THREE RIVERS HEALTH THREE RIVERS, MICHIGAN
2012 COMMUNITY HEALTH NEEDS ASSESSMENT
ADOPTED BY BOARD RESOLUTION (DATE)1
1 Response to Schedule H (Form 990) Part V B 2
Dear Community Resident: Three Rivers Health (TRH) welcomes you to review this document as we strive to meet the health and medical needs in our community. All not-for-profit hospitals are required to develop this report in compliance with the Accountable Care Act. The “2012 Community Health Needs Assessment” identifies local health and medical needs and provides a plan to indicate how the Hospital will respond to such needs. This document suggests areas where other local organizations and agencies might work with us to achieve desired improvements and illustrates one way we, TRH, are meeting our obligations to efficiently deliver medical services. TRH will conduct this effort at least once every three years. As you review this plan, please see if, in your opinion, we have identified the primary needs and if our intended response should make appropriate needed improvements. We do not have adequate resources to solve all the problems identified. Some issues are beyond the mission of the hospital and action is best suited for a response by others. Some improvements will require personal actions by individuals rather than the response of an organization. We view this as a plan for how we, along with other organizations and agencies, can collaborate to bring the best each has to offer to address the more pressing identified needs. The report is a response to a federal requirement of not-for-profit hospital to identify the community benefit it provides in responding to documented community need. Footnotes are provided to answer specific tax form questions; for most purposes, they may be ignored. Of greater importance, however, is the potential for this report to guide our actions and the efforts of others to make needed health and medical improvements. Please think about how to help us improve the health and medical services our area needs. I invite your response to this report. We all live and work in this community together and our collective efforts can make living here more enjoyable and healthier. Thank you
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Table of Contents
Executive Summary ...... 1 Project Objectives ...... 2 Brief Overview of Community Health Needs Assessment ...... 2 Financial Opportunity Summary ...... 4 Approach ...... 5 Findings ...... 9 Definition of Area Served by the Hospital Facility ...... 10 Demographic of the Community ...... 11 Findings ...... 11 Summary of Observations from St. Joseph County Compared to All Other Michigan Counties, in Terms of Community Health Needs ...... 12 Summary of Observations from St. Joseph County Peer Comparisons ...... 12 Conclusions from the Demographic Analysis Comparing the Service Area to National Averages13 Key Conclusions from Consideration of the Other Statistical Data Examinations ...... 14 Existing Health Care Facilities and Resources ...... 15 Definitions of High Priority Need Listed in Highest to Lowest Rank Order of Need ...... 16 Definitions of Low Priority Needs Listed in Highest to Lowest Rank Order of Need ...... 38 Overall Community Need Statement and Priority Ranking Score: ...... 55 Management Action Plan ...... 57 Appendices ...... 64 Appendix A ...... 65 Appendix B – St. Joseph County Compared to National Peer Counties ...... 75 Appendix C – St. Joseph County Compared to All Other Michigan Counties ...... 85 Appendix D – Leading Causes of Death ...... 89 Appendix E – St. Joseph County Selected Additional Health Status Factors ...... 92 Appendix F – St. Joseph County Service Area Population Characteristics ...... 102 Appendix G – Local Expert Priority Setting Process ...... 108 Appendix H ...... 124
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EXECUTIVE SUMMARY
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Executive Summary
Three Rivers Health (TRH) is organized as a not-for-profit hospital. A “Community Health Needs Assessment” (CHNA) is part of the required hospital documentation of “Community Benefit” under the Affordable Care Act (ACA), required of all not-for-profit hospitals as a condition of retaining tax-exempt status. A CHNA assures TRH identifies and responds to the primary health needs of its residents. This study is designed to comply with standards required of a not-for-profit hospital2. Tax reporting citations in this report are superseded by the most recent 990 H filings made by the hospital. In addition to completing a CHNA and funding necessary improvements, a not-for-profit hospital must document the following:
Financial assistance policy and policies relating to emergency medical care;
Billing and collections; and
Charges for medical care. Further explanation and specific regulations are available from Health and Human Services (HHS), the Internal Revenue Service (IRS) and the U.S. Department of the Treasury3. Project Objectives Three Rivers Health (TRH) partnered with QHR for the following4:
Complete a Community Health Needs Assessment report, compliant with Treasury – IRS;
Provide the Hospital with information required to complete the IRS – 990h schedule; and
Produce the information necessary for the hospital to issue an assessment of community health needs and document its intended response. Brief Overview of Community Health Needs Assessment Typically, nonprofit hospitals qualify for tax-exempt status as a Charitable Organization, described in Section 501(c) 3 of the Internal Revenue Code; however, the term “Charitable Organization” is undefined. Prior to the passage of Medicare, charity was generally recognized as care provided to the less fortunate without means to pay. With the introduction of Medicare, the government met the burden of providing compensation for such care. In response, IRS Revenue ruling 69-545 eliminated the Charitable Organization standard and established the Community Benefit Standard as the basis for tax-exemption. Community Benefit
2 Part 3 Treasury/IRS – 2011 – 52 Notice … Community Health Needs Assessment Requirements… 3 As of the date of this report Notice of proposed rulemaking was to be published 6/26/2012 and available at http://federalregister.gov/a/2012-15537 4 Part 3 Treasury/IRS – 2011 – 52 Section 3.03 (2) third party disclosure notice
Proprietary Three Rivers Health Community Health Needs Assessment Three Rivers, Michigan Page 3 determines if hospitals promote the health of a broad class of individuals in the community, based on factors including:
Emergency room open to all, regardless of ability to pay;
Surplus funds used to improve patient care, expand facilities, train, etc.;
Control by independent civic leaders; and
All available and qualified physicians are privileged. Specifically, the IRS requires:
Effective on tax years beginning after March 23, 2012, each 501(c) (3) hospital facility is required to conduct a community health needs assessment at least once every three taxable years and adopt an implementation strategy to meet the community needs identified through such assessment;
The assessment may be based on current information collected by a public health agency or nonprofit organization and may be conducted together with one or more other organizations, including related organizations;
The assessment process must take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge or expertise of public health issues;
The hospital must disclose in its annual information report to the IRS (Form 990 and related schedules) how it is addressing the needs identified in the assessment and, if all identified needs are not addressed, the reasons why (e.g., lack of financial or human resources);
Each hospital facility is required to make the assessment widely available, and ideally downloadable from the hospital web site;
Failure to complete a community health needs assessment in any applicable three-year period results in a penalty to the organization of $50,000. For example, if a facility does not complete a community health needs assessment in taxable years one, two or three, it is subject to the penalty in year three. If it then fails to complete a community health needs assessment in year four, it is subject to another penalty in year four (for failing to satisfy the requirement during the three-year period beginning with taxable year two and ending with taxable year four); and
An organization that fails to disclose how it is meeting needs identified in the assessment is subject to existing incomplete return penalties.5
5 Section 6652
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Financial Opportunity Summary TRH intends to work toward a Community Benefit allocation of $2,430,944 annually6 in response to Community Benefit7 obligations (see chart below).
12 Months Ending April 20128 Net Revenue $57,071,378 Bad Debt $8,452,872 Total Net Revenue $48,816,872 $1,464,506 Community Benefit Goal 3% to to 5% of Total Net Revenue $2,440,844 Current Charity $795,800 990 Documented Community $218,763 Benefit CHNA Anticipated Expenditures $551,000 Total Provided Community $1,565,563 Benefit
6 Response to Schedule H (Form 990) Part V B 6 f 7 “Community Benefit” is defined as the term used in the Accountable Care Act and by the IRS 990 instructions. This term may be defined differently by the Hospital when complying with reporting requirements of “Community Benefit” or “Charity” as defined by the State. Amounts shown are for planning and budgetary purposes only. Actual dollar allocations will vary year to year and are documented on the Corporate 990 return. 8 All values are obtained from the QHR comparative database, except “Response to Community Benefit” which is sourced from the 990 of the hospital.
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APPROACH
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Approach
To complete a CHNA, the Hospital must:
Describe the processes and methods used to conduct the assessment;
o Sources of data, and dates retrieved;
o Analytical methods applied;
o Information gaps impacting ability to assess the needs; and
o Identify with whom the Hospital collaborated.
Describe how the hospital gained input from community representatives;
o When and how the organization consulted with these individuals;
o Names, titles and organizations of these individuals; and
o Any special knowledge or expertise in public health possessed by these individuals.
Describe the process and criteria used in prioritizing health needs;
Describe existing resources available to meet the community health needs; and
Identify the programs and resources the hospital facility plans to commit to meeting each identified need and the anticipated impact of those programs and resources on the health need. QHR takes a comprehensive approach to assess community health needs. We perform several independent data analyses based on secondary source data, augment this with local survey data and resolve any data inconsistency or discrepancies from the combined opinions formed from local experts. We rely on secondary source data and most secondary sources use the county as the smallest unit of analysis. Since the service area does not comprise the entire county, we asked local residents to note if they perceived the problems, or needs, identified by secondary sources to exist in their portion of the county.9 The data displays used in our analysis are presented in the Appendices. Data sources include:10
www.countyhealthrankings.com – to assess the health needs of St. Joseph County compared to all Michigan counties;
www.Communityhealth.hhs.gov – to assess the health needs of St. Joseph County compared to its national set of “peer counties”;
Thomson Market Planner – to assess characteristics of the hospital’s primary service area, at a zip code level, based on classifying the population into various socio-economic groups,
9 Response to Schedule H (Form 990) Part V B 1 i 10 Response to Schedule H (Form 990) Part V B 1 d
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determining the health and medical tendencies of each group and creating an aggregate composition of the service area according to the contribution each group makes to the entire area; and, to access population size and socio-economic characteristics;
www.capa.org – to determine the availability of Palliative Care programs and services in the area;
http//apps.nccd.gov – to determine the potential importance of stroke and heart attack comorbidities, complications and death rates, and cholesterol checking; and
http://www.worldlifeexpectancy.com/usa-health-rankings – to determine cause of death. In addition, we deployed a Community Health Need Assessment survey within the local population for any resident to complete11.
We received community input from 620 area residents; survey responses started Friday, January 13, 2012 at 11:45 a.m. and ended with the last response on Monday, February 27 at 10:22 p.m.;
The terms of gaining input stipulated each respondent would remain anonymous;
The internet based survey was promoted through a paid advertisement in a local newspaper and distributed to local civic and health organizations with a request for participation. Preliminary conclusions were presented to a local group of experts, who were asked to validate prior assessments and to establish priority among various identified health and medical issues12; and
Information analysis augmented by local opinions showed how St. Joseph County relates among its peers in terms of primary and chronic needs, as well as other issues of uninsured persons, low-income persons and minority groups; respondents commented on if they believe certain population groups (or people with certain situations) need help to improve their condition and if so, who needs to do what13. When the analysis was complete, we put the information and summary conclusions before our local group of experts14 who were asked to agree or disagree with the summary conclusions. They were free to augment potential conclusions with additional statements of need; new needs could, and did, emerge from this exchange.15 Consultation with local experts occurred again via an internet based survey (explained below) during the period beginning Tuesday, May 15, 2012 at 11:13 a.m. and ending Tuesday, June 5, 2012 at 8:50 a.m. With the prior steps identifying potential community needs, the local experts participated in a structured communication technique called a Delphi method, originally developed as a systematic,
11 Response to Schedule H (Form 990) Part V B 1 h 12 Part response to Schedule H (Form 990) Part V B 3 13 Response to Schedule H (Form 990) Part V B 1 f 14 Part response to Schedule H (Form 990) Part V B 3 15 Response to Schedule H (Form 990) Part V B 1 e
Proprietary Three Rivers Health Community Health Needs Assessment Three Rivers, Michigan Page 8 interactive forecasting method which relies on a panel of experts. Experts answer questionnaires in a series of rounds. We contemplated and implemented one round as referenced during the above dates. After each round, we provide an anonymous summary of the experts’ forecasts from the previous round, as well as the reasons provided for their judgments. The process encourages experts to revise their earlier answers in light of the replies of other members of their panel. Typically, this process decreases the range of answers and moves the expert opinions toward a consensus "correct" answer. The process stops when we identify the most pressing, highest priority community needs. In the TRH process, each local expert allocated 100 points among all identified needs, having the opportunity to introduce needs previously unidentified and to challenge conclusions developed from the data analysis. A rank order of priorities emerged, with some needs receiving virtually no support and other needs receiving identical point allocations. We dichotomized the rank order into two groups: high priority needs and low priority needs. The determination of the break point, high as opposed to low, was a qualitative interpretation by QHR and the TRH executive team where a reasonable break point in rank occurred, indicated by the weight amount of points each potential need received and the number of local experts allocating any points to the need. When presented to the TRH executive team, the dichotomized need rank order identified which needs the hospital considered high responsibility to respond vs. low responsibility to respond. The result provided a matrix of needs and guided the hospital in developing its implementation response16.
16 Response to Schedule H (Form 990) Part V Section B 6 g, h and Part V B 1 g
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FINDINGS
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Findings
Definition of Area Served by the Hospital Facility17
Three Rivers Health, in conjunction with QHR, defines its service area as the following ZIP codes: 49093 – Three Rivers, Michigan; 49072 – Mendon, Michigan; 49032 – Centreville, Michigan; 49042 – Constantine, Michigan; and 49099 – White Pigeon, Michigan. In 2010, the Medical Center received 72.3% of its patients from this area which comprises over fifty percent (50.6%) of the population in St. Joseph County, Michigan. County data is used as most information is not available at the geographic level of a zip code. The demographic information for Three Rivers’ service area and St. Joseph is similar, differing primarily in the size of the population.
