urban death rates in New England

Center for Rural Health, University of North Dakota https://ruralhealth.und.edu/projects/health-reform-policy-research-center/rural-urban-mortality

Life expectancy at birth

Franklin County

73.1 86.6 65 70 75 80 85 90

414 413 405.01 405.02 407.01 410 412 411 402 403 404 409 415.02 407.02 401 408 415.01 406

Centers for Disease Control and Prevention, https://www.cdc.gov/nchs/nvss/usaleep/usaleep.html

Median household income

Franklin County

$32,582 $81,458 $0 $20,000 $40,000 $60,000 $80,000

413 414 405.02 407.01 405.01 415.02 401 412 404 407.02 408 402 411 403 410 409 406 415.01

US Census Bureau, American Community Survey, 2013-2017

Educational attainment by census tract

Franklin County

14% 61% 0% 20% 40% 60% 80%

414 405.01 405.02 407.01 413 404 401 407.02 410 402 403 412 411 415.02 408 409 415.01 406

% Bachelor's degree or more

US Census Bureau, American Community Survey, 2013-2017

% occupied housing units with no vehicle available - Franklin County

23% 2% 0% 10% 20%

414 407.01 405.01 413 411 412 407.02 408 405.02 415.02 402 403 410 404 401 409 406 415.01

US Census Bureau, American Community Survey, 2013-2017

Census tract Life expectancy at birth % Bachelor's degree or more Median household income No vehicle available Greenfield (east of I91 south of downtown, & Deerfield St) 414

73.1 14%

$35,924

23%

Greenfield (downtown) 413 76.1 25%

$32,582

13% Orange (northeast and center) 405.01 76.9 14% $44,648 15% Orange (remaining town) 405.02 78.2 20% $40,682 6% Montague (Turners Falls) 407.01 78.7 23% $43,100 16% Greenfield (west of I91) 410 79.2 36% $72,500 4% Greenfield (Pierce to Silver Street) 412 79.6 39% $54,909 8% Greenfield (east of I91 north of downtown, & High St) 411 80.4 41% $68,393 8% Bernardston, Gill, Leyden 402 81.1 37% $66,764 4% Northfield 403 81.5 38% $69,028 4% Erving, Warwick, Wendell 404 81.6 28% $58,571 4% Deerfield 409 82.3 55% $78,949 3% Buckland, Shelburne 415.02 82.9 44% $53,500 5% Montague (remaining town) 407.02 83.4 32% $60,444 6% Charlemont, Colrain, Hawley, Heath, Monroe, Rowe 401 84 30% $54,308 4% Sunderland, Whately 408 84.7 53% $61,146 6% Ashfield, Conway 415.01 85.5 55%

$81,458

2% Leverett, New Salem, Shutesbury 406

86.6 61%

$80,795

2%

Health equity

“Health equity means that everyone has a fair and just opportunity to be healthier….” “…This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”

PART THREE: THE BAYSTATE FRANKLIN COMMUNITY HEALTH ASSESSMENT

What is a Community Health Assessment?

What kind of data is going into this Health Assessment?

• Department of Public Health data
• School data
• State Healthy Aging Report
• Partner reports from our region
• Health Equity data
• Focus groups
• Interviews
• You!

PART FOUR: TABLE WORK!

First Question: What are the top 3 most pressing health needs in your community?

– And who do they impact the most? People in a certain place? Of a certain age? – Table facilitators bring answers to front of room

Second Question: Choose a strategy from the 2017-2020 CHIP priority list for the Network to focus on in 2019.

Results of Table Work Questions?

Join us in 2019!

Tuesday, March 26 9-11 AM: County Health Rankings for 2019 2019 CHIP Progress Review meetings from 9-11 AM at Olver Transit Center

• Tuesday, April 30
• Tuesday, July 30
• Tuesday, November 26

Community Health Assessment: https://www.facebook.com/westernmachna/ Report Release: Summer 2019 www.frcog.org/chip

Community Health Improvement: Progress in 2018 and Plans for 2019

Franklin County/North Quabbin Community Health Improvement Plan (CHIP) Network Meeting 1/29/19

Today’s Agenda: Four Parts

• 2018 Progress Review
• Health Equity Data for our region
• Community Health Assessment Update
• Your Input and Ideas!

CHIP MISSION

The Community Health Improvement Plan will:

• identify priority health needs and disparities and the

factors that contribute to them;

• build on our strengths by identifying current

resources in the community to address priority health issues;

• identify the most effective strategies for addressing

the priority health needs;

• reduce gaps and duplication in services; and
• increase our collective ability to secure resources to

improve health in our region.

CHIP VISION

All residents of Franklin County and the North Quabbin Region have the opportunity to pursue healthy lifestyles and achieve social, emotional, physical, and spiritual well- being; and to participate in shaping the systems that affect their health.

CHIP STEERING COMMITTEE

Factors that Impact Health

Another image..

