WELCOME DOUG JACKSON VIRGINIA DEPARTMENT OF HOUSING & - - PowerPoint PPT Presentation

WELCOME

DOUG JACKSON

VIRGINIA DEPARTMENT OF HOUSING & COMMUNITY DEVELOPMENT

Explore how NRV Community Health Assessment findings relate to your work. Learn how other communities are making strategic investments to address identified needs Contribute ideas, experiences, and energy to improve health and well being in the NRV.

TODAY WE’LL

BILL FLATTERY

CARILION CLINIC WELCOME + INTRODUCTION

STEPHEN CHANDLER

LEWIS GALE WELCOME + INTRODUCTION

ASHLEY HASH

CARILION NEW RIVER VALLEY MEDICAL CENTER

COMMUNITY HEALTH ASSESSMENT

MICHELLE BRAUNS

COMMUNITY HEALTH CENTER OF THE NEW RIVER VALLEY

COMMUNITY HEALTH ASSESSMENT

SYSTEMS AT WORK

DOUG JACKSON

VA DHCD

SYSTEMS AT WORK

TAKEAWAYS

SYSTEMS AT WORK

JESSICA WIRGAU

COMMUNITY FOUNDATION OF THE NEW RIVER VALLEY

SYSTEMS AT WORK

DOUG JACKSON

VA DHCD

SYSTEMS AT WORK

TAKEAWAYS

WEIGHING IN BY MOVING ABOUT

WEIGHING IN BY MOVING ABOUT

Which of the CHA priorities do you perceive to be the greatest barrier for your clients/citizens?

1

• A. Access to Care

B. . Affordable, Safe Housing C. . Child Abuse / Domestic Violence D.

• D. Culture: Healthy behaviors not a priority

E.

• E. Lack of knowledge of resources

F. . Poverty / low avg. household income G. . Substance Use H.

• H. Transportation

GREATEST BARRIER

WEIGHING IN BY MOVING ABOUT

If we could address one priority area, which one do you think would have the greatest impact on

• ur region?

2

• A. Access to Care

B. . Affordable, Safe Housing C. . Child Abuse / Domestic Violence D.

• D. Culture: Healthy behaviors not a priority

E.

• E. Lack of knowledge of resources

F. . Poverty / low avg. household income G. . Substance Use H.

• H. Transportation

GREATEST IMPACT

WEIGHING IN BY MOVING ABOUT

Which priority do you think there is the greatest energy to work on?

3

• A. Access to Care

B. . Affordable, Safe Housing C. . Child Abuse / Domestic Violence D.

• D. Culture: Healthy behaviors not a priority

E.

• E. Lack of knowledge of resources

F. . Poverty / low avg. household income G. . Substance Use H.

• H. Transportation

GREATEST ENERGY

SYSTEMS AT WORK

JEFF DINGER

GILES COUNTY

SYSTEMS AT WORK

JEFF DINGER

GILES COUNTY

SYSTEMS AT WORK

TAKEAWAYS

SYSTEMS THINKING

SYSTEMS THINKING

mycorrhizal networks

SYSTEMS THINKING

SYSTEMS THINKING

SYSTEMS SYSTEMS THINKING SEEING

The glaringly obvious

• nly glares at you

after you see it.

First Steps Information Sharing Network Shared Resources Service Delivery Joint Planning

2016 2019

SYSTEMS SYSTEMS THINKING SEEING

SYSTEMS THINKING

The network as part of a system, actively engaging in the system by understanding it.

LEARNING TOGETHER

SYSTEMS THINKING

The network as part of a system, actively engaging in the system by understanding it.

LEARNING TOGETHER

SYSTEMS SYSTEMS THINKING SEEING

SYSTEMIC

SYSTEMS THINKING

SYSTEMS THINKING

Get it at donnellameadows.org

SYSTEMS THINKING

Learn to read causal loops at systemsandus.com

SYSTEMS THINKING

But what are we trying to identify in the system?

• Overlooked resources
• Missed perspectives
• Nontraditional partners
• Norms
• Patterns
• Synthesis over analysis
• New frames of reference
• Complexity!
• Feedback patterns
• Environmental inputs
• Leverage points
• Policy implications

SYSTEMS THINKING

Learn to read causal loops at systemsandus.com

“We’re disrupting how we think about the community.”

Jessica Wirgau

“Then we get them all together.

Chris McKlarney

BARRIERS & LEAPS

LUNCH

• DR. NOELLE

BISSELL, M.D.

NEW RIVER HEALTH DISTRICT

• DR. NANCY WELCH, M.D.