17 Responds to IRS Form 990 (h) Part V B 1 a
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Demographic of the Community18 The 2011 population for the Three Rivers service area is estimated to be 31,17819, but is expected to decline at a rate of almost two percent (-1.9%) projecting a 2016 population of 30,575. St. Joseph County’s 2011 population is estimated to be 61,553, but an anticipated negative growth rate of 1.5% projects a 2016 population of 60,628. The population loss is greater than the Michigan state average rate of population loss (-0.7%) and is considerably lower than the national growth rate (4%). According to the U.S. Census Bureau, the 2011 median age for St. Joseph County is 37.8 years, younger than the Michigan median age (38.6 years) but older than the national median age (37 years). The Three Rivers 2011 Median Household Income is $43,043, which is considerably lower than the Michigan median income of $47,634 and the national median income of $49,713. St. Joseph County’s unemployment rate as of April, 2012 was 5.6%20, considerably better than the higher 8.3% Michigan rate and the national unemployment rate of 8.1%. The portion of the population over 65 is 14.5%, above the Michigan average of 13.9%. The portion of the population of women of childbearing age is 18%, lower than the Michigan average of 19.5%. Additional demographic data is presented in Appendix F. Findings Upon completion of the CHNA, QHR identified several issues within the Three Rivers Health community: Conclusions from Public Input to Community Health Needs Assessment
Leading issues (mental health issues, obesity and lack of access to needed services) seem to relate to a lack of affordable health insurance coverage and the cost of medical care:
o Responses noted four topics as their most serious concerns:
o No health insurance is a major concern to 75% of respondents;
o Teen birth/pregnancy are major concerns to 53% of respondents;
o Mental health issues are a major concern to 53% of respondents; and
o Unhealthy food choices/obesity are a major concern to 51% of respondents.
Mental health issues present as a focus on adult alcohol and drug abuse as well as youth alcohol and drug abuse; meth and meth lab cleanup are specific drug related concerns. A problem with school bullying also was a noted concern;
Individual, family and healthy living concerns comments revolve around ability to pay, unhealthy eating, lack of fitness and obesity. Comments submitted in Spanish translated as "I
18 Responds to IRS Form 990 (h) Part V B 1 b 19 All population information, unless otherwise cited, sourced from Thomson Market Planner 20 http://research.stlouisfed.org/fred2/series/MISTJO5URN
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want you to know that I, as Hispanic cannot pay for consultations. I have nothing else to tell. I have nothing!”; and
Other than substance abuse, obesity and pregnancy concerns, no specific disease or condition was frequently mentioned. Summary of Observations from St. Joseph County Compared to All Other Michigan Counties, in Terms of Community Health Needs
In general, St. Joseph County health status compares unfavorably among Michigan Counties, ranking 70th in Healthy Outcomes (with 1st being the best) among the 82 ranked counties. Among the various Health Factors analyzed, St. Joseph County scores better, ranking 58th among the 82 ranked counties;
Physical Environmental Factors are positive influences on overall county rankings as all measures are below State averages and many have achieved or surpassed goal benchmarks;
Clinical factors are not a serious depressing factor in scoring the rankings. Uninsured rates, preventable hospital stays, diabetic screening rates and mammography use are basically at the state average. Improvement is possible but would have little impact on improving the ranking of St. Joseph County;
The highest ranked positive influence among the health status factors is the lack of low birth weight babies. St. Joseph County performance is better than average among Michigan counties and is close to achieving desired national benchmarks;
Premature deaths, deaths prior to age 75, show a three year trend of increasing values, meaning an increasing number of younger residents are dying;
Twenty-four percent of the population self describe their health status as "Poor" or "Fair." This is almost double the rate for the State of Michigan; and
Lack of healthy behavior is the leading factor depressing the St. Joseph Health Factor ranking. The rate of smoking, impacting 26% of adults, is a driver for scoring low. Motor Vehicle deaths are more than double the State rate. Teen birth rates are among the worst in Michigan. Adult obesity and physical inactivity are at about the Michigan averages, but could improve. Excessive drinking and Sexually Transmitted diseases are beneficial influences on scoring because of their low rates. Summary of Observations from St. Joseph County Peer Comparisons UNFAVORABLE observations when compared to peers and national averages: 1. BIRTHS TO WOMEN UNDER 18 2. BIRTHS TO UNMARRIED WOMEN 3. NO CARE IN FIRST TRIMESTER
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4. INFANT MORTALITY 5. WHITE NON-HISPANIC INFANT MORTALITY 6. HISPANIC INFANT MORTALITY 7. NEONATAL INFANT MORTALITY 8. POST NEONATAL INFANT MORTALITY 9. FEMALE BREAST CANCER 10. COLON CANCER 11. CORONARY HEART DISEASE 12. MOTOR VEHICLE INJURIES 13. SUICIDE SOMEWHAT A CONCERN observations as rates are unfavorable compared to peer counties: VERY LOW BIRTH WEIGHT (less than 1500g). SOMEWHAT A CONCERN observations as rates are unfavorable compared to national rates: LUNG CANCER; and STROKE. Potential conditions which are not a health need because performance is BETTER than peers and national rates: LOW BIRTH WEIGHT (<2500 grams); PREMATURE BIRTHS (<37 weeks); BIRTHS TO WOMEN AGE 40 - 54; and UNINTENTIONAL INJURY. Conclusions from the Demographic Analysis Comparing the Service Area to National Averages Adverse uses and rates compared to national norms brought forward the following issues impacting 10% to 24% of the population: 1. Chronic diabetes; 2. Lack of healthy eating habits; 3. Not receiving a Cancer Screen Test in the last two years; and 4. Not receiving a routine Cardiac Screening Test in the last two years.
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25% or more of the population: 1. High use of PRIMARY CARE PHYSICIANS (72% of population); 2. High use of EMERGENCY SERVICES (35% of the population); 3. Low use of OBSTETRIC PHYSICIANS (39% of the population); 4. CHRONIC LOW BACK PAIN (29% of the population); 5. MORBID/OBESE (28% of the population); and 6. HIGH BLOOD PRESSURE (28% of the population). The most adverse finding, 11% above the national average, impacting 29% of the population was USE OF TOBACCO, CIGARETTES Key Conclusions from Consideration of the Other Statistical Data Examinations Additional examinations of St. Joseph County data found: 1. Leading causes of deaths, accounting for over 50%, are HEART DISEASE and CANCER; 2. Increase in male and female life expectancy, with male expectancy improving faster; 3. No PALLIATIVE CARE programs in St. Joseph County, but three HOSPICE programs exist; 4. Parts of the County, primarily served by Three Rivers Health, are DESIGNATED MEDICALLY UNDERSERVED; 5. STROKE death rates exceed the Michigan average and note DIABETES as a moderate comorbidity, while HYPERTENSION has a high incidence as a comorbid condition; 6. HEART DISEASE, the leading cause of death, is below the state average as a rate of death; multiple comorbidities occur "moderately" or have a "fair incidence"; and 7. DIABETES prevalence among the population age 30 and over is about average, in the fifth of ten deciles.
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EXISTING HEALTH CARE FACILITIES AND RESOURCES
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Existing Health Care Facilities and Resources Available to Respond to the Community Health Needs
We used the priority ranking of area health needs to organize the search for locally available resources.21 The following list identifies locally available resources corresponding to each priority need. In general, TRH and Sturgis Hospital are the major hospitals in the service area. The next closest facilities are outside the service area and include:
Borgess Medical Center, a 353 bed referral hospital – 30 miles from TRH (40 minutes) and 50.3 miles (1 hour 10 minutes) from Sturgis Hospital;
Bronson Methodist, a 384 bed referral hospital – 44 miles from Sturgis Hospital (1 hour 7 minutes) and 29.2 miles from TRH (39 minutes);
Bronson Vicksburg, a critical access hospital in Vicksburg, Michigan – 18.3 miles from TRH (27 minutes) and 30 miles from Sturgis Hospital (44 minutes);
Community Health Center of Branch County, a 188 bed community hospital in Coldwater, Michigan – 35.6 miles from Three Rivers Health (48 minutes) and 19.8 miles from Sturgis Hospital (26 minutes);
Parkview LaGrange Hospital, a 25 bed critical access hospital in LaGrange, Indiana – 11.4 miles from Sturgis Hospital (19 minutes) and 31.1 miles from Three Rivers Health (44 minutes); and
Three Rivers Health and Sturgis Hospital are 22.1 miles (35 minutes) from each other. In rank order of need, the following local resources could be available to respond to the need. Definitions of High Priority Need Listed in Highest to Lowest Rank Order of Need 1. MENTAL HEALTH is one of the top four concerns by 53% of residents; METH related problems and bullying (Listed as choice #10 in the need determination survey considered by the local experts). Problem Statement: There is a lack of available, affordable mental health and substance abuse services. Methamphetamine manufacture and use and bullying are specific problems to resolve. Local resources include the following:
ADAPT – 202 Morse Street Coldwater, MI 49036, 517-279-7531;
Amidson, Donald, Psychology – 909 E. Chicago, Sturgis, MI 49091, 269-651-9579;
21 Response to IRS Form 990 h Part V B 1 c
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The ARC of Calhoun County – 217 West Hamblin Ave. Battle Creek, MI 49701, 800-400- 2941 or 269-966-2575;
Autism Society of Michigan – 1213 Center Street, Suite B Lansing, MI 48906. 517-885- 2800;
Borgess Health – 1521 Gull Road, Kalamazoo, MI 49048, 269-266-7000;
Boys Scouts of America – 1035 West Maple Street, Kalamazoo, MI 49008, 269-343-4687; or 1018 North Avenue Battle Creek, MI 49017, 269-962-8513;
Bronson Lakeview Hospital – 408 Hazen Street, Paw Paw, MI 49079, 269-657-3141;
Burr Oak Recreation – 326 Eagle Street Burr Oak, 49030, 260-489-2213;
Catholic Family Services – 1819 Gull Road, Kalamazoo, MI 49048, 800-873-8336 or 269- 381-9800;
Centers for Disease Control and Prevention – http://www.cdc.gov/mentalhealth/;
Community Healing Center – 203 Williams Street, Sturgis, MI 49091, 269-6514-1212;
Community Health Center of Branch County – 274 E. Chicago, Coldwater, MI 49036, 517-279-5400;
Community Mental Health and Substance Abuse Services – 677 East Main Street, Centreville, MI, 800-622-3967 or 269-467-1000;
Counseling and Psychological Services – 30 North Main Street, Three Rivers, MI, 269- 278-2003;
Disability Network of Southwest Michigan – 570 N. Marshall, Coldwater, MI 49036, 517-278-2494;
Easter Seal Michigan – 4065 Saladin Drive Southeast, Grand Rapids, MI 49546, 800-292- 2729 and 616-942-2081;
Family Counseling Services – 338 Fisher St., Centreville, MI, 269-467-4270;
Gateway Community Services – Lansing – 2875 Northwind Drive, Suite 105, East Lansing, MI 48823, 517-351-4000;
Gryphon Place – 1104 South Westnedge Ave., Kalamazoo, MI 49008, 269-381-4357 or 269-381-1510;
Jade’s Hope, Inc. – 1202 E. Chicago Road, Sturgis, MI 49091, 269-319-0204;
Kalamazoo Community Mental Health & Substance Abuse Services Regional Coordinating Agency – 418 W. Kalamazoo Ave., Kalamazoo, MI 49007, 269-553-8000;
Oakridge Counseling Center – 497 East Columbia Battle Creek, MI, 269-963-7135;
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Perra, Robert, Psychology – 103 S. Fourth Street, Sturgis, MI 49091, 269-651-3902;
Pinerest Christian Mental Health Services – 37 68th Street, Grand Rapids, MI 49501, 616-455-5000;
Psychological Consultants of Michigan, P.C. – 151 North Avenue Battle Creek, MI 49017, 269-968-2811;
Senior Diagnostic Center of South Central Michigan – 3630 Capital Avenue Southwest, Battle Creek, MI 49015, 269-441-1136;
Shaeffer, Sara Sue, Psychology – 909 E. Chicago, Sturgis, MI 49091, 269-651-9579;
Sturgis Youth and Family Council – 107 West Street, Sturgis, MI 49091, 269-659-3664;
Substance Abuse and Mental Health Services Administration – http://www.samhsa.gov/;
Summit Pointe – 140 West Michigan Ave., Battle Creek, MI 49017, 800-632-5449 or 269- 966-1460;
Three Rivers Area Mentoring – 25 Railroad Drive, Three Rivers, MI 49093, 269-278-8726;
Transitions Wellness Center – 1519 N. Main St., #C, Three Rivers, MI, 269-273-2024; and
United Cerebral Palsy Association of Michigan – 4970 Northwind Drive, Suite 102, East Lansing, MI 48823, 800-828-2714 or 517-203-1200. 2. BABY DEATHS – HISPANIC INFANT MORTALITY worse than peers and national average; INFANT MORTALITY worse than peers and national average; NEONATAL INFANT MORTALITY worse than peers and national average; LOW BIRTH WEIGHT BABIES are infrequent and a positive health status factor, better performance than peers and national averages; PREMATURE BIRTHS not a concern, performance better than peers and national average; POSTNEONATAL INFANT MORTALITY is worse than peers and national average; VERY LOW BIRTH WEIGHT somewhat a concern, adverse peer comparison; WHITE NON HISPANIC INFANT MORTALITY worse than peers and national average (Listed as choice #2 in the need determination survey considered by the local experts). Problem Statement: The number of infant deaths needs to decline. Local resources include the following:
Borgess Health – 1521 Gull Road, Kalamazoo, MI 49048, 269-266-7000;
Branch-Hillsdale-St. Joseph Community Health Agency – 1110 Hills Street, Three Rivers, MI 49093, 269-273-2161;
Bronson Methodist Hospital – 609 John Street, Kalamazoo, MI 49007, 269-341-7654;
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Child Death Review Team – Human Services Commission – 692 E. Main Street, Centreville, MI 49032, 269-467-1223;
Community Health Center of Branch County – 274 E. Chicago, Coldwater, MI 49036, 517-279-5400;
Connect Health Services, PLLC – 600 E. Michigan Ave., Albion, MI 49224, 517-629- 3497;
DeVos Children’s Hospital – 1840 Wealthy Street SE, Grand Rapids, MI 49506, 616-744- 7800;
Family Care – Centreville – 677-B East Main St., Centreville, MI, 49032, 269-467-9011;
Mamby, Audley, M.D., OB-GYN – 711 S. Health Parkway, Suite 1, Three Rivers, MI 49093, 269-273-6400;
March of Dimes, Michigan Chapter – 27600 Northwestern Hwy., Suite 150, Southfield, MI, 48034, 248-359-1550;
Melendez, Eliezer, M.D., Pediatrics – 1717 E. Chicago Road, Sturgis, MI 49091, 269- 651-7114;
Planned Parenthood of South Central Michigan – 4201 West Michigan Ave., Kalamazoo, MI 49006, 269-372-1200;
Pregnancy Helpline of St. Joseph County – 1125 North Nottawa, Sturgis, MI 49091, 269-659-1100;
Pregnancy Helpline of Three Rivers – 172 East Michigan Ave., Three Rivers, MI 49093, 269-278-2211 or 800-395-4357;
Riverside Clinic – 2007 East Michigan Ave., Three Rivers MI 49093, 269-273-8723;
Safe Kids Coalition of Branch-Hillsdale-St. Joseph County – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Silver Lining Family Services – 4615 Lauren Lane, St. Joseph, MI 49085, 269-408-0222;
Singh, Emily-Rae, M.D., OB-GYN – 721 S. Health Parkway, Three Rivers, MI 49093, 269-273-3700;
St. Joseph County Council for the Prevention of Child Abuse/Neglect, Inc. – 17975 Centreville-Constantine Road, Constantine, MI 49042, 269-435-7288;
Sturgis Hospital – 916 Myrtle, Sturgis, MI 49091, 269-651-7824;
Three Rivers Family Care – 721 6th Ave, Three Rivers, MI 49093, 269-273-9782;
Three Rivers Health – 701 South Health Parkway, Three Rivers, MI 49093, 269-279-1120;
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Three Rivers Health Women’s Services – 711 S. Health Parkway, Suite 1, Three Rivers, MI 49093, 269-273-6400;
Tomorrows Child/Michigan SIDS – 112 East Allegan, Lansing, MI 48933, 800-331-7437 or 517-485-7437; and
Women’s Healthcare – 600 S. Lakeview, Sturgis, MI. 269-651-4744. 3. HEALTH INSURANCE/UNINSURED rates at state average but among the four top major concerns by 75% of residents; Spanish concerns are recorded (Listed as choice #7 in the need determination survey considered by the local experts). Problem Statement: Efforts should be taken to remove actual and perceived financial barriers limiting access to medical and health services, especially as it impacts Spanish language speaking residents. Local resources include the following:
Area Agency on Aging – Region III B (MI Choice) – 200 W. Michigan Ave., Battle Creek, MI 49017;
Branch-Hillsdale-St. Joseph County Health Plan – 1110 Hill Street, Three Rivers, MI 49093, 269-467-1200;
Branch-Hillsdale-St. Joseph Community Health Agency – 1110 Hill Street, Three Rivers, MI 49093, 269-273-2161;
Care Source (MHP) – 2900 West Road, Suite 201, East Lansing, MI 48823, 800-390-7102;
Cassopolis Family Clinic (FQHC) – 109 School Street, Cassopolis, MI 49031, 269-445- 3874;
Community Mental Health and Substance Abuse Services – 677 East Main Street, Centreville, MI, 800-622-3967 or 269-467-1000;
Coventry Cares of Michigan (MHP) – 1333 Gratiot, Suite 400, Detroit, MI, 866-316- 3784;
Family Health Center Portage (FQHC) – 325 E. Centre Street, Portage, MI 49002, 269- 488-7342;
Family Health Center South (FQHC) – 2030 Portage Road, Kalamazoo, MI 49001, 269- 349-0888;
Lending Hands of Michigan – 5348 Ivanhoe Court Portage, MI 49002, 269-567-4381;
Medicaid – 269-467-1200;
Meridian Health Plan of Michigan, Inc. (MHP) – 777 Woodward Avenue, Suite 600, Detroit, MI 48226, 313-324-3700;
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Michigan Department of Human Services – 692 E. Main Street, Centreville, MI 49032, 269-467-1200;
Riverside Free Clinic – 2007 East Michigan Ave., Three Rivers, MI 49093, 269-273-8723;
Senior Services, Inc. (MI Choice) – 918 Jasper, Kalamazoo, MI 49001, 269-382-0515;
SJC Health Plan – 269-273-2161; and
United Healthcare Community Plan (MHP) – 26957 Northwestern Highway, Suite 400, Southfield, MI 48033, 248-599-5656 or 800-903-5253. 4. OBESITY/PHYSICAL INACTIVITY at Michigan average, impacts 29% of residents; LACK OF HEALTHY EATING HABITS an abnormal finding impacting 24% of the population; UNHEALTHY FOOD CHOICES are the fourth highest concern by 53% of residents (Listed as choice #12 in the need determination survey considered by the Local Experts). Problem Statement: Additional obesity reduction efforts, including an emphasis on health eating, are needed. Local resources include the following:
ASEA Wellness – Jacque Jennings Carter, Schoolcraft, MI 49087, 269-353-4000;
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Burr Oak Recreation – 326 Eagle Street Burr Oak, 49030, 260-489-2213;
Curves – 1108 W. Michigan Ave. Suite #4, Three Rivers, MI 49093, 800-615-7352;
Curves – 255 N US Highway 131, Three Rivers, MI 49093, 269-273-4966;
Curves – 121 W. Chicago Road, Sturgis, MI 49091, 800-615-7352;
Community Action – 175 Main Street Battle Creek, MI 49016, 269-965-7766;
Conqueror Health & Fitness – 1539 E. Chicago Road, Sturgis, MI 49091, 269-651-2626;
Constantine Little League – Meadow Lane, Constantine, MI 49042, 269-435-8707;
Doyle Community Center – 310 Franks Ave., Sturgis, MI 49091, 269-659-8110;
Express Nutrition – 865 S. Centreville Road, Sturgis, MI 49091, 269-659-3800;
Fitness First – 54 N. Main Street, Three Rivers, MI 49093, 269-279-9160;
Fitness First – 11333 Elizabeth Drive, Three Rivers, MI , 269-279-9160;
Fit Zone for Women – 943 S. Centreville Road, Sturgis, MI 49091, 269-503-7095;
Health Trac – 501 S. Health Parkway, Three Rivers, MI 49093, 269-278-8722;
Herbalife – 26070 Findley Road, Sturgis, MI 49091, 269-278-8715;
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GNC – 748 S. US Highway 131, Three Rivers, MI 49093, 269-273-2334;
GNC – 1386 S. Centreville Road, Sturgis, MI 49094, 269-659-3592;
M & M Nutrition – 65355 Sevison Road, Constantine, MI 49042, 269-435-7512;
Michigan State University Extension – 612 E. Main Street, Centreville, MI 49032, 269- 467-5511;
Nikken International Wellness Specialist – Schoolcraft, MI 49087, 269-353-4000;
Shaklee Distributor – 17021 Cotherman Lake Road, Three Rivers, MI 49093, 269-273- 8272;
St. Joseph Parks and Recreation – 62 E. Main Street, Centreville, MI 49032, 269-467- 5519;
Sturgis Hospital – 916 Myrtle Avenue, Sturgis, MI 49091, 269 659-4385;
Sturgis Community Pool – 216 Vinewood Avenue Sturgis, MI 49091, 269-659-1585;
Take Off Pounds Sensibly (TOPS) – 139 W. Chicago Street Fellowship Hall, Bronson, MI 49028, 517-521-4934;
Take Off Pounds Sensibly (TOPS) – First United Methodist Church, 200 Pleasant St. Parlor, Sturgis, MI 49091, 517-521-4934;
Three Rivers Community Center – 103 S. Douglas Ave., Three Rivers, MI, 49093, 269- 279-8083;
Van Beek Nutrition – 3537 W Yz Ave. Schoolcraft, MI 49087, 269-679-5441;
Weightwatchers – Three Rivers Health Trac, 501 S. Health Parkway, Three Rivers, MI 49093;
Weightwatchers – Three Rivers Health Trac, 501 S. Health Parkway, Three Rivers, MI 49093;
Weightwatchers – Young Auditorium, 201 N. Nottawa Street, Sturgis, MI 49091; and
YMCA Camp Eberhart – 10481 Camp Eberhart Road Three Rivers, MI 49093, 269-244- 5125; 5. BIRTHS – TO WOMEN AGE 40 TO 54 not a concern, performance better than peers and national average; TO UNMARRIED WOMEN worse than peer and national average; NO CARE IN THE FIRST TRIMESTER worse than peers and national average; TEEN BIRTH RATE among the worst in Michigan; one of the top four major concerns by 53% of residents; worse than peers and national average (Listed as choice #1 in the need determination survey considered by the Local Experts).
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Problem Statement: An increase is needed in the provision of pregnancy related services, education and treatment. Local resources include the following:
Borgess Health – 1521 Gull Road, Kalamazoo, MI 49048, 269-266-7000;
Branch-Hillsdale-St. Joseph Community Health Agency – 1110 Hills Street, Three Rivers, MI, 49093, 269-273-2161;
Bronson Methodist Hospital – 609 John Street, Kalamazoo, MI 49007, 269-341-7654;
Community Health Center of Branch County – 274 E. Chicago, Coldwater, MI 49036, 517-279-5400;
Community Action – 175 E. Main, Battle Creek, MI, 49016, 269-965-7766 or 877-422- 2726;
Connect Health Services, PLLC – 600 E. Michigan Ave., Albion, MI 49224, 517-629- 3497;
Domestic and Sexual Abuse Services – 197 East Michigan Ave., Three Rivers, MI 49093, 269-273-6154 or 800-828-2023;
Family Care – Centreville – 677-B East Main St., Centreville, MI, 49032, 269-467-9011;
Glen Oaks Community College – 62249 Shimmel Road, Centreville, MI, 49032, 269- 467- 9945 or 888-994-7818;
Mamby, Audley, M.D., OB-GYN – 711 S. Health Parkway, Suite 1, Three Rivers, MI 49093, 269-273-6400;
March of Dimes, Michigan Chapter – 27600 Northwestern Hwy., Suite 150, Southfield, MI, 48034, 248-359-1550;
Michigan Department of Human Services – 692 E. Main Street, Centreville, MI 49032, 269-467-1200;
Planned Parenthood of South Central Michigan – 4201 West Michigan Ave., Kalamazoo, MI, 49006, 269-372-1200;
Pregnancy Helpline of St. Joseph County – 1125 North Nottawa, Sturgis, MI 49091, 269-659-1100;
Pregnancy Helpline of Three Rivers – 172 East Michigan Ave., Three Rivers, MI 49093, 269-278-2211 or 800-395-4357;
Riverside Clinic – 2007 East Michigan Ave., Three Rivers MI 49093, 269-273-8723;
Silver Lining Family Services – 4615 Lauren Lane, St. Joseph, MI 49085, 269-408-0222;
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Singh, Emily-Rae, M.D., OB-GYN – 721 S. Health Parkway, Three Rivers, MI 49093, 269-273-3700;
Sturgis Hospital – 916 Myrtle Sturgis, MI 49091, 269-651-7824;
Three Rivers Family Care – 721 6th Ave, Three Rivers, MI 49093, 269-273-9782;
Three Rivers Health – 701 South Health Parkway, Three Rivers, MI 49093, 269-279-1120;
Three Rivers Health Women’s Services – 711 S. Health Parkway, Suite 1, Three Rivers, MI 49093, (269) 273-6400;
Woman’s Co-Op – 2055 E. Columbia Ave., Battle Creek, MI 49017, 269-966-8988; and
Women’s Healthcare – 600 S. Lakeview, Sturgis, MI. 269-651-4744. 6. PHYSICIAN PRIMARY USE high; EMERGENCY USE high; OBSTETRICS USE low; northern St. Joseph designated MEDICALLY UNDER SERVED (Listed as choice #16 in the need determination survey considered by the Local Experts). Problem Statement: The availability of physician services needs to better relate to needs. Local resources include the following:
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Community Mental Health and Substance Abuse Services – 677 East Main Street, Centreville, MI, 800-622-3967 or 269 -467-1000;
Health Resources and Services Administration – http://www.hrsa.gov/;
Michigan Department of Community Health, Michigan Healthcare Workforce Center – Policy and Planning Administration, 7th Floor Capital View Building,201 Townsend Street, Lansing, MI 48913, 517- 373-2559;
Michigan Center for Rural Center – B-218 West Fee Hall, Michigan State University, East Lansing, Michigan 48824, 517- 355-7757;
Michigan Health Council – Michigan Health Council, 2410 Woodlake Drive, Okemos, Michigan 48864, 517-347-3332;
Michigan Primary Care Association – 7215 Westshire Drive, Lansing, MI 48917, 517- 381-8000;
National Health Services Corp – http://nhsc.hrsa.gov/;
Sturgis Hospital – 916 Myrtle Sturgis, MI 49091, 269-651-7824;
Three Rivers Health – 701 South Health Parkway, Three Rivers, MI 49093, 269-279-1120;
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Three Rivers Health Family Care Centreville – 677 E. Main, Centreville, MI. 269-467- 9011;
Three Rivers Health Family Care Three Rivers – 721 6th Avenue, Suite B, Three Rivers, MI. 269-273-9782;
Three Rivers Health Family Care White Pigeon – 119 S. Kalamazoo St., White Pigeon, MI. 269-483-7624;
Three Rivers Health Internal Medicine – 711 S. Health Parkway, Three Rivers, MI. 269- 273-8557;
Area Physicians by Specialty and Mid Levels:
o Allgor, Jane, CNM – Three Rivers Health, 7221 S. Health Parkway, Three Rivers, MI, 49093;
o Amaria, Yazdi N., MD (Family Practice/Surgery) – 111 S. Monroe, Sturgis, MI 49091, 269-651-3218;
o Amidson, Donald , D., MIN LPC (Psychology) – 909 E. Chicago Road, Sturgis, MI 49091, 269-651-9579;
o Andino, Raul, MD (OB/GYN) – Three Rivers Health, Women's Services, 721 S. Health Parkway, Three Rivers, MI 49093, 269-273-6400;
o Andrzej and Anna Chebes, MD – Internal Medicine – 1021 Hill Street, Suite 300, Three Rivers, MI. 269-858-3024;
o Anson, Ruth, CNM (Nurse Practioner/OB-GYN) – Three Rivers Health, Women's Services, 721 S. Health Parkway, Three Rivers, MI 49093, 269-273-6400;
o Aqeel, Ahmed, MD (Nephrology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Azimi, Mohammed, MD – Three Rivers Health, 7221 S. Health Parkway, Three Rivers, MI 49093;
o Balogh, George , MD (Radiology) – Three Rivers Health, 711 S. Parkway, Three Rivers, MI 49093, 269-273-9638;
o Bandaru, Himabindu, MD (Internal Medicine) – Three Rivers Surgical, 701 S. Health Parkway, Three Rivers, MI 49093, 269-278-1145;