PART ONE: PROGRESS IN 2018

OUR 2018 PRIORITIES

Recorder Photo

2018 CHIP Plan Progress: Clinical Care

• State Community Health Worker and Recovery Coach

Certifications… and Supervisor Training

• School Dental Program Growing
• Dental at the Emergency Department at BFMC
• Concerns: fluoride varnish in medical practices,

funding for Chronic Disease Self-Management groups, lack of access to Methadone, especially in North Quabbin.

252 Residential Treatment Beds

• 32 detox beds – Franklin Recovery Center (BHN)
• 32 CSS beds – Northern Hope (BHN)
• 16 coed detox beds for substance use and mental

health disorders – Mowry Building (BHN)*

• 32 coed diversion ATS beds – (BHN)*
• 25 beds for women – Two Rivers Recovery Center

(CHD)

• 17 residential recovery beds for men – Orange

Recovery House (ServiceNet)

• 28 coed residential recovery beds – Beacon

Programs (ServiceNet)

• 8 residential recovery beds for men – Cass Farm

(GAAMHA)

• 22 coed residential recovery beds for substance use

and mental health disorders – Naukeag at Prescot (McLean)

• 12 residental re-entry beds for men – Kimball House

(FCSO)

• 28 bed mininimum sercurity treatment center –

Franklin County Sheriff’s Office (FCSO)

12

DLM1

Slide 12 DLM1 Add GAAMHA and McLean logos

Debra McLaughlin, 12/11/2018

Number of Fatal Opioid-Related Overdoses in Franklin County/North Quabbin

For 2017-2018, additional cases are still being confirmed by the Office of the Chief Medical Examiner. 2018 data as

• f November 20, 2018, includes Athol (NWDA).

5 15 4 25 4 35 22

8 10 10 19 13 9 17 2012 2013 2014 2015 2016 2017 2018

13

2018 Progress: Social and Economic Factors

• Increase to Minimum Wage
• Paid Family and Medical Leave law
• Pregnant Worker Fairness Act
• Nurturing Families groups
• Concerns: Fair Share Amendment, Hands-Free

Cell phone law

Recorder Photo

2018 Progress: Health Behaviors

• Diabetes Prevention at YMCAs
• New Parks and Trails
• Breastfeeding Support
• School Prevention Education
• School Nutrition Project

Concerns: Tobacco (and Vaping) Cessation, Youth and Marijuana Legalization

LifeSkills: Evidence-Based Substance Use Prevention Curriculum

30 class sessions spread over 3 years of middle school All Franklin County school districts implementing 75% of local students are participating in Year 1 of the program 50% of local students are participating in Year 2 of the program 45% of local students are participating in Year 3 of the program Student pre-post-tests measuring gains in knowledge and attitudes Teen Health Survey measuring reductions in youth drug & alcohol use

Next step: PreVenture Pilot?

School Nutrition Technical Assistance Consultancy

• $10K Award from County Health Rankings and Roadmaps/Robert Wood

Johnson Foundation

• Conversations with all Food Service Directors in Franklin County/North

Quabbin

• Site visit to one school per district to observe lunch prep and service
• Report provided to each school
• Met with Superintendents December 2018

to share regional recommendations

• Selected two recommendations to cover in

January 2019 School Food Service Workshop and Networking Session

20

Recorder Photo

2018 Progress: Physical Environment

• Housing Rehab funds awarded to Orange (high

priority) and other towns.

• Complete Streets Redesign of roads in local towns
• Concerns: loss of staff in Greenfield Health

Department, MassRides closure, Housing Rehab in Charlemont/Hawley/Heath, State Transit funding, need for more sober housing

Status of Complete Streets Work in Franklin County

• Policy, Plan and Funding: Sunderland,

Greenfield, Montague, Whately

• Policy and Plan: Buckland, Orange, Deerfield,

Colrain

Housing Rehabilitation Progress

• CDBG funds came to:

– Greenfield, Montague, Orange, Leverett, Sunderland, Conway, Deerfield

• 31 units rehabbed – for $840,000
• New affordable units and sober housing in

Greenfield

• Plans underway for senior housing in Sunderland
• Major impediments include regulations, building

a waitlist, and completing paperwork with applicants.

Current and Potential Sober Housing Units in Our Region

2 beds – 315 Deerfield Street, Greenfield (Greenfield Housing Authority) 8 beds – 317-319 Deerfield Street, Greenfield, (Greenfield Housing Authority) 6 beds for single women – 40-42 Cedar Street, Greenfield (SAGE/GAAMHA) 8 beds – 28 Russell Street, Greenfield (Could be acquired) 4 beds – 23 Pond Street, Greenfield (Could be acquired)

.

25

2018 Progress: CHIP Organization is Growing Up!

• Grant Funding from Baystate Health
• Membership
• Community Voices Mini-Grants

PART TWO: HEALTH EQUITY DATA FOR FRANKLIN COUNTY/NORTH QUABBIN

Health Equity

“Health equity means that everyone has a fair and just opportunity to be healthier….”

