Know the Facts: Informing Health Care Decisions with Data Nov. 30, 2017 Mike Geeslin, President and CEO, Central Health Katie Coburn, Manager, Regional Healthcare Partnership, Central Health Christie Garbe, Vice President and Chief Strategy Officer, Central Health Jaeson T. Fournier, CEO, CommUnityCare JP Eichmiller, Director of Strategic Communications, Central Health
RHP 7 2017 Community Needs Assessment Katie Coburn, MPH, PMP
Purpose of Assessment v Required component of Region 7’s RHP Plan Update, due to THHSC next spring v Approved RHP Plan Update necessary for Waiver/DSRIP participation, funds v Fresh look at social, economic, and health environment for Medicaid and low income populations in RHP 7 v Foundation for DSRIP providers’ v RHP 7: Bastrop, planning Caldwell, Fayette, Hays, Lee, Travis counties 3
Summary of Themes • Affordable Housing and Migration • Economic and Health Disparities • Chronic Conditions, Prenatal Care, Sexually Transmitted Infections • Behavioral Health • Accessibility of Health Care and Transportation 4
Median Monthly Housing Costs, Renter-Occupied “The price of housing - If you’re on a fixed income like me, they won’t rent to you.” -Community Member Focus Group ParLcipant 2010 2015 $1,054 $973 $917 $891 $882 $848 $807 $786 $765 $760 $701 $695 $615 $593 Texas Bastrop Caldwell Faye>e Hays Lee Travis DATA SOURCE: U.S. Census Bureau, American Community Survey 5-Year Es?mates, 2006-2010 and 2011-2015 5
Median Household Income, by Race/ Ethnicity, 2015 White, non-Hispanic Black or African American Hispanic or LaLno, any race $80,000 $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 $0 Texas Bastrop Caldwell Faye>e Hays Lee Travis DATA SOURCE: U.S. Census Bureau, American Community Survey 5-Year Es?mates, 2011-2015 6
Self-Reported High Blood Pressure by Race/Ethnicity, 2015 “We can’t con?nue to see the health dispari?es in the African-American community get worse. It’s about the needs being met.” -Key Informant Interviewee Texas RHP 7 44.7% 42.3% 33.8% 30.5% 28.2% 26.7% 23.8% 21.7% 21.0% 19.8% Overall White, non- Black, non- Hispanic Other/MulLracial, Hispanic Hispanic non-Hispanic DATA SOURCE: Texas Behavioral Risk Factor Surveillance Survey (BRFSS), 2011-2015 NOTE: Survey data based upon self-report 7 7
Percent of Adults without a Personal Doctor or Provider, by Race/Ethnicity, 2015 Texas RHP 7 49.2% 48.6% 34.9% 34.5% 32.8% 31.2% 30.2% 25.8% 22.0% 21.3% Overall White, non- Black, non-Hispanic Hispanic Other/MulLracial, Hispanic non-Hispanic DATA SOURCE: Texas Behavioral Risk Factor Surveillance Survey (BRFSS), 2011-2015 NOTE: Survey data based upon self-report 8
Leading Causes of Mortality - 2015 Bastrop Caldwell Fayette Hays Lee Travis Texas County County County County County County Heart disease Heart disease Cancer Heart disease Heart disease Cancer Cancer Chronic Condi*ons, Prenatal Care, STIs 1 Cancer Cancer Heart disease Cancer Cancer Heart disease Heart disease 2 Cerebrovascu Cerebrovascu Accidents N/A Accidents N/A Accidents lar diseases lar diseases 3 Chronic lower Chronic lower Alzheimer's Cerebrovascu respiratory respiratory N/A N/A N/A disease lar diseases diseases diseases 4 Chronic lower Chronic lower Alzheimer's Alzheimer's respiratory respiratory N/A N/A N/A disease disease diseases diseases 5 DATA SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, Underlying Cause of Death 1999-2015 on CDC WONDER Online Database, 2015 9
Premature Births, 2012 and 2014 • 63% of providers that responded to the stakeholder survey rated access to prenatal/maternal care as ‘Hard’ or ‘Very Hard’ for the low-income community in RHP 7. 2012 2014 17.6% 15.7% 12.4% 12.3% 11.9% 11.7% 11.7% 11.1% 11.0% 10.6% 10.2% 10.1% 9.8% 9.0% Texas Bastrop Caldwell Faye>e Hays Lee Travis DATA SOURCE: Texas Department of State Health Services, Center for Health Sta?s?cs, Texas Health Data, Vital Sta?s?cs Annual Report, 2012 and 2014 NOTE: Premature birth defined as prior to the 37 th week of gesta?on Shown as Percent of Total Births 10 10
STI Rates per 100,000, 2012 and 2015 2012 2015 C HLAMYDIA 809.4 661.8 608.5 610.9 592.0 549.5 487.3 477.4 467.6 349.9 338.4 271.0 254.5 246.9 Texas Bastrop Caldwell Faye>e Hays Lee Travis 2012 2015 G ONORRHEA 206.6 155.5 151.5 150.4 136.7 122.9 115.1 86.8 73.4 64.6 47.3 40.4 36.3 27.9 Texas Bastrop Caldwell Faye>e Hays Lee Travis 11