o Barkway, Lauri, MD – Three Rivers Health, ER – 701 S. Health Parkway, Three Rivers, MI 49093;
o Bickle, Jennifer, FNP (Midlevel/Family Practice) – Sturgis Hospital Medical Commons, 1717 E. Chicago, Sturgis, MI 49091, 269-651-3554;
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o Blix, George, MD (Urology) – Three Rivers Health Specialty Clinics, 711 S. Health Parkway, Medical Office Building, Three Rivers, MI 49093, 269-349-9745;
o Bohm, Deb, PA- C – Three Rivers Family Care, 677 B, E. Main, Centreville, MI 49032;
o Bormann, John , MD, (Radiology) – Sturgis Hospital, 916 Myrtle Ave., Sturgis, MI 49091, 269-651-7824;
o Bowditch, Brian T., MD (Emergency Medicine) – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093, 269-278-1145;
o Brenner, Thomas E., MD – Sturgis Medical Group, 1717 E. Chicago, Suite 2, Sturgis, MI 49091, 269-651-1471;
o Broadbent, Wallace, MD – (Emergency Medicine) – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093, 269-278-1145;
o Bruno, Joseph, MD – Three Rivers, ER – 701 S. Health Parkway, Three Rivers, MI 49093;
o Bullard, Timothy, MD – Three Rivers, ER – 701 S. Health Parkway, Three Rivers, MI 49093;
o Burke, David W, MD (Cardiology) – Heart Center for Excellence, 1772 Shaffer Street, Suite 1, Kalamazoo, MI 49048, 800-632-7737 or 269-381-3963;
o Bussema, Christopher, DPM (Podiatry) – Sturgis Foot & Ankle Clinic, P.O. Box 730, Sturgis, MI 49091, 269-651-2320;
o Cabansag, Sharon, MD (Family Practice) – 68930 Vinewood Ave., Sturgis, MI 49091, 269-651-9302;
o Cabansag, Vincente D., Jr., M.D., (General Surgery) – SW MI Laser – 219 Vinewood, Sturgis, MI 49091, 269-651-9302;
o Carlin, Andrea, PA-C – Three Rivers Family Care, 677 B, E. Main, Centreville MI 49032;
o Clark, Joh , MD, (OB/GYN) – Sturgis OB/GYN, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4646;
o Colberg, Douglas L, MD (Emergency Medicine) – 916 Myrtle , Sturgis, MI 49091, 269-651-7824;
o Davis, Kristy K, DO (Family Medicine) – 916 Myrtle , Sturgis, MI 49091, 269-659- 4250;
o Dunne, Thomas, MD (Neurology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
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o Edara, Lokesh, MD (Allergy/Immunology) – Three Rivers Health, 711 S. Health Parkway, Three Rivers, MI 49093;
o Egyed, Lynn, PA-C – Three Rivers Family Care, P.O. Box 295, White Pigeon, MI 49099;
o Evans, Linda S., MD (Pediatrics) – Family Care – Centreville, 677-B, East Main Street, Centreville, MI 49032, 269-467-9011;
o Ford, Adria, MD (Surgery) – Three Rivers Surgical Services, 715 S. Parkway, Three Rivers, MI 49093, 269-273-8471;
o Fuehr, Mary, NP – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Gearing, David , M.D. (Radiology) – Sturgis Hospital, 916 Myrtle Ave., Sturgis, MI 49091, 269-651-7824;
o Graham, Kurt W., MD (Physical Medicine) – Rehabilitation Pavilion, 1111 W. Broadway, Three Rivers, MI 49093, 269-273-9795;
o Grannell, James, DO (Orthopedics) – Sturgis Orthopedics, 600 S. Lakeview, Suite 205, Sturgis, MI 49091, 269-659-4210;
o Greene, Glendora G., MD (Family Practice) – Doctors Center Suite 3, 751 S. Health Parkway, Three Rivers, MI 49093, 269-279-5240;
o Gustafson, J. Gary, MD (Cardiology) – Sturgis Hospital Specialty Clinic, 916 Myrtle Avenue, Sturgis, MI, 49091, 269-651-7824;
o Hackman, Amy, CNP (Midlevel/Pediatrics) – Sturgis Pediatrics, 1717 E. Chicago Road, Sturgis, MI 49091, 269-651-7114;
o Haylett, Nancy, FNP (Midlevel/Family Practice) – Sturgis Hospital Medical Commons, 1717 E. Chicago, Sturgis, MI 49091, 269-651-3554;
o Heft, Tad, MD – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Heggie, Glen, MD (Oncology) – Three Rivers Health, Specialty Clinic, 711 S. Health Parkway, Medical Building One, Three Rivers, MI 49093, 269-273-9691;
o Kane, Patty, FNP – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Kelley, Beth, FNP, CNM – Three Rivers Health, Women's Services, 721 S. Health Parkway, Three Rivers, MI 49093;
o Kido, Akiyoshi, M.D. (Surgery) – Three Rivers Surgical Services, 715 S. Parkway, Three Rivers, MI 49093, 269-273-8471;
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o Kim, Seong C, MD (Family Practice) – 68934 Vinewood Ave., Sturgis, MI 49091, 269-651-1411;
o Kimberly, Ehzroth, MD – Women's Care, 721 S. Health Parkway, Three Rivers, MI 49093, 269-273-6400;
o King, Anthony, MD (Cardiology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview Ave. Sturgis, MI, 49091, 269-659-4382;
o Kordish, Theresa, MD – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Kotia, Godson G,, MD (Surgery) – Michigan Surgical Associates, 1904 E. Chicago, Sturgis, MI 49091, 269-651-7003;
o Krinock, Mark, MD (Neurosurgery) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Kujacznski, Lucinda – Riverside Health Clinic, 207 E. Michigan Ave., Three Rivers, MI 49093;
o Leo, Richard J., MD (Ophthalmology) – Modern Eye Care & Surgery PC, 600 S. Lakeview, Suite 201, Sturgis, MI 49091, 269-659-4545;
o Lucas, Mark, MD (Urology) – Three Rivers Health Specialty Clinics, 711 S. Health Parkway, Medical Office Building, Three Rivers, MI 49093, 269-349-9745;
o Mahmood, Fayyaz, MD (Neurology) – Three Rivers Health Specialty Clinic, 711 S. Health Parkway, Medical Office Building, Three River, MI 49093, 269-659-4382;
o Mamby, Audley , M.D. (OB/GYN) – 711 S. Health Parkway, Suite 1, Three Rivers, MI 49093, 269-273-6400;
o Martin, Dana, PA -C (Physician Assistant) – 1904 E. Chicago, Sturgis, MI 49091;
o Maskill, Michael, DPM (Podiatry) – Three Rivers Health, Surgical Services, 715 S. Health Parkway, Medical Office Building 3, Three Rivers, MI 49093, 269-278-1829;
o McCartney, Dawn , MD – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o McClain, James H., DPM (Podiatry) – Midwest Foot & Ankle, 68689 Vinewood Ave., Sturgis, MI 49091;
o McCormick, Mark, MD (GI/Internal Medicine) – Sturgis Hospital Specialty Clinic, 916 Myrtle Ave., Sturgis, MI 49091, 269-659-6552;
o Melendez, Eliezer, MD (Pediatrics) – Sturgis Medical Group, 1717 E. Chicago, Sturgis, MI 49091, 269-651-7114;
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o Milik, Alicja, MD (Hospitalist) – 701 S. Health Parkway, Three Rivers, MI 49093, 269-278-1145;
o Millard, Tammi , CNP – Sturgis Medical Group, 1717 E. Chicago Road, Suite 2, Sturgis, MI 49091;
o Miller, Tom, PA-C – Three Rivers Family Care – P.O. Box 295, White Pigeon, MI 49091;
o Mithal, Manoj, MD – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Moffit, Robin, FNP (Midlevel/Family Practice) – Sturgis Hospital Medical Commons, 1717 E. Chicago, Sturgis, MI 49091, 269-651-3554;
o Mohiuddin, Mohtasham, MD (Internal Medicine) – Three Rivers Internal Medicine, 633 S. Erie Street, Three Rivers, MI 49093, 269-279-2120;
o Montes, Manalo, MD – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093, 269-273-9737;
o Myers, Barry, PA-C – Sturgis Medical Group, 1717 E. Chicago Road, Suite 2, Sturgis, MI 49091;
o Nandihalli, Kallan, MD (Internal Medicine) – Three Rivers Internal Medicine, 633 S. Erie Street, Three Rivers, MI 49093, 269-273-8557;
o Neal, Trevor R., DPM (Podiatry) – Sturgis Foot & Ankle Clinic, P.O. Box 730, Sturgis, MI 49091, 269-651-2320;
o Newhouse, Peter M., MD, (Family Practice) – ProMed Family Practice, 1241 W. Broadway, Three Rivers, MI 49093, 269-273-9539;
o Orca, Marian, MD (Urology) – Lake Country Health Alliance, 17 Vinewood Ave., Sturgis, MI 49091, 269-651-4708;
o Oxhom-Uribe, Nilda, MD – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Pancholoy, Navin, MD – Three Rivers Surgical Services, 715 S. Health Parkway, Three Rivers, MI 49093;
o Parial, Arsenio T., MD (Ophthalmology) – Parial Eye Physicians, 600 S. Lakeview, Suite 102, Sturgis, MI 49091, 269-651-7808;
o Park, Ro Jong, MD (General Surgery) – Three Rivers Surgical, 715 S. Health Parkway, Three Rivers, MI 49093, 269-273-8471;
o Patel, Keyur, MD (Family Practice) – Sturgis Medical Group, 1717 E. Chicago, Suite 2, Sturgis, MI 49091, (269) 651-1471;
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o Patel, Paras, MD, R.Ph. (Hospitalist) – Borgess Medical Center, 1521 Gull Road, Suite 3, Kalamazoo, MI;
o Patel, Veera, MD (Internal Medicine) – JM Wellness, 1021 Hill Street, Three Rivers, MI 49093, 269-273-8511;
o Perra, Robert , EdD (Psychology) – 104 S. Fourth, Sturgis, MI 49091, 269-651- 3902;
o Phillips, James, MD – 20390 Hillandale Road, White Pigeon, MI 49099;
o Pinon, Al J., MD (Family Practice) – ProMed Family Practice, 1241 W. Broadway, Three Rivers, MI 49093, 269-273-9539;
o ProMed – 1241 West Broadway, Three Rivers, MI. 269-273-9539;
o Puckett, Jessica, DO (OB/GYN) – Three Rivers Health, Women's Services, 721 S. Health Parkway, Three Rivers, MI 49093, 269-273-6400;
o Pulford, Mike, CRNA – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Rahman, Abidur, MD (Vascular Surgery) – Sturgis Hospital Specialty Clinic, 916 Myrtle Ave., Sturgis, MI 49091, 269-651-7824;
o Reid, Anita, FNP – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Reiff, James S., DO (Addictions) – 28275 E. Congress, Sturgis, MI 49091, 269-659- 4706;
o Robertson, John P., MD (Emergency Medicine) – 916 Myrtle , Sturgis, MI 49091, 269-651-7824;
o Rogers, Brett, MD (Emergency Medicine) – 916 Myrtle , Sturgis, MI 49091, 269- 651-7824;
o Rogers, William Brett, MD, (Family Practice) – Sturgis Hospital, 916 Myrtle, Sturgis, MI 49091, 269-651-1471;
o Rosario, Gisselle, PA-C – Three Rivers Family Care, 721 6th Street, Three Rivers, MI 49093;
o Ruihley, Karen, PA-C – 916 Myrtle Ave, Suite 200, Sturgis, MI 49091, 269-651-1471;
o Saad, Tom, MD – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Sabek, Sayed, MD (Emergency Medicine) – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093, 269-278-1145;
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o Salvi, Seema, MD (Pediatrics) – Three Rivers Family Care, 721 6th Ave., Three Rivers, MI 49093, 269-273-9782;
o Sandborn, Michael, MD (Rehabilitation) – Three Rivers Health, Rehab Pavilion, 701 S. Health Parkway, Three Rivers, MI 49093, 269-273-9795;
o Sandeep, Ahluwalia, MD (Radiology) – Sturgis Hospital, 916 Myrtle Ave., Sturgis, MI 49091, 269-651-7824;
o Sanders, Kellie , MD (Family Practice) – Sturgis Medical Group, 1717 E. Chicago, Suite 2, Sturgis, MI 49091, (269) 651-1471;
o Sawa, Wilson, MD (Gynecology) – Michiana Women's Center , 600 S. Lakeview, Suite 103, Sturgis, MI 49091, 269-651-8071;
o Schaefer, Robert , MD (Orthopedics) – 633 S. Erie Street, Three Rivers, MI 49093, 269-278-1829;
o Schaeffer, Sarah Sue, EdD, LPC (Psychology) – 909 E. Chicago Road, Sturgis, MI 49091, 269-651-9579;
o Schimnoski, Donald R., MD (Family Practice) – Doctors Center, Suite 4, 711 S. Health Parkway, Three Rivers, MI 49093, 269-273-2454;
o Schumaker, Jonathon, MD (Family Medicine) – Colon Medical Clinic, 171 Franklin Street, Colon, MI 49040;
o Schwartz, Nyla, NP – Family Care – Centreville, 677-B East Main St., Centreville, MI 49032;
o Searing, Kim, CNM – Three Rivers Health, Women's Services, 721 S. Health Parkway, Three Rivers, MI 49093;
o Semler, David, MD (Dermatology) – Three Rivers Health Specialty Clinic, 711 S. Health Parkway, Three Rivers, MI 49093, 269-321-7546;
o Sharp, Carol L., OGNP (Midlevel/Obstetrics/Gynecology) – Sturgis OB/GYN, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4646;
o Sidhu, Price, MD (Nephrology) – 711 S. Health Parkway, Medical Building One, Three Rivers, MI 49093, 269-349-6759;
o Emily-Rae Singh, MD – Family Medicine – 721 S. Health Parkway, Three Rivers, MI. 269-273-3700;
o Soper, Steven P., MD (Pathology) – Midwestern Pathology, P.C., 1111 W. Broadway, Three River, MI 49093, 269-278-1145;
o St. Joseph CISD/Pathfinder – Immunization Staff, 62445 Shimmel Road, Centreville, MI 49032, 269-467-5454;
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o Steenstra, Mary Jo, MD – Women's Care, 721 S. Health Parkway, Three Rivers, MI 49093, 269-273-6400;
o Tacia, Blane, MD (Surgery) – 635 E. Main Street, Centreville, MI 49032, 269-467- 4093;
o Tanzo, Venus, MD – Lake Country Health Alliance, 17 Vinewood, Sturgis, MI 49091, 269-651-4708;
o Tavarone, Thomas, MD (Surgery) – Three Rivers Surgical Services, 715 S. Parkway, Three Rivers, MI 49093, 269-273-8471;
o Tecca, John, PhD (Audiology) – Three Rivers Health Specialty Clinics, 711 S. Health Parkway, Three Rivers, MI 49093, 888-660-2482;
o Thomas, Karan , NP – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o Ugboma, Stell , MD (Anesthesiology) – 274 E. Chicago Street, Coldwater, MI 49036, 517-278-8229;
o Vakharia, Bharat, MD (Internal Medicine) – 600 S. Lakeview, Suite 206, Sturgis, MI 49091, 269-651-2011;
o Vanderbuilt, Jeffrey, CRNP – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093;
o VanGorden, Traci, CFNP (Midlevel) – Three Rivers Health, 701 S. Health Parkway, Three Rivers, MI 49093, 269-278-1145;
o Veera Patel, MD – 1021 Hill Street, Three Rivers, MI 269-273-8511;
o Vega, Luis – Colon Medical Clinic, 121 Franklin Street, Colon, MI 49040, 269-432- 3221;
o Verma, Ashish, MD (Internal Medicine) – Sturgis Medical Group, 1717 E. Chicago, Suite 2, Sturgis, MI 49091, 269-651-4744;
o Warlick, Michael , MD, (Psychology) – Three Rivers Health Specialty Clinics, 711 S. Health Parkway, Medical; and
o Williams, Alicia, DO (Cardiology) – Heart Center for Excellence, 1772 Shaffer Street, Suite 1, Kalamazoo, MI 49048, 800-632-7737 or 269-381-3963. 7. CANCER is second leading cause of death; CANCER SCREENING not adequate; BREAST CANCER worse than peers and national average; COLON CANCER worse than peers and national average; LUNG CANCER somewhat a concern, exceeds national average; MAMMOGRAPHY use at state average (Listed as choice #3 in the need determination survey considered by the Local Experts).