CHESAPEAKE HEALTH DEPARTMENT

DANIELLE PORZIG

HEALTHY CHEASAPEAKE KEYNOTE SPEAKERS

12/18/2019

Healthy Chesapeake

A Unique Partnership for Addressing Population Health Needs New River Presentation| November 2019

• Chesapeake City had declined to 44th per the

annual Virginia RWJF County Health Rankings

• Recent joint Community Needs Assessment

conducted by the health department and hospital indicated specific focus areas for improvement

• Data analysis showed large disparities in segments
• f our community
• Now it is 37

Declining community health status drove the formation

7 7

Data Shows Large Disparity Gaps within the city

Low Health Opportunity = BAD

Health Opportunity Index (HOI) Factors also show big differences

VDH calculates a Health

Opportunity Index, or

HOI, which is a composite measure comprised of 13 indices that reflect a broad array of social determinants

• f health affecting the

community. We are electing to work in low HOI areas initially where the impact

• pportunity is the greatest.

Population Health Issues in Chesapeake

• Food Insecurity

There are an estimated 26,630 food insecure individuals in Chesapeake1

• Diabetes Prevalence

At 15%, Chesapeake is 1.5 times the state average2

• Adult Obesity Prevalence

1 in 3 Chesapeake adults are obese3

• Aging

There is an expected 114 percent increase in the population 65 years + projected by 20404

A small working group with two representatives from the City and two from Chesapeake Regional Medical Center, under the leadership of the Health Director strategized the development of a unique concept that eventually became Healthy Chesapeake, Inc. How to address these community health needs?

• Inaugural interest meeting for development of Coalition led by Mayor

Krasnoff and Health Director, Dr. Nancy Welch

Community leadership buy-in critical

Broad Group of Initial Stakeholders

Internal and External Focus Group Meetings = Initial Direction

• The Health Director serves as the public health advisor for the Board

Decision to establish a unique hybrid

• perating relationship

The Healthy Chesapeake Executive Director is contracted and participates in strategic planning and liaisons with other Health Department units for integration opportunities

Mission – Healthy Chesapeake is committed to building a culture of wellness that supports, sustains, and advocates for a healthier Chesapeake Vision – To be ranked the healthiest community in Virginia per the Robert Wood Johnson County Health Ranking Board – Board of Directors that provide the guidance and financial oversight of our program initiatives Coalition – Voluntary group of citizens, community agencies, city

departments, faith-based organizations, health care providers, and

• thers that collaborate on direct service delivery

501(c)(3) – Established and operational with an Executive Director reporting to the Board and administrative and programmatic staff that support the Coalition Strategy – Facilitate and provide support for population health

programs and services developed and delivered by the Coalition in response to priorities identified by Community Needs Assessment, Chesapeake Neighborhood Quality of Life Study, Chesapeake Comprehensive Plans for Youth and 55 and Better, etc.

Chesapeake Responds: Healthy Chesapeake

• Healthy Chesapeake, Inc. is

designated by the Chesapeake Health District and approved by VDH as the population health manager to lead the response to Virginia’s Plan for Well Being.

• Healthy Chesapeake, Inc. is charged

with providing and ensuring: “…coordination and collaboration of all sectors of the community government, health care, education, businesses and community

• rganizations including the faith

based .. in working together to improve the conditions needed for people to be healthy.”

Unique Contractual Relationship with The Chesapeake Health District

Plan created by statewide multi- faceted taskforce to address population health issues in Virginia.

• This Memorandum of Agreement between Chesapeake

Health Department (CHD), and Healthy Chesapeake, Inc. (HCI), for the purpose of cooperation and coordination related to the implementation of strategic initiatives related to improvement of the population health of Chesapeake.

• WHEREAS, in 2017 HCI was designated the population

health manager for CHD with responsibility to implement the Plan for Wellbeing in Chesapeake.

• CHD Responsibilities

1. Subject to appropriation for CHD budget and contingent on available non-designated funding, the CHD agrees to disburse funds in support for the operation of HCI and the delivery of population health programs and services. 2. The CHD Health Director shall serve as a non-voting Public Health Advisor to the board and coalition.

MOU with Healthy Chesapeake

A unique hybrid/lateral structure is established by the corporate bylaws and outlines the operating process.

Important Roles

Shared Mission

Healthy Chesapeake Board Healthy Chesapeake Coalition

Collective Impact Premise

• The Coalition is a separate entity with its own chair

and operating structure that includes work teams consisting of internal and external stakeholders

• The Coalition is lateral to the Board and drives the

direction of the programs that are then financially supported by the Board

• The Board has two voting members from the Coalition

that reinforce program priorities

• The Executive Director is an experienced community

and economic development professional that facilitates the relationship between the two entities

Uses the Collective Impact Model

1. Expanded the knowledge base of partners and community

• fficials to focus on population health.