• - Robert Wood Johnson Foundation

% of population experiencing 15+ poor health days in the past month (MA)

13% 11% 10% 21% 13% 10% 5% 22% 13% 10% 8% 5% Hisp/Latinx Black?Afr Amer White <high school high school grad 1-3 yrs college college grad <$25000 $25000--$34999 $35000--$49999 $50000--$74999 $75000+ race/ethnnicity education income

MA BRFSS, 2016, https://www.mass.gov/behavioral-risk-factor-surveillance

Median household income by race/ethnicity - Franklin County

$0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000

white black/AfrAmer Hispanic/Latinx

US Census Bureau, American Community Survey, 2013-2017

MA hospitalizations per 100,000 population, by race/ethnicity

white black/Afr Amer Hisp/Lat. 50 100 150 200 250 300 350 asthma, children ages 2-17 white black/Afr Amer. Hisp/Lat. 50 100 150 200 250 300 350 long-term complications of diabetes, adults white black/Afr Amer. Hisp/Lat. 50 100 150 200 250 300 350 hypertension, adults age 18 and over

Agency for Healthcare Research and Quality, https://www.ahrq.gov/policymakers/chipra/demoeval/demostates/ma.html

Place matters!

Rural vs urban

New England

5% 8% 15% 22% 26% 29% 60% Malignant neoplasms Heart disease Cerebrovascular diseases Alzheimer's Diabetes Unintentional injuries Suicide

% rural death rates exceed urban death rates in New England

Center for Rural Health, University of North Dakota https://ruralhealth.und.edu/projects/health-reform-policy-research-center/rural-urban-mortality

Life expectancy at birth

Franklin County

73.1 86.6 65 70 75 80 85 90

414 413 405.01 405.02 407.01 410 412 411 402 403 404 409 415.02 407.02 401 408 415.01 406

Centers for Disease Control and Prevention, https://www.cdc.gov/nchs/nvss/usaleep/usaleep.html

Median household income

Franklin County

$32,582 $81,458 $0 $20,000 $40,000 $60,000 $80,000

413 414 405.02 407.01 405.01 415.02 401 412 404 407.02 408 402 411 403 410 409 406 415.01

US Census Bureau, American Community Survey, 2013-2017

Educational attainment by census tract

Franklin County

14% 61% 0% 20% 40% 60% 80%

414 405.01 405.02 407.01 413 404 401 407.02 410 402 403 412 411 415.02 408 409 415.01 406

% Bachelor's degree or more

US Census Bureau, American Community Survey, 2013-2017

% occupied housing units with no vehicle available - Franklin County

23% 2% 0% 10% 20%

414 407.01 405.01 413 411 412 407.02 408 405.02 415.02 402 403 410 404 401 409 406 415.01

US Census Bureau, American Community Survey, 2013-2017

Census tract Life expectancy at birth % Bachelor's degree or more Median household income No vehicle available Greenfield (east of I91 south of downtown, & Deerfield St) 414

73.1 14%

$35,924

23%

Greenfield (downtown) 413 76.1 25%

$32,582

13% Orange (northeast and center) 405.01 76.9 14% $44,648 15% Orange (remaining town) 405.02 78.2 20% $40,682 6% Montague (Turners Falls) 407.01 78.7 23% $43,100 16% Greenfield (west of I91) 410 79.2 36% $72,500 4% Greenfield (Pierce to Silver Street) 412 79.6 39% $54,909 8% Greenfield (east of I91 north of downtown, & High St) 411 80.4 41% $68,393 8% Bernardston, Gill, Leyden 402 81.1 37% $66,764 4% Northfield 403 81.5 38% $69,028 4% Erving, Warwick, Wendell 404 81.6 28% $58,571 4% Deerfield 409 82.3 55% $78,949 3% Buckland, Shelburne 415.02 82.9 44% $53,500 5% Montague (remaining town) 407.02 83.4 32% $60,444 6% Charlemont, Colrain, Hawley, Heath, Monroe, Rowe 401 84 30% $54,308 4% Sunderland, Whately 408 84.7 53% $61,146 6% Ashfield, Conway 415.01 85.5 55%

$81,458

2% Leverett, New Salem, Shutesbury 406

86.6 61%

$80,795

2%

Health equity

“Health equity means that everyone has a fair and just opportunity to be healthier….” “…This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”

PART THREE: THE BAYSTATE FRANKLIN COMMUNITY HEALTH ASSESSMENT

What is a Community Health Assessment?

What kind of data is going into this Health Assessment?

• Department of Public Health data
• School data
• State Healthy Aging Report
• Partner reports from our region
• Health Equity data
• Focus groups
• Interviews
• You!

PART FOUR: TABLE WORK!

First Question: What are the top 3 most pressing health needs in your community?

– And who do they impact the most? People in a certain place? Of a certain age? – Table facilitators bring answers to front of room

Second Question: Choose a strategy from the 2017-2020 CHIP priority list for the Network to focus on in 2019.

Results of Table Work Questions?

Join us in 2019!

Tuesday, March 26 9-11 AM: County Health Rankings for 2019 2019 CHIP Progress Review meetings from 9-11 AM at Olver Transit Center

• Tuesday, April 30
• Tuesday, July 30
• Tuesday, November 26

Community Health Assessment: https://www.facebook.com/westernmachna/ Report Release: Summer 2019 www.frcog.org/chip