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Problem Statement: Oncology diagnostic resources and treatment capability should be increased. Local resources include the following:
Access Breast Cancer Screenings – P.O. Box 51365, Kalamazoo, MI 49005, 269-808- 2206;
American Cancer Society Resource Center at Bronson – 601 John Street, Kalamazoo, MI 49007, (269) 341-7654;
American Cancer Society of Southwest Michigan Area Service Area – 1400 West Milham Ave., Portage, MI, 49024, 800-465-5244 or 269-349-8719;
Area Agency on Aging 3 C – 1110 Hill Street, Three Rivers, MI 49093, 269-273-2161;
Borgess Medical Center – 1521 Gull Rd, Kalamazoo, MI 49048, 269-226-7000;
Bronson Oncology Service, Bronson Methodist Hospital – 601 John Street, Kalamazoo, MI 49007, (269) 341-7654;
Centers for Disease Control and Prevention – http://www.cdc.gov/cancer/;
Children’s Leukemia Foundation – 5455 Corporate Drive, Suite 306, Troy, MI, 48098, 800-825-2536;
Community Health Center of Branch County Cancer Center – 370 East Chicago Street, Suite 100, Coldwater, MI 49036, 877-499-4673;
Heggie, Glen, MD (Oncology) – Three Rivers Health, Specialty Clinic, 711 S. Health Parkway, Medical Building One, Three Rivers, MI 49093, 269-273-9691;
Michigan Breast Cancer Support Group – Sturgis Hospital, 916 Myrtle Ave., Sturgis, MI 49091, 269- 651-7824;
Michigan Department of Community Health, Cancer Prevention and Control Section – P.O. Box 30195, Lansing, MI 48909;
National Cancer Institute – http://www.cancer.gov/;
St. Joseph County Commission On Aging – 103 S Douglas Avenue, Three Rivers, MI 49093, (269) 279-8083;
Sturgis Senior Center – 304 North Jefferson Street Sturgis, MI 49091, 269-651-8417;
Sturgis Hospital – 916 Myrtle Sturgis, MI 49091, 269-651-7824;
Sturgis Relay for Life – 1400 W. Milham Portage, MI 49024, 269-349-8719;
Three Rivers Health Specialty Clinic – 711 S. Health Parkway, Three Rivers, MI. 269- 273-9691 (Glen Heggie, MD); and
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West Michigan Cancer Center – 200 North Park St., Kalamazoo, MI. 269-273-9691. 8. SMOKING drives low health status score factor; negative factor deviates most from national norms; impacts 29% of residents (Listed as choice #19 in the need determination survey considered by the Local Experts). Problem Statement: The number of local residents who smoke needs to decline. Local resources include the following:
American Cancer Society Southwest Michigan – 1400 W. Milham Portage, MI 49024, 269-349-8719;
American Heart Association – http://www.heart.org/HEARTORG/;
American Legacy Foundation – http://www.becomeanex.org/;
American Lung Association – http://www.lung.org/;
Branch-Hillsdale-St. Joseph Community Health Agency – 1110 Hill Street, Three Rivers, MI, 49093, 269-273-2161;
Centers for Disease Control and Prevention – http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm;
Craniosacral Therapy Center – 124 S Kalamazoo St, White Pigeon, MI 49099, 269-483-9305;
Inter-Tribal Council of Michigan – 2956 Ashmun Street, Suite A, Sault Ste. Marie, MI 49783, 906-632-6896;
Michigan Department of Community Health, Tobacco Section – 109 W. Michigan Ave., P.O. Box 30195, Lansing, MI 48913, (517) 335-8376;
Michigan Tobacco Quitline – 800-480-QUIT (7848);
My Time to Quit – http://www.mytimetoquit.com/sites/mttq/pages/index.aspx;
National Cancer Institute – http://www.cancer.gov/cancertopics/tobacco/smoking;
National Partnership to Help Pregnant Smokers Quit – http://www.helppregnantsmokersquit.org/;
Nicotine Anonymous – http://www.nicotine-anonymous.org/;
NovaCare Rehabilitation – 228 W Chicago Rd, Sturgis, MI 49091, (269) 651-2550;
Physicians:
o Andrzej and Anna Chebes, MD – Internal Medicine – 1021 Hill Street, Suite 300, Three Rivers, MI. 269-858-3024;
o Veera Patel, MD – 1021 Hill Street, Three Rivers, MI 269-273-8511;
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o Glendora Greene, MD – Family Medicine – 850 S. Health Parkway, Three Rivers, MI 269-279-5240; and
o Emily-Rae Singh, MD – Family Medicine – 721 S. Health Parkway, Three Rivers, MI. 269-273-3700.
Prevention Network – East Lansing, MI, 517-393-6890;
ProMed – 1241 West Broadway, Three Rivers, MI. 269-273-9539;
Quitnet – http://www.quitnet.com/qnhomepage.aspx;
Smoke-Free Environments Law Project – Ann Arbor, MI, 734-665-1126;
Smoke Free.gov – http://www.smokefree.gov/;
Sturgis Hospital Physical Therapy – 1717 E Chicago Rd # 1, Sturgis, MI 49091, 269- 659-4468;
Three Rivers Health, Cardiac Rehabilitation – 701 S. Health Parkway | Three Rivers, MI 49093 | Phone: (269) 278-1145;
Three Rivers Health Family Care Centreville – 677 E. Main, Centreville, MI. 269-467- 9011;
Three Rivers Health Family Care Three Rivers – 721 6th Avenue, Suite B, Three Rivers, MI. 269-273-9782;
Three Rivers Health Family Care White Pigeon – 119 S. Kalamazoo St., White Pigeon, MI. 269-483-7624;
Three Rivers Health Internal Medicine – 711 S. Health Parkway, Three Rivers, MI. 269- 273-8557;
Tobacco Free Kids – http://www.tobaccofreekids.org/;
Tobacco Free Michigan – Lansing, MI 517-827-0020;
Try to Stop – http://makesmokinghistory.org/; and
Way2Quit – http://www.way2quit.com/. 9. DIABETES at national average but often a comorbidity for other conditions; impacts 11% of the population; DIABETIC SCREENING not a serious concern (Listed as choice #5 in the need determination survey considered by the Local Experts). Problem Statement: Diabetic education and treatment resources should increase. Local resources include the following:
American Diabetes Association, Michigan Office – 1550 East Beltline Ave SE, Grand Rapids, Kent, MI 49506, 616- 458-9341;
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American Heart Association, West Michigan – Regional Office – 3940 Peninsular Drive SE Suite 180, Grand Rapids, MI 49546, 616-285-1888;
Borgess Medical Center – 1722 Shaffer Street, Suite 3, Kalamazoo, MI 49048, (269) 226- 8321;
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Bronson Methodist Hospital – 820 John Street, Ste 104, Kalamazoo, MI 49001, (269) 341- 8585;
Centers for Disease Control and Prevention – http://www.ndep.nih.gov/;
Diabetes Partners in Action Coalition (DPAC) – Lansing, MI, http://www.dpacmi.org/;
Diabetes Support Group – Sturgis location. 269-659-4358;
Diabetes Support Group – Three Rivers location. 269-273-9778;
Michigan Department of Community Health, Diabetes and Other Chronic Diseases Section – Washington Square Bldg, P.O. Box 30195, Lansing, MI 48909, 517-335-9892;
National Diabetes Education Program – http://www.ndep.nih.gov/;
National Kidney Foundation of Michigan – 260 Leonard NW, Ste. 260, Grand Rapids, MI 49504, 616-458-9520;
St. Joseph County Commission On Aging – 103 S Douglas Avenue, Three Rivers, MI 49093, 269-279-8083;
Sturgis Hospital Diabetes Education- 600 South Lakeview Sturgis, MI 49091, 269-659- 4358;
Sturgis Senior Center- 304 North Jefferson Street Sturgis, MI 49091, 269-651-8417;
Three Rivers Health – 701 S. Health Parkway, Three Rivers, MI 49093, 269-273-9778; and
Three Rivers Health Endocrinology – 721 S. Health Parkway, Three Rivers, MI. 269-273- 9650. 10. CORONARY HEART DISEASE is leading cause of death; values worse than peers and national average, but below state average as rate of death; SCREENING inadequate (Listed as choice #4 in the need determination survey considered by the Local Experts) Problem Statement: The number of heart related deaths needs to decline and diagnostic resources need to increase. Local resources include the following:
Alliance Cardiovascular – 711 S Health Pkwy, Three Rivers, MI 49093, 800-875-8700;
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American Diabetes Association, Michigan Office – 1550 East Beltline Ave SE, Grand Rapids, Kent, MI 49506, 616- 458-9341;
American Heart Association, West Michigan – Regional Office – 3940 Peninsular Drive SE Suite 180, Grand Rapids, MI 49546, 616-285-1888;
American Red Cross of Greater Kalamazoo Area – 5460 Venture Court, Kalamazoo, MI 49009, 269-353-6180;
Borgess Medical Center – 1722 Shaffer Street, Suite 3, Kalamazoo, MI 49048, 269-226- 8321;
Borgess Cardiology Group – 1711 Shaffer St., Suite 232, Kalamazoo, MI. 269-226-5050;
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Bronson Methodist Hospital – 820 John Street, Ste 104, Kalamazoo, MI 49001, 269- 341- 8585;
Burke, David W, MD (Cardiology) – Heart Center for Excellence, 1772 Shaffer Street, Suite 1, Kalamazoo, MI 49048, 800-632-7737 or 269-381-3963;
Cardiology Care – 1535 Gull Rd., Suite 110, Kalamazoo, MI. 269-276-0800;
Centers for Disease Control and Prevention – http://www.cdc.gov/heartdisease/;
Gustafson, J. Gary, MD (Cardiology) – Sturgis Hospital Specialty Clinic, 916 Myrtle Avenue, Sturgis, MI, 49091, 269-651-7824;
Heart Center for Excellence – 1722 Shaffer St., Kalamazoo, MI. 269-381-3963;
King, Anthony, MD (Cardiology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview Ave. Sturgis, MI, 49091, 269-659-4382;
Michigan Department of Community Health, Cardiovascular Health, Nutrition and Physical Activity Section – 109 W. Michigan Ave., P.O. Box 30195, Lansing, Michigan 48909, 517-335-8180;
Rahman, Abidur, MD (Vascular Surgery) – Sturgis Hospital Specialty Clinic, 916 Myrtle Ave., Sturgis, MI 49091, 269-651-7824;
St. Joseph County Commission On Aging – 103 S Douglas Avenue, Three Rivers, MI 49093, 269-279-8083;
Sturgis Hospital – 600 South Lakeview Sturgis, MI 49091, 269-659-4358;
Sturgis Senior Center – 304 North Jefferson Street Sturgis, MI 49091, 269-651-8417;
Three Rivers Health Specialty Clinic – 711 S. Health Parkway, Three Rivers, MI. 269- 273-9691;
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Williams, Alicia, DO (Cardiology) – Heart Center for Excellence, 1772 Shaffer Street, Suite 1, Kalamazoo, MI 49048, 800-632-7737 or 269-381-3963. Definitions of Low Priority Needs Listed in Highest to Lowest Rank Order of Need 11. SUICIDE worse than peers and national average (Listed as choice #21 in the need determination survey considered by the Local Experts). Problem Statement: The number of suicide deaths needs to decline. Local resources include the following:
Amidson, Donald, Psychology – 909 E. Chicago, Sturgis, MI 49091, 269-651-9579;
Borgess Health – 1521 Gull Road, Kalamazoo, MI 49048, 269-266-7000;
Bronson Lakeview Hospital – 408 Hazen Street, Paw Paw, MI 49079, 269-657-3141;
Catholic Family Services – 1819 Gull Road, Kalamazoo, MI 49048, 800-873-8336 or 269- 381-9800;
Centers for Disease Control and Prevention ww.cdc.gov/ViolencePrevention/suicide/index.html;
Community Healing Center – 203 Williams Street Sturgis, MI 49091, 269-6514-1212;
Community Health Center of Branch County – 274 E. Chicago, Coldwater, MI 49036, 517-279-5400;
Community Mental Health – 677 W. Main St., #A, Centreville, MI. 269-467-1000;
Community Mental Health and Substance Abuse Services – 307 W Chicago Road Sturgis, MI 49091, 269-467-1000;
CrisisChat.org – http://www.crisischat.org/;
Counseling and Psychological Services – 30 North Main Street, Three Rivers, MI. 269- 278-2003;
Domestic and Sexual Abuse Services – 197 East Michigan Ave., Three Rivers, MI 49093, 269-273-6154 or 800-828-2023;
Family Counseling Services – 338 Fisher St., Centreville, MI. 269-467-4270;
Gryphon Place – 1104 South Westnedge Avenue Kalamazoo, MI 49008, 269-381-1510;
Horizons of Michigan – 401 Howard St, Kalamazoo, MI 49001, 269-383-9055;
Jade’s Hope, Inc.– 1202 E. Chicago Road, Sturgis, MI 49091, 269-319-0204;
National Hopeline Network – 1-800-SUICIDE (800-784-2433);
National Suicide Prevention Lifeline – 1-800-273-8255;
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Oakridge Counseling Center – 497 East Columbia Battle Creek, MI, 269-963-7135;
Perra, Robert, Psychology – 103 S. Fourth Street, Sturgis, MI 49091, 269-651-3902;
Pinerest Christian Mental Health Services – 37, 68th Street, Grand Rapids, MI 49501 616-455-5000;
Postpartum Depression – 1-800-773-6667;
Pregnancy Helpline – 172 E. Michigan Ave., Three Rivers, MI 49093,269-278-2211;
Psychological Consultants of Michigan, P.C.- 151 North Avenue Battle Creek, MI 49017, 269-968-2811;