2. Expands population health response capacity with a 40+ member coalition instead of a single staff member. 3. Brings broad breadth of expertise to bear via coalition participation. 4. Extends the ability for leveraging resources 5. Reduces administrative processes and restrictive purchasing. 6. Improves the ability for resource gathering via in-kind, tax deductible giving and grant-writing eligibility. 7. Better able to serve as a neutral facilitator. 8. Allows the external contractual relationships of the Health District be extended to Healthy Chesapeake via MOU’s.

Benefits of a Nonprofit as a Health District Population Health Manager

Public Health is a Community Value

Two years after establishment and extensive community collaboration and projects, the city was approached for financial support. City Council approved 15 cent per pack increase in cigarette tax and earmarked it for public health projects with

6 cents directed for Healthy Chesapeake, Inc.

This unique allocation for community-led health initiatives and provides Healthy Chesapeake on-going organizational stability.

Chesapeake… the city that cares!

City of Chesapeake Support

As a founding partner of Healthy Chesapeake, Chesapeake Regional Healthcare has been a linchpin for this city-wide effort. With a focused commitment to addressing population health, this regional hospital has continued to provide resources, guidance, and engagement in all facets of Healthy Chesapeake. It has leveraged both financial and in-kind resources to enable this effort to develop.

Chesapeake Regional Healthcare

• Program Support:

❖ Diabetes and Hypertension Community-based Response HUB in high risk area with staffing and supplies ❖ Purchase and renovation of Community Food Farmacy projected at $375,000 when completed Fall 2018

• Participation of Staff on Board and Coalition in-kind donation of

$75,000 annually ❖ Board: Vice President of Operations ❖ Coalition: Vice-chair of Coalition ❖ Coalition: Mental Health & Community Ambassador work team leadership

• Space and Webhosting in-kind donation of over $40,000 annually

❖ Provision of Healthy Chesapeake Office Space, usage of board and training space, and on-going web hosting

CRH Engagement with Healthy Chesapeake

ODU through an MOU assumed the leadership role in gathering and performing the external review and evaluation for all Healthy Chesapeake projects.

Old Dominion University

• Volunteer Management Policy

initial draft

• Financial Management Policy

initial draft

• Program Policies and

Procedures initial draft

• Administrative Data Analysis
• Coordination of the SPARK Pilot

Project

• IRB development for Cooking

Class Program evaluation

• Individual gardening project

evaluation

• Youth employment program

development and evaluation

• An overview of evidence-based

chronic diseases prevention programs in Virginia and descriptions

• Healthy Chesapeake Program

Evaluation (assistance w/ instrument research)

• Active Lifestyle Phone Surveys

and compilation of data

• Baby Care Project Evaluation
• HUB Medical Intervention Data

Collection

• Family Planning Program

Evaluation

• Functional Food Project

Development

• Assessment of transportation

services provided by free clinics

• FAMIS project with DVH

through Chesapeake Health Department

Healthy Chesapeake & ODU Academic Evaluations/Research

FREE Diabetes prevention and management program within high risk communities

Includes: Transportation, Testing, Cooking School, Social Work, and Food distribution through Food Farmacy

PARTNERS: CRH, Health Department, Fire Department, Liberty Street Clinic, Chesapeake Care Clinic, Cooperative Extension, Foodbank, American Diabetes Association, Norfolk State University, Community Churches

Plan for VA Well-being Aims 3 & 4

The HUB Diabetes and Hypertension Center

Need Providers Client referrals Southeastern Virginia Health System Chesapeake Care Clinic Free, frequent medical checks at site location Chesapeake Regional Healthcare EMS, City of Chesapeake Medical supplies and equipment provided Access Partnership Chesapeake Care Clinic Social work referral assistance Norfolk State University Kin and Kids Consulting Wellness coaching Chesapeake Health Department Fresh food access Healthy Chesapeake Education Chesapeake Health Department American Diabetes Association Transportation assistance To be contracted

Case Study: Diabetes and Hypertension Management (HUB)

Services and service providers confirmed

Case Study: Diabetes and Hypertension Management (HUB)

• Healthy Chesapeake sought and

received funding from Hampton Roads Community Foundation: $147,750 over 3 years

• HUB program launched
• External evaluation performed during

pilot phase by the ODU Center for Global Health

Case Study: Diabetes and Hypertension Management (HUB)