Behavioral Health – Majority of Top Five Most Difficult Services to Access Community Member Provider • InpaLent Psychiatric Care • Specialty Care • InpaLent Alcohol/Substance • InpaLent Psychiatric Care Use Treatment • InpaLent Alcohol/Substance • Specialty Care Use Treatment • Cancer Treatment • Dental Care • OutpaLent Alcohol/Substance • OutpaLent Alcohol/Substance Use Treatment Use Treatment DATA SOURCE: RHP 7 Community Needs Assessment Stakeholder Survey, 2017 NOTE: Community Members responded based upon their own community; provider responses based upon low-income popula?on served. 12
Percent of Population Under 65 Years Old that is Uninsured, 2012 and 2015 ‘ Insurance problems/lack of coverage’ or ‘cost of co-pays’, had made it harder to access care for approximately 40% of community members that responded to the survey 2012 2015 26.2% 24.9% 25.0% 24.7% 25.2% 21.6% 21.6% 22.7% 20.7% 20.8% 20.4% 19.2% 16.2% 16.0% Texas Bastrop Caldwell Faye>e Hays Lee Travis DATA SOURCE: U.S. Census Bureau, Small Area Health Insurance Es?mates, Interac?ve SAHIE Data and Mapping Tool, 2012 and 2015 13
Presentation to : Central Health Board of Managers Strategic Planning Committee September 12, 2017 By Stephanie Hayden, Chair, Austin Public Health Cassie DeLeon, Austin Public Health
M ETHODOLOGY ¢ This CHA was guided by the National Association for County and City Officials (NACCHO) Mobilizing for Action Through Planning and Partnerships (MAPP) framework. ¢ MAPP includes four assessments: Community Themes and Strengths 1. Community Health Status Assessment 2. Forces of Change 3. Local Public Health System Assessment 4. 15 15
A REAS OF INTEREST FROM THE 2017 CHA ¢ Even though Travis County is healthy overall, good health and wellbeing is not experienced equally by all in our community. ¢ Issue areas identified in the CHA Equity and Health Impact Education and workforce development Health care access and affordability Transportation Mental health and wellbeing Access to safe recreation space Access to healthy food Environmental health 16
Fin Findin ings fr gs from CUC om CUC’s s Comp Compreh ehen ensiv sive Commu e Community ity Health Health Need Needs Assessmen s Assessment t Jaeson T. Fournier, DC, MPH Chief ExecuLve Officer, CommUnityCare Health Centers
Comp Compreh ehen ensiv sive Commu e Community ity Health Health Need Needs Assessmen s Assessment t v The Health Center Clusters Program requires Federally Qualified Health Centers to complete a comprehensive Community Health Needs Assessment at least once every three years to ensure that resources within the service area and the needs of the FQHC’s target populaLon are idenLfied. v A FQHC must be located in or serve a high need community as federally designated Medically Underserved Area or PopulaLon. • Travis County currently 10 census tracts designated as MUAs, all located in downtown AusLn. Aus0n’s MUA’s were last designated in 1994. 18 Community Health Needs Assessment - Highlights
CommUn CommUnityCar ityCare’ e’s S Ser ervice Ar vice Area ea • Service Area = Travis County 19 Community Health Needs Assessment - Highlights
CommUn CommUnityCar ityCare’ e’s T Tar arget P Pop opula@ la@on on • Target PopulaLon = Travis County Residents with Incomes below 200% of Federal Poverty (or 2 Lmes poverty) • EsLmates for 2016 – 322,188 at our below 200% FPL • Total EsLmated Uninsured for Travis County – 194,290 (16.2% of total populaLon) • About 40% of Travis County residents with incomes below 200% are uninsured • FY 2017 CUC Unduplicated PaLents – 96,777 20 Community Health Needs Assessment - Highlights
21 Community Health Needs Assessment - Highlights
22 Community Health Needs Assessment - Highlights
Med Medic ical Ou al Outcomes in omes in Au Aus@ s@n Clinical Preven0ve Services – Women 65 and Over Rou0ne Medical Check with – 18 Years and Over Colorectal Cancer Screening Rates – Adults 50 -75 Mammography Use – Women 50 - 74 23 Community Health Needs Assessment - Highlights
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