Senior Diagnostic Center of South Central Michigan – 3630 Capital Avenue Southwest, Battle Creek, MI 49015, 269-441-1136;
Shaeffer, Sara Sue, Psychology – 909 E. Chicago, Sturgis, MI 49091, 269-651-9579;
Summit Pointe – 140 West Michigan, Ave., Battle Creek, MI 49017, 800-632-5449 or 269- 966-1460;
Transitions Wellness Center – 1519 N. Main St., #C, Three Rivers, MI. 269-273-2024;
Ulifeline – Counseling Centers and Crisis Lines for Your College or University – http://www.ulifeline.org/;
Youth America Hotline – Counseling for Teens by Teens – 1-877-youthline or 1-877-968- 8454; and
Veterans Crisis Line (Suicide Hotline ) – 1-800-273-8255. 12. PALLIATIVE CARE programs do not exist in County but three HOSPICE programs are available (Listed as choice #13 in the need determination survey considered by the Local Experts). Problem Statement: Palliative care services should exist in the County. Local resources include the following:
American Academy of Hospice and Palliative Medicine – http://www.aahpm.org/;
Area Agency on Aging – 1110 Hill Street Three Rivers, MI 49093, 517-278-2538;
Heartland Hospice Services – 8075 Creekside Dr #120, Portage, MI 49024, 269- 312- 7146;
Hospice Care of Southwest Michigan – 222 N Kalamazoo Mall, Kalamazoo, MI 49007 (269) 345-0273;
Home Health Care and Hospice – Sturgis, 800-891-1332;
Michigan Hospice and Palliative Care Organization – 12800 Escanaba Drive, Suite E, DeWitt, MI, 517-866-6667;
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Michigan Nurses Association – 2310 Jolly Oak Road, Okemos, MI 48864, 517-349-5640;
National Hospice and Palliative Care Organization – http://www.nhpco.org;
Sturgis Hospital – 916 Myrtle Sturgis, MI 49091, 269-651-7824; and
Three Rivers Health Homecare and Hospice – 633 S. Erie St., Three Rivers, MI. 269- 278-6108. 13. EXCESS DRINKING not a concern from statistics, but public comments present an adult and adolescent concern (Listed as choice #6 in the need determination survey considered by the Local Experts). Problem Statement: The number of individuals involved in excessive drinking of alcoholic beverages needs to decline. Local resources include the following:
Alcoholics Anonymous Hotline – 269-467-1107;
Al-Anon – St. John Episcopal Church, 110 S. Clay, Sturgis, MI, 49091; First Presbyterian Church, 320 N. Main Street, Three Rivers, MI, 49093;
Centers for Disease Control and Prevention – http://www.cdc.gov/alcohol/;
Community Healing Center – 203 Williams Street Sturgis, MI 49091, 269-6514-1212;
Community Health Center of Branch County – 274 E. Chicago, Coldwater, MI 49036;
Community Mental Health and Substance Abuse Services – 307 W Chicago Road Sturgis, MI 49091, 269-467-1000;
Kalamazoo Community Mental Health & Substance Abuse Services Regional Coordinating Agency – 418 W. Kalamazoo Ave., Kalamazoo, MI 49007, 269-553-8000;
MADD – MICHIGAN STATE OFFICE, 625 E. Big Beaver, Suite 200, Troy, MI 48083, 248-528-1745;
March of Dimes (FAS) – 1930 West Milham Rd., Suite A, Kalamazoo, MI, 49024, 269- 343-5586;
Michigan Department of Community Health, Bureau of Substance Abuse and Addiction Services – 320 S. Walnut, Lansing, MI 48913, 48933, 517-373-4700; and
Substance Abuse and Mental Health Services Administration – http://www.samhsa.gov/. 14. STROKE deaths exceed Michigan average; somewhat a concern as exceeds national average (Listed as choice #20 in the need determination survey considered by the Local Experts)
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Problem Statement: The number of local residents having strokes should decline. Local resources include the following:
Alliance Cardiovascular – 711 S Health Pkwy, Three Rivers, MI 49093, (800) 875-8700;
American Diabetes Association, Michigan Office – 1550 East Beltline Ave SE, Grand Rapids, Kent, MI 49506, 616- 458-9341;
American Red Cross of Greater Kalamazoo Area – 5460 Venture Court, Kalamazoo, MI 49009, 269-353-6180;
American Stroke Association – A Division of the American Heart Association – West Michigan – Regional Office – 3940 Peninsular Drive SE Suite 180, Grand Rapids, MI 49546, 616-285-1888;
Borgess Medical Center (Primary Stroke Hospital) – 1722 Shaffer Street, Suite 3, Kalamazoo, MI 49048, 269-226-8321;
The Brain Attack Coalition – http://www.stroke-site.org/contactus/contactus.html;
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Bronson Methodist Hospital (Primary Stroke Hospital) – 820 John Street, Ste 104, Kalamazoo, MI 49001, 269-341-8585;
Centers for Disease Control and Prevention, National Heart and Stroke Prevention – http://www.cdc.gov/dhdsp/programs/nhdsp_program/mi.htm;
Lakeland Health Care Niles (Primary Stroke Hospital)- 2 N Saint Joseph Ave, Niles, MI 49120, 269- 687-1419;
Michigan Department of Community Health, Cardiovascular Health, Nutrition and Physical Activity Section – 109 W. Michigan Ave., P.O. Box 30195, Lansing, Michigan 48909, 517-335-8180;
Michigan Stroke Network – 44405 Woodward Avenue, Pontiac, MI 48341-5023, 866-522- 8MSN (8676);
Michigan Stroke Initiative – http://www.michiganstrokeinitiative.org/default.asp;
National Stroke Association – http://www.stroke.org/site/PageNavigator/HOME;
National Institute of Neurological Disorders and Stroke – http://www.ninds.nih.gov/disorders/disorder_index.htm.
Physicians:
o Chebes, Andrzej and Anna, MD – Internal Medicine – 1021 Hill Street, Suite 300, Three Rivers, MI. 269-858-3024;
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o Dunne, Thomas, MD (Neurology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Greene, Glendora, MD – Family Medicine – 850 S. Health Parkway, Three Rivers, MI 269-279-5240;
o Krinock, Mark, MD (Neurosurgery) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Mahmood, Fayyaz, MD (Neurology) – Three Rivers Health Specialty Clinic, 711 S. Health Parkway, Medical Office Building, Three River, MI 49093, 269-659-4382;
o Patel, Vera, MD – 1021 Hill Street, Three Rivers, MI 269-273-8511;
o Singh, Emily-Rae, MD – Family Medicine – 721 S. Health Parkway, Three Rivers, MI. 269-273-3700; and
o ProMed – 1241 West Broadway, Three Rivers, MI. 269-273-9539.
St. Joseph County Commission On Aging – 103 S Douglas Avenue, Three Rivers, MI 49093, 269-279-8083;
Sturgis Hospital – 600 South Lakeview Sturgis, MI 49091, 269-659-4358;
Sturgis Senior Center- 304 North Jefferson Street Sturgis, MI 49091, 269-651-8417;
Three Rivers Family Care Centreville – 677 E. Main, Centreville, MI. 269-467-9011;
Three Rivers Health Family Care Three Rivers – 721 6th Avenue, Suite B, Three Rivers, MI. 269-273-9782;
Three Rivers Health Family Care White Pigeon – 119 S. Kalamazoo St., White Pigeon, MI. 269-483-7624; and
Three Rivers Health Internal Medicine – 711 S. Health Parkway, Three Rivers, MI. 269- 273-8557. 15. SEXUALLY TRANSMITTED DISEASE not a concern (Listed as choice #17 in the need determination survey considered by the Local Experts). Problem Statement: The number of residents acquiring sexually transmitted diseases needs to decrease. Local resources include the following:
American Social Health Association – http://www.ashastd.org/;
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Centers for Disease Control – http://www.cdc.gov/sexualhealth/;
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Community AIDS Resource and Education Services of Southwest Michigan – 629 Pioneer Street Kalamazoo, MI 49008, 269-381-2437;
Family Health Center Portage (FQHC) – 325 E. Centre Street, Portage, MI 49002, 269- 488-7342;
Family Health Center South (FQHC) – 2030 Portage Road, Kalamazoo, MI 49001, 269- 349-0888;
Michigan AIDS Hotline – 2751 East Jefferson Suite 301 Detroit, MI 48207, 800- 872- 2437;
National Institute of Allergy and Infectious Diseases – http://health.nih.gov/topic/SexuallyTransmittedDiseases;
National Prevention Information Network – http://www.cdcnpin.org/;
Physicians:
o Cassopolis Family Clinic (FQHC) – 109 School Street, Cassopolis, MI, 49031, 269- 445-3874;
o Chebes, Andrzej and Anna, MD – Internal Medicine – 1021 Hill Street, Suite 300, Three Rivers, MI. 269-858-3024;
o Greene, Glendora, MD – Family Medicine – 850 S. Health Parkway, Three Rivers, MI 269-279-5240;
o Patel, Veera, MD – 1021 Hill Street, Three Rivers, MI 269-273-8511;
o Singh, Emily-Rae, MD – Family Medicine – 721 S. Health Parkway, Three Rivers, MI. 269-273-3700;
o Three Rivers Health Women Services – 711 S. Health Parkway, Suite 1, Three Rivers, MI. 269-273-6400;
o Three Rivers Health Family Care Centreville – 677 E. Main, Centreville, MI. 269- 467-9011;
o Three Rivers Health Family Care Three Rivers – 721 6th Avenue, Suite B, Three Rivers, MI. 269-273-9782;
o Three Rivers Health Family Care White Pigeon – 119 S. Kalamazoo St., White Pigeon, MI. 269-483-7624; and
o Three Rivers Health Internal Medicine – 711 S. Health Parkway, Three Rivers, MI. 269-273-8557.
Planned Parenthood – 800-559-9093;
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Planned Parenthood of South Central Michigan – 4201 West Michigan Ave., Kalamazoo, MI, 49006, 269-372-1200;
ProMed – 1241 West Broadway, Three Rivers, MI. 269-273-9539;
Riverside Clinic – 2007 East Michigan Ave., Three Rivers MI 49093, 269-273-8723; and
Sturgis Medical Group – 1717 E. Chicago, Suite 2, Sturgis, MI 49091, 269-651-1471. 16. HIGH BLOOD PRESSURE impacts 28% of the population; a moderate comorbidity in stroke and heart disease conditions (Listed as choice #8 in the need determination survey considered by the Local Experts). Problem Statement: More residents need to be aware of their blood pressure and take active efforts to manage it. Local resources include the following:
Alliance Cardiovascular – 711 S Health Pkwy, Three Rivers, MI 49093, (800) 875-8700;
American Diabetes Association, Michigan Office – 1550 East Beltline Ave SE, Grand Rapids, Kent, MI 49506, 616- 458-9341;
American Red Cross of Greater Kalamazoo Area – 5460 Venture Court, Kalamazoo, MI 49009, 269-353-6180;
American Stroke Association – A Division of the American Heart Association – West Michigan – Regional Office – 3940 Peninsular Drive SE Suite 180, Grand Rapids, MI 49546, 616-285-1888;
Borgess Medical Center (Primary Stroke Hospital) – 1722 Shaffer Street, Suite 3, Kalamazoo, MI 49048, 269-226-8321;
The Brain Attack Coalition – http://www.stroke-site.org/contactus/contactus.html;
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Bronson Methodist Hospital (Primary Stroke Hospital) – 820 John Street, Ste 104, Kalamazoo, MI 49001, 269-341-8585;
Centers for Disease Control and Prevention, National Heart and Stroke Prevention – http://www.cdc.gov/dhdsp/programs/nhdsp_program/mi.htm;
Lakeland Health Care Niles (Primary Stroke Hospital)- 2 N Saint Joseph Ave, Niles, MI 49120, 269- 687-1419;
Michigan Department of Community Health, Cardiovascular Health, Nutrition and Physical Activity Section – 109 W. Michigan Ave., P.O. Box 30195, Lansing, Michigan 48909, 517-335-8180;
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Michigan Stroke Network – 44405 Woodward Avenue, Pontiac, MI 48341-5023, 866-522- 8MSN (8676);
Michigan Stroke Initiative – http://www.michiganstrokeinitiative.org/default.asp;
National Stroke Association – http://www.stroke.org/site/PageNavigator/HOME;
National Institute of Neurological Disorders and Stroke – http://www.ninds.nih.gov/disorders/disorder_index.htm;
Physicians:
o Chebes, Andrzej and Anna, MD – Internal Medicine – 1021 Hill Street, Suite 300, Three Rivers, MI. 269-858-3024;
o Dunne, Thomas, MD (Neurology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Greene, Glendora, MD – Family Medicine – 850 S. Health Parkway, Three Rivers, MI 269-279-5240;
o Krinock, Mark, MD (Neurosurgery) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Mahmood, Fayyaz, MD (Neurology) – Three Rivers Health Specialty Clinic, 711 S. Health Parkway, Medical Office Building, Three River, MI 49093, 269-659-4382;
o Patel, Veera, MD – 1021 Hill Street, Three Rivers, MI 269-273-8511; and
o Singh, Emily-Rae, MD – Family Medicine – 721 S. Health Parkway, Three Rivers, MI. 269-273-3700.