Outcome: Decrease in hospitalizations and ER visits

Any Hospitalization in the past 12 months before starting Hub Any ER Visit in the past 12 months before starting Hub Any ER Visit in the past 9 months since starting Hub Any Hospitalization in the past 9 months since starting Hub

Case Study: Diabetes and Hypertension Management (HUB)

102

Outcome: Decrease in mean A1C

Outcome: Decrease in mean arterial pressure

Case Study: Diabetes and Hypertension Management (HUB)

Outcome: Improved healthy eating and active lifestyle behaviors

Case Study: Diabetes and Hypertension Management (HUB)

0% 20% 40% 60% 80% 100% 120%

Daily Fruits and Vegetables Consumption Daily moderate sport for at least 10 minutes Daily water consumption

At 9 Months Baseline

Active Coalition Partners and Program Engagement Active Coalition Partners and Program Engagement

Active Coalition Partners and Program Engagement

• Volunteer Management Policy
• Financial Management Policy
• Program Policies and Procedures
• Administrative Data
• Coordination of the SPARK Pilot Project
• IRB development for Cooking Class

• Individual gardening project

• Youth employment program

• An overview of evidence-based chronic

• Healthy Chesapeake Program Evaluation

• Active Lifestyle Phone Surveys
• Baby Care Project
• HUB Data Collection
• Family Planning
• Functional Food
• Assessment of transportation services

• FAMIS project with DVH through Chesapeake

Healthy Chesapeake ODU Projects

Opportunities for individuals to grow their own food or have access to healthy foods. Sites at community and senior locations managed by the residents and production sites at churches and schools.

Pending Project : 22 Acre research, teaching and production site

Healthy Food Access

Goal: Provide the knowledge and skills on how to eat healthier

❖ Healthy Chef is a multi-part cooking school on how to cook healthier. ❖ Use mobile cooking stations ❖ Grant PARTNERS:

✓ Hampton Roads Community Foundation ✓ The City of Chesapeake Social Services ✓ Southeast Virginia Community Foundation. AIM 3

Utilization of Healthy Foods

Healthy Chesapeake convenes and facilitates, but the Coalition partners take

• wnership!

See the Concept in Action

Strategy: Utilize the VA Plan for Well-Being Goals and Strategies as the

• perational framework:
• AIM 1: Healthy Connected Communities

• AIM 2: Strong Start for Children

• AIM 3: Preventative Actions

• AIM 4: System of Health Care

VA Plan for Well-Being as a Healthy Chesapeake Action Guide

• County Health Rankings are used as directional benchmarks.
• Virginia Plan for Well-Being correlated with the County

Health Rankings.

• The Chesapeake Community Action Plan and Community

Health Needs Assessment currently conducted in conjunction with hospital.

• The RU Ready comprehensive plan, the 55Plus

comprehensive plan and the cities 2030 plan are also integrated.

Melding of local, state & national priorities striving for goal of health in all policies

*A Food Farmacy in a low HOI area with Chesapeake Regional Hospital.

PARTNERS:

• Foodbank
• Farmers Market
• Local Farmers
• Healthy Chef Cooking School
• Youth Employment
• Non-profit Buffalow Family and Friends
• Health Department

Healthy Foods Access Site

Plan for VA Well-being Aim 1

*in process

Health Ambassadors and Support of Neighborhoods

Voices for the community and serve on our work-teams This Fall initiate Diabetes and Hypertension Pilot PARTNERS:

• African American Churches in low HOI
• NC State Faithful Families curriculum

Peer-to-peer is a long-proven effective strategy

VOICES from the community

Plan for VA Well-being Aim 1

Goal: Virginians Follow a Healthy Diet and Live Actively

SPARK senior and youth do and learn program-expands free meal program, social engagement, and wellness activities. PARTNERS: ▪ Chesapeake Libraries ▪ School Nutrition Program ▪ Senior Services of Southeast VA ▪ 15 other service providers

• f various activities

Active Lifestyles - SPARK

• 1. Continue to build Coalition
• 2. Improve internal and external communications
• 3. Enhance advocacy role
• 4. Adjust to evaluation findings

115

Next Steps

• 5. Determine need and role in addressing other social determinant

issues; i.e.., transportation, housing, etc.

• 6. Expand beyond pilot areas

116

Next Steps

Buying Motivation: Do You Actually Buy Products?

• Fashion: Purchased to look better, feel more valued, have

greater confidence, fit in/stand out.

• Books/Information: Bought to further education, feel

more intellectual, gain understanding, escape reality.

• Furniture: Purchased for comfort, security, greater self-

esteem and aesthetics.

• Food: Bought for the experience, self-esteem, body-

consciousness (e.g. diet food).

The Pepsi Generation Story

Lets go back to 1960’s America for a few minutes.

Set The Stage

1.The youth of the day were fighting for liberation, equality and battling against the restrictions put in place by the previous generation. …Afros, bell-bottom jeans, mini-skirts, lava lamps and tie dye t-shirts were all the rage. …Things were getting- how can I put this- groovy.

• 2. And there was one company dominating the soft-drink industry, Coca-
• Cola. They were outselling their nearest competitor, Pepsi, by almost 6 to

1.

• 3. They’d used branding and advertising to promote themselves as a

representative of everything that made American’s proud to be American- wholesome values, tradition and national pride.

Advertising

• Alan Pottasch, decided that the brand should stop talking about

their product and instead, start talking about the user

• …and more specifically, those who saw themselves as different

to the previous generation.

The Pepsi Generation

In 1963 Pepsi launched an ad campaign named The Pepsi Generation.

• Pepsi took a huge chunk of Coca-Cola’s market share. The campaign

had successfully advertised the type of person who bought their product, INSTEAD of their product (which was almost identical to their biggest rivals).

Buying Motivation: Anybody Can Harness It

• Social media offers brands the perfect opportunity to target their

ideal market for very low costs…

• The key selling point of your product, is not actually your product, it’s

what it can help your customer achieve.

• …and all these things add up to one thing: a better version of

themselves.

• People don’t buy products, they buy what the product will do TO

them.

Shift Your Focus

The first thing you need to do is shift your advertising focus away from your product and put the spotlight on your target market. Whilst a beginner would spend all their time and focus advertising the second step (the product), an experienced advertiser would primarily focus their efforts on the difference between step 1 and step 3.

Coalition Workteams

124

Current and developing programs

Health Behaviors

Diet and Exercise Healthy Chef

Garden2Table

Mike Andruczyk

Food Farmacy FIT Benjamin Camras

Clinical Care

Access to Care HUB Mary Trosien Mental Health

Social and Economic

Education Employment Family and Social Support SPARK Kathryn Jesse Volunteer (MRC) Thomas Johnson Faithful Families

County Health Rankings

2014 2015 2016 2017 2018

Chesapeake Trend Depictions

Health Outcomes Health Factors Quality of Life Health Factor/Behaviors Adult Obesity Physical Inactivity Access to Exercise Opportunity Alcohol Related Deaths STD Teen Births Drug Overdose Deaths

County Health Rankings

2014 2015 2016 2017 2018

Chesapeake Trend Depictions

Health Behaviors Clinical Care Soc & Econ. Factors Length of Life Clinical Care Social & Economic Factors Uninsured Primary Care Physician Ratio Dentist Ratio Mental Health Provider Ratio Mammogram Screening Violent Crime Injury Deaths Median Household Income Children reduced lunch

Strategic Plan Development

Healthy Chesapeake Programs

• 11 community, production or learning gardens,

including a garden and training program for Chesapeake Correctional Center female inmates

• 50 individual grow box projects for low-income

individuals

• Seedbank launched to provide community

gardens and individuals with free supplies

Year One Highlights: Garden2Table

• Launched faith-based wellness program (Faithful

Families)

• Sponsored 10 youth and 2 senior stipends to

support community programming

• Supported community events, trainings, and

learning activities for more than 1500 individuals

Year One Highlights: CARE

https://www.odu.edu/hs/centers/globalhealth

Public health is not a department but rather a community value

For More Information:

• Dr. Nancy Welch, Health Director

• Dr. Wendy Schofer, Coalition Co-Chair

SYSTEMS AT WORK

DOUG JACKSON

VA DHCD

SYSTEMS AT WORK

TAKEAWAYS

SYSTEMS AT WORK

TINA KING

NEW RIVER VALLEY AGENCY ON AGING

SYSTEMS AT WORK

TAKEAWAYS

SYSTEMS AT WORK

DOUG JACKSON

VA DHCD

NEXT STEPS

DOUG JACKSON

VA DHCD

NEXT STEPS

NEXT STEPS

What key institutions or

• rganizations (or type of

institutions or organizations) do you believe are critical in providing stewardship for our collective next steps?

1

NEXT STEPS

What are the two top things you’d ask the steering team to pursue as initial steps?

1

KEVIN BYRD

NEW RIVER VALLEY REGIONAL COMMISSION WRAP UP

• DR. NOELLE

BISSELL, M.D.

NEW RIVER HEALTH DISTRICT CLOSING

THANK YOU