ProMed – 1241 West Broadway, Three Rivers, MI. 269-273-9539;
St. Joseph County Commission On Aging – 103 S Douglas Avenue, Three Rivers, MI 49093, 269-279-8083;
Sturgis Hospital – 600 South Lakeview Sturgis, MI 49091, 269-659-4358;
Sturgis Senior Center – 304 North Jefferson Street Sturgis, MI 49091, 269-651-8417;
Three Rivers Health Family Care Centreville – 677 E. Main, Centreville, MI. 269-467- 9011;
Three Rivers Health Family Care Three Rivers – 721 6th Avenue, Suite B, Three Rivers, MI. 269-273-9782;
Three Rivers Health Family Care White Pigeon – 119 S. Kalamazoo St., White Pigeon, MI. 269-483-7624; and
Three Rivers Health Internal Medicine – 711 S. Health Parkway, Three Rivers, MI. 269- 273-8557.
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17. MOTOR VEHICLE INJURY almost double state rate; worse than peers and national average (Listed as choice #11 in the need determination survey considered by the Local Experts). Problem Statement: A determination is needed to identify and implement actions to reduce the number of motor vehicle injuries. Local resources include the following:
Borgess Medical Center – 1722 Shaffer Street, Suite 3, Kalamazoo, MI 49048, 269-226- 8321;
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Bronson Methodist Hospital – 820 John Street, Ste 104, Kalamazoo, MI 49001, 269-
341-8585;
Centers for Disease Control and Prevention – http://www.cdc.gov/niosh/topics/motorvehicle/;
Centreville Fire Dept – 212 W Main St, Centreville, MI 49032, 269-467-4215;
Centreville Police Dept – Centreville, MI 49032, 269-467-4195;
Child Death Review Team – Human Services Commission – 692 E. Main Street, Centreville, MI 49032, 269-467-1223;
Colon Fire Station – 126 S Swan St, Colon, MI 49040, 269-432-3211;
Colon Police Dept – 127 E State St, Colon, MI 49040, 269- 432-2182;
Community Mental Health and Substance Abuse Services – 677 East Main Street, Centreville, MI, 800-622-3967 or 269 -467-1000;
Constantine Fire Department – 180 W Water St, Constantine, MI 49042, 269- 435-5325;
Constantine Village Government Police Department – 270 E Water St, Constantine, MI 49042, 269-435-4355;
Life Care Ambulance Svc – Three Rivers, MI 49093 , 269-278-2400;
Lockport, Fabius and Park Twps Fire Dept – 15571 Millard Rd, Three Rivers, MI 49093, 269-278-1104;
Mendon Fire Dept – 303 W State St, Mendon, MI 49072 , 269-467-4195;
Mendon Village Office – 206 W Main St, Mendon, MI 49072, 269-496-4395; and
Michigan Department of Community Health, Injury & Violence Prevention Section –P.O. Box 30195, Lansing, Michigan 48909, 517-335-9518;
National Highway Traffic Safety Administration (NHTSA) – http://www.nhtsa.gov/;
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Office of Highway Safety Planning (MSP) – 333 South Grand Avenue, P.O. Box 30634 Lansing , Michigan 48909, 517-241-2500;
Safe Kids Coalition of Branch-Hillsdale-St. Joseph County – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Schoolcraft Fire Dept – N Grand St, Schoolcraft, MI 49087, 269-679-4756;
Schoolcraft Police Dept – 154 W Eliza St, Schoolcraft, MI 49087, 269-679-5600;
St. Joseph Emergency Svc – 650 E Main St, Centreville, MI 49032, 269-467-6201;
St. Joseph Sheriff Dept – 650 E Main St, Centreville, MI 49032, 269-467-9045;
Sturgis Fire Dept – 124 N Nottawa St, Sturgis, MI 49091, 269-659-7257;
Sturgis City Government – 122 N Nottawa St, Sturgis, MI 49091, 269-651-3231;
Sturgis Hospital – 600 South Lakeview Sturgis, MI 49091, 269-659-4358;
Three Rivers Fire Dept – 333 W Michigan Ave, Three Rivers, MI 49093, 269-278-3755;
Three Rivers Police Dept – 333 W Michigan Ave, Three Rivers, MI 49093, 269-278-1235;
Three Rivers Health – 701 S. Health Parkway, Three Rivers, MI 49093, 269-273-9778;
Tri-Township Fire Department – 31481 E Lafayette Rd, Sturgis, MI 49091, 269-651- 2646;
White Pigeon Fire Dept – 16975 US Highway 12, White Pigeon, MI 49099, 269-483-9414; and
White Pigeon Police Dept – 118 S Kalamazoo St, White Pigeon, MI 49099, 269-483-7109. 18. PREMATURE DEATHS is increasing but may result from other factors; LIFE EXPECTANCY increased (Listed as choice #15 in the need determination survey considered by the Local Experts). Problem Statement: A determination is needed to identify and implement actions to reduce the number of residents dying prior to age 75. Local resources include the following:
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Child Death Review Team – Human Services Commission – 692 E. Main Street, Centreville, MI 49032, 269-467-1223;
Michigan Department of Community Health – Behavioral Risk Factor Surveillance System – http://michigan.gov/mdch/0,1607,7-132-2945_5104_5279_39424---,00.html;
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Michigan Department of Community Health – Vital Records – http://michigan.gov/mdch/0,4612,7-132-2944_4669---,00.html;
Physicians:
o Chebes, Andrzej and Anna, MD – Internal Medicine – 1021 Hill Street, Suite 300, Three Rivers, MI. 269-858-3024;
o Dunne, Thomas, MD (Neurology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Greene, Glendora, MD – Family Medicine – 850 S. Health Parkway, Three Rivers, MI 269-279-5240;
o Krinock, Mark, MD (Neurosurgery) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Mahmood, Fayyaz, MD (Neurology) – Three Rivers Health Specialty Clinic, 711 S. Health Parkway, Medical Office Building, Three River, MI 49093, 269-659-4382;
o Patel, Veera, MD – 1021 Hill Street, Three Rivers, MI 269-273-8511; and
o Singh, Emily-Rae, MD – Family Medicine – 721 S. Health Parkway, Three Rivers, MI. 269-273-3700.
ProMed – 1241 West Broadway, Three Rivers, MI. 269-273-9539;
Three Rivers Health Family Care Centreville – 677 E. Main, Centreville, MI. 269-467- 9011;
Three Rivers Health Family Care Three Rivers – 721 6th Avenue, Suite B, Three Rivers, MI. 269-273-9782;
Three Rivers Health Family Care White Pigeon – 119 S. Kalamazoo St., White Pigeon, MI. 269-483-7624; and
Three Rivers Health Internal Medicine – 711 S. Health Parkway, Three Rivers, MI. 269- 273-8557. 19. SELF DESCRIBED HEALTH STATUS 24% of the population describe their status as “Fair” or “Poor” (Listed as choice #18 in the need determination survey considered by the Local Experts). Problem Statement: A determination is needed to identify and implement actions to reduce the number of residents perceiving their health status to be less than good. Local resources include the following:
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
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Child Death Review Team – Human Services Commission – 692 E. Main Street, Centreville, MI 49032, 269-467-1223;
Michigan Department of Community Health – Behavioral Risk Factor Surveillance System – http://michigan.gov/mdch/0,1607,7-132-2945_5104_5279_39424---,00.html;
Michigan Department of Community Health – Vital Records - http://michigan.gov/mdch/0,4612,7-132-2944_4669---,00.html;
Physicians:
o Chebes, Andrzej and Anna, MD – Internal Medicine – 1021 Hill Street, Suite 300, Three Rivers, MI. 269-858-3024;
o Dunne, Thomas, MD (Neurology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Greene, Glendora, MD – Family Medicine – 850 S. Health Parkway, Three Rivers, MI 269-279-5240;
o Krinock, Mark, MD (Neurosurgery) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Mahmood, Fayyaz, MD (Neurology) – Three Rivers Health Specialty Clinic, 711 S. Health Parkway, Medical Office Building, Three River, MI 49093, 269-659-4382;
o Patel, Veera, MD – 1021 Hill Street, Three Rivers, MI 269-273-8511; and
o Singh, Emily-Rae, MD – Family Medicine – 721 S. Health Parkway, Three Rivers, MI. 269-273-3700.
ProMed – 1241 West Broadway, Three Rivers, MI. 269-273-9539;
Three Rivers Health Family Care Centreville – 677 E. Main, Centreville, MI. 269-467- 9011;
Three Rivers Health Family Care Three Rivers – 721 6th Avenue, Suite B, Three Rivers, MI. 269-273-9782;
Three Rivers Health Family Care White Pigeon – 119 S. Kalamazoo St., White Pigeon, MI. 269-483-7624; and
Three Rivers Health Internal Medicine – 711 S. Health Parkway, Three Rivers, MI. 269- 273-8557. 20. LOW BACK PAIN impacts 29% of residents (Listed as choice #9 in the need determination survey considered by the Local Experts).
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Problem Statement: A determination is needed to identify and implement actions to improve the back health of area residents. Local resources include the following:
Ccn (Chiropractor Services) – 10044 Water St, Three Rivers, MI 49093, 269-244-1294;
Craniosacral Therapy Center (Massage/Physical Therapy) – 124 S Kalamazoo St, White Pigeon, MI 49099, 269-483-9305;
Cupp Sharon K (Massage Therapy) – 55487 S Thompson Ln, Three Rivers, MI 49093, 269-273-1972;
Deboard Thimothy DC (Chiropractor Services) – 204 E West St, Sturgis, MI 49091, 269- 651-9448;
Dr John R Schroer Chiropractic (Chiropractor Services) – 59738 Canoe Rd, Three Rivers, MI 49093, 269-244-8680; 182 S Washington St, Constantine, MI 49042, 269-435- 2785;
Fourth Street Chiropractic (Chiropractor Services) – 106 S 4th St, Sturgis, MI 49091, 269-651-6421;
Golden Touch Salon (Massage Therapy) – 1108 W. Michigan Suite 2,3 and 4, Three Rivers, MI 49093, 269-278-8234;
Headlines Hair Designs (Massage Therapy) – 204 E Chicago Rd, Sturgis, MI 49091, 269-659-8559;
Health Thru Massage (Massage Therapy) – 208 W Chicago Rd # 8A, Sturgis, MI 49091, 269- 651-3776;
Heartland Health Care Center – Three Rivers – 517 S Erie St, Three Rivers, MI 49093, 269- 273-8661;
Higley Chiropractic Center (Chiropractor Services) – 58882 S US Highway 131, Three Rivers, MI 49093, 269-279-5703;
I Med Physical Therapy (Physical Therapy) – 16587 Enterprise Dr, Three Rivers, MI 49093, 269-279-6700;
Kotcher Chiropractic Office – 106 S 4th St, Sturgis, MI 49091, 269-651-6421;
Mais Chiropractic Clinic PC (Chiropractor Services) – 115 S Grand St, Schoolcraft, MI 49087, 269-679-5530;
Manual of Arms Inc (Physical Therapy) – 51971 Buckhorn Rd, Three Rivers, MI 49093, 269-506-7809;
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Mc Leod Chiropractic Center (Chiropractor Services) – 1107 W Broadway St., Suite C, Three Rivers, MI 49093, 269-273-6712;
Medical Massage (Massage Therapy) – 414 W Michigan Ave, Three Rivers, MI 49093, 269-273-9207;
Muscle & Dematherapy Center (Massage Therapy) – 916 Myrtle St, Sturgis, MI 49091, 269-659-2699;
Muscle Therapy & Acupuncture (Massage Therapy) – 16648 US Highway 12, White Pigeon, MI 49099 269- 483-7251;
R J Medical Massage (Massage Therapy) – 414 W Michigan Ave, Three Rivers, MI 49093, 269- 273-9207;
Physicians:
o Chebes, Andrzej and Anna, MD – Internal Medicine – 1021 Hill Street, Suite 300, Three Rivers, MI. 269-858-3024;
o Dunne, Thomas, MD (Neurology) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Greene, Glendora, MD – Family Medicine – 850 S. Health Parkway, Three Rivers, MI 269-279-5240;
o Krinock, Mark, MD (Neurosurgery) – Sturgis Hospital Specialty Clinic, 600 S. Lakeview, Sturgis, MI 49091, 269-659-4382;
o Mahmood, Fayyaz, MD (Neurology) – Three Rivers Health Specialty Clinic, 711 S. Health Parkway, Medical Office Building, Three River, MI 49093, 269-659-4382;
o Patel, Veera, MD – 1021 Hill Street, Three Rivers, MI 269-273-8511; and
o Singh, Emily-Rae, MD – Family Medicine – 721 S. Health Parkway, Three Rivers, MI. 269-273-3700.
ProMed – 1241 West Broadway, Three Rivers, MI. 269-273-9539;
Sturgis Hospital Physical Therapy (Physical Therapy) – 1717 E Chicago Rd # 1, Sturgis, MI 49091, 269-659-4468;
Three Rivers Health Physical Therapy Services (Physical Therapy) – 501 S Health Pkwy, Three Rivers, MI 49093, 269- 273-9682;
Three Rivers Health Family Care Centreville – 677 E. Main, Centreville, MI. 269-467- 9011;
Three Rivers Health Family Care Three Rivers – 721 6th Avenue, Suite B, Three Rivers, MI. 269-273-9782;
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Three Rivers Health Family Care White Pigeon – 119 S. Kalamazoo St., White Pigeon, MI. 269-483-7624;
Three Rivers Health Internal Medicine – 711 S. Health Parkway, Three Rivers, MI. 269- 273-8557; and
Walworth Thomas M DC (Chiropractor Services) – 1101 E Chicago Rd, Sturgis, MI 49091, 269- 651-7814. 21. PHYSICAL ENVIRONMENTAL FACTORS do not appear a concern as it has a positive influence on health status (Listed as choice #14 in the need determination survey considered by the Local Experts). Problem Statement: A determination is needed to identify and implement actions to continue to improve the local physical environment. Local resources include the following:
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Centers for Disease Control and Prevention – http://www.cdc.gov/Environmental/;
Michigan Department of Agriculture & Rural Development – Lansing, MI, 1-800-292- 3939;
Michigan Department of Community Health – Division of Environmental Health – Lansing, MI, 517- 335-8350;
Michigan Department of Environmental Quality – Constitution Hall , 525 West Allegan Street, P.O. Box 30473, Lansing, MI 48909-7973, 517- 373-7917;
Michigan Department of Natural Resources – P.O. Box 30028, Lansing, MI 48909;
St. Joseph County Govt. – Land Resource Centre – St. Joseph County Annex I, 115 S. Dean St., Centreville MI, 49032, 269) 467-5576;
St. Joseph County Govt. – Parks and Recreation – 602 E. Main St., Centreville MI, 49032, 269-467-5519;
St. Joseph County Govt. – Planning Commission – 125 W. Main St., Centreville MI, 49032, 269-467-5500;
St. Joseph Emergency Svc – 650 E Main St, Centreville, MI 49032, 269-467-6201; and
U.S. Environmental Protection Agency – http://www.epa.gov/. 22. UNINTENTIONAL INJURY not a concern, rate better than peer and national norms (Listed as choice #22 in the need determination survey considered by the Local Experts) Problem Statement: A determination is needed to identify and implement action to
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reduce the number of unintentional injuries among area residents. Local resources include the following:
American Red Cross of Greater Kalamazoo Area – 5460 Venture Court, Kalamazoo, MI 49009, 269-353-6180;
Area Agency on Aging – 1110 Hill Street Three Rivers, MI 49093, 517-278-2538;
Blodgett Regional Poison Center – Augusta, MI 49012, 800-222-1222;
Borgess Medical Center – 1722 Shaffer Street, Suite 3, Kalamazoo, MI 49048, 269-226- 8321;
Branch-Hillsdale-St. Joseph Community Health Agency – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Bronson Methodist Hospital – 820 John Street, Ste 104, Kalamazoo, MI 49001, 269-341- 8585;
Centers for Disease Control and Prevention – http://www.cdc.gov/InjuryViolenceSafety/;
Centreville Fire Dept – 212 W Main St, Centreville, MI 49032, 269-467-4215;
Centreville Police Dept – Centreville, MI 49032, 269-467-4195;
Child Death Review Team – Human Services Commission – 692 E. Main Street, Centreville, MI 49032, 269-467-1223;
Colon Fire Station – 126 S Swan St, Colon, MI 49040, 269-432-3211;
Colon Police Dept – 127 E State St, Colon, MI 49040, 269- 432-2182;
Community Mental Health and Substance Abuse Services – 677 East Main Street, Centreville, MI, 800-622-3967 or 269 -467-1000;
Constantine Fire Department – 180 W Water St, Constantine, MI 49042, 269- 435-5325;
Constantine Village Government Police Department – 270 E Water St, Constantine, MI 49042, 269-435-4355;
Domestic and Sexual Abuse Services – 197 East Michigan Ave., Three Rivers, MI 49093, 269-273-6154 or 800-828-2023;
Jade’s Hope, Inc.– 1202 E. Chicago Road, Sturgis, MI 49091, 269-319-0204;
Life Care Ambulance Svc – Three Rivers, MI 49093 , 269-278-2400;
Lockport, Fabius and Park Twps Fire Dept – 15571 Millard Rd, Three Rivers, MI 49093, 269-278-1104;
Mendon Fire Department – 303 W State St, Mendon, MI 49072 , 269-467-4195;
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Mendon Village Office – 206 W Main St, Mendon, MI 49072, 269-496-4395;
Michigan Department of Community Health, Injury & Violence Prevention Section –P.O. Box 30195, Lansing, Michigan 48909, 517-335-9518;
Michigan Department of Human Services – 692 E. Main Street, Centreville, MI 49032, 269-467-1200;
Michigan Occupational Health and Safety Administration (MIOSHA) – P.O. Box 30643 7150 Harris Drive, Lansing, MI, 48909-8143, 800-866-4674;
National Institute of Occupational Safety and Health – http://www.cdc.gov/niosh/;
Occupational Safety and Health (OSHA) – http://www.osha.gov/;
Safe Kids Coalition of Branch-Hillsdale-St. Joseph County – 570 North Marshall Road Coldwater, MI 49036, 517-279-9561;
Schoolcraft Fire Dept – N Grand St, Schoolcraft, MI 49087, 269-679-4756;
Schoolcraft Police Dept – 154 W Eliza St, Schoolcraft, MI 49087, 269-679-5600;
St. Joseph County Council for the Prevention of Child Abuse/Neglect, Inc. – 17975 Centreville-Constantine Road, Constantine, MI 49042, 269-435-7288;
St. Joseph County Commission On Aging – 103 S Douglas Avenue, Three Rivers, MI 49093, 269-279-8083;
St. Joseph Emergency Svc – 650 E Main St, Centreville, MI 49032, 269-467-6201;
St. Joseph Sheriff Dept – 650 E Main St, Centreville, MI 49032, 269-467-9045 ;
Sturgis Fire Dept – 124 N Nottawa St, Sturgis, MI 49091, 269-659-7257;
Sturgis City Government – 122 N Nottawa St, Sturgis, MI 49091, 269-651-3231;
Sturgis Hospital – 600 South Lakeview Sturgis, MI 49091, 269-659-4358;
Sturgis Senior Center – 304 North Jefferson Street Sturgis, MI 49091, 269-651-8417;
Three Rivers Fire Dept – 333 W Michigan Ave, Three Rivers, MI 49093, 269-278-3755;
Three Rivers Police Dept – 333 W Michigan Ave, Three Rivers, MI 49093, 269-278-1235;
Three Rivers Health – 701 S. Health Parkway, Three Rivers, MI 49093, 269-273-9778;
Tri-Township Fire Department – 31481 E Lafayette Rd, Sturgis, MI 49091, 269-651- 2646;
White Pigeon Fire Dept – 16975 US Highway 12, White Pigeon, MI 49099, 269-483-9414; and
White Pigeon Police Dept – 118 S Kalamazoo St, White Pigeon, MI 49099, 269-483-7109.
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23. DENTAL CARE services are limited. Problem Statement: Additional dental services need to be available within St. Joseph County. Local Resources Available to Respond to This Need Include the Following: Michigan Community Dental Clinic – 269-273-3247. Overall Community Need Statement and Priority Ranking Score: High Priority Issues where Hospital has High Implementation Responsibility 1. Mental Health; 4. Obesity/Physical Inactivity; 6. Physician; 7. Cancer; 8. Smoking; and 9. Diabetes. Low Priority Issues where Hospital has High Implementation Responsibility 11. Suicide; 14. Stroke; 15. Sexually Transmitted Disease; 16. High Blood Pressure; 20. Low Back Pain; and 23. Dental Care. High Priority Issues where Hospital has Low Implementation Responsibility 2. Baby Deaths; 3. Health Insurance/Uninsured; 5. Births; and 10. Coronary Heart Disease. Low Priority Issues where Hospital has Low Implementation Responsibility 12. Palliative Care; 13. Drinking; 17. Motor Vehicle Deaths;
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18. Premature Deaths; 19. Self Describes Health Status; 21. Physical Environmental factors; and 22. Unintentional Injury.
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MANAGEMENT ACTION PLAN
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Management Action Plan
The following Management Action Plan (MAP) provides Hospital management with a standalone tool for operationalizing its response to the Community Health Needs it identified.22
22 Response to Schedule H (Form 990) Part V B 6 a and b
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Management Action Plan TRH Community Need Response to Needs Identified as HIGH PRIORITY and where TRH Holds HIGH RESPONSIBILITY Hospital Reference Fundamental Desired Other Resources to Issue to Address Hospital Role or Action Assigned Number Change Sought Apply or Seek Resources
([H] Has sole / primary responsibility to enact change; [L] Take leadership role to enact change; (what collaboration or other (assigned to whom; (end result and leading indicator(s) used [C] Coordinate actions primarily taken by actions are required by others; Priority (problem statement) budget; other resources to measure change) others; [A] Allocate resources to address need; what resource contributions / from Hospital) [E] Educational effort; [M] Monitor issue for commitments made by others) change; [O] Other role as specified)
There is a lack of available, affordable mental health and substance abuse Physician recruitment, 1 Mental Health services. Methamphetamine H,L,C,A service development - Community Mental health manufacture, use and bullying are $50,000 specific problems to resolve.
Problem Statement: Additional obesity Education program at School District, Community 4 Obesity reduction efforts, including an emphasis H,L,C,E schools on health eating, are needed. Mental Health
Diabetic Education 9 Diabetes Problem Statement: Diabetic education E,H,L,C,A Clinic, Endocrin Clinic - and treatment resources should increase. $21,000
Problem Statement: The number of local Establish a free smoke 8 Smoking H,L,A,E residents who smoke needs to decline. stop program - $10,000 Problem Statement: The availability of Physician Recruitment - 6 Physician physician services needs to better relate H,L,A $400,000 to needs.
Expand local access to Problem Statement: Oncology St Joseph patients, 7 Cancer diagnostic resources and treatment L,C,A,E West MI Cancer Center Dietary consultation, capability should be increased. screening - $10,000
NOTE: Leading indicator is an action which predicts problem change and is within the ability of the organization to enact NOTE: Hospital Role or Action may include multiple actions H, L, C, A, E or O but at least one must be specified. M actions are not appropriate for Needs with this priority
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TRH Community Need Response to Needs Identified as LOW PRIORITY and where TRH Holds HIGH RESPONSIBILITY Hospital Reference Fundamental Desired Other Resources to Issue to Address Hospital Role or Action Assigned Number Change Sought Apply or Seek Resources
([H] Has sole / primary responsibility to enact change; [L] Take leadership role to enact change; (what collaboration or other (assigned to whom; (end result and leading indicator(s) used [C] Coordinate actions primarily taken by actions are required by others; Priority (problem statement) budget; other resources to measure change) others; [A] Allocate resources to address need; what resource contributions / from Hospital) [E] Educational effort; [M] Monitor issue for commitments made by others) change; [O] Other role as specified)
Obtain certification and Problem Statement: The number of Diamond Healthcare,Community 11 Suicide C,A,E offer classes, Staff time suicide deaths needs to decline. Mental health and material - $10,000
Component of Problem Statement: The number of Women's Clinic 15 Sexually Transmitted Disease C,A,E Public Health residents acquiring sexually transmitted Services, Adolescent diseases needs to decrease. Clinic
Blood Pressure Problem Statement: The number of Screening, Community 14 Stroke local residents having strokes should C,A,E Borgess Program coordination Education, Cardiologist decline. recruitment - $50,000
Blood Pressure Problem Statement: More residents Screening, Community 16 High Blood Pressure need to be aware of their blood pressure C,A,E Borgess Program coordination Education, Cardiologist and taking active effort to manage it. recruitment
Problem Statement: A determination is needed to identify and implement 20 Low Back Pain L,C,A,E Occ Med, Pain Clinic Borgess Program coordination actions to improve the back health of area residents.
Problem Statement: Additional dental Space for indigent St.Joseph HSC, County Public 23 Dental Care services need to be available within St C,E dental care program Health Joseph County.
NOTE: Leading indicator is an action which predicts problem change and is within the ability of the organization to enact NOTE: Hospital Role or Action may include multiple actions H, L, C, A, E, M or O but at least one must be specified
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TRH Community Need Response to Needs Identified as HIGH PRIORITY and where TRH Holds LOW RESPONSIBILITY Hospital Reference Fundamental Desired Other Resources to Issue to Address Hospital Role or Action Assigned Number Change Sought Apply or Seek Resources
([H] Has sole / primary responsibility to enact change; [L] Take leadership role to enact change; (what collaboration or other (assigned to whom; (end result and leading indicator(s) used [C] Coordinate actions primarily taken by actions are required by others; Priority (problem statement) budget; other resources to measure change) others; [A] Allocate resources to address need; what resource contributions / from Hospital) [E] Educational effort; [M] Monitor issue for commitments made by others) change; [O] Other role as specified)
Problem Statement: The number of Adolescent Clinic, 2 Baby Deaths L,C,A,E Health Services Commission infant deaths needs to decline. Women's Services
Problem Statement: Efforts should be taken to remove actual and perceive financial barriers limiting access to Medicaid and other 3 Insurance L,C,A,E State of Michigan medical and health services, especially as program eligability it impacts Spanish language speaking residents.
Problem Statement: An increase is needed in the provision of pregnancy Adolescent Clinic, 5 Births C,E,A Schools, HSC related services, education and Women's Services treatment.
Cardiac rehab, Cardilogy Problem Statement: The number of and Pulmonology Borgess, Bronson, HSC, School 10 Coronary Heart Disease heart related deaths needs to decline and L,C,A,E services, Health Track District diagnostic resources need to increase. (fitness program), Three Rivers Corp Fit
NOTE: Leading indicator is an action which predicts problem change and is within the ability of the organization to enact NOTE: Hospital Role or Action may include multiple actions L, C, A, E, M or O but at least one must be specified. H actions are not appropriate for need with this priority.
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TRH Community Need Response to Needs Identified as LOW PRIORITY and where TRH Holds LOW RESPONSIBILITY Hospital Reference Other Resources to Issue to Address Fundamental Desired Change Sought Hospital Role or Action Assigned Number Apply or Seek Resources
([H] Has sole / primary responsibility to enact (what collaboration or other change; [L] Take leadership role to enact change; (assigned to actions are required by [C] Coordinate actions primarily taken by whom; budget; others; what resource Priority (problem statement) (end result and leading indicator(s) used to measure change) others; [A] Allocate resources to address need; other resources contributions / [E] Educational effort; [M] Monitor issue for from Hospital) commitments made by change; [O] Other role as specified) others)
Problem Statement: Palliative care services should exist in the 12 Palliative Care M County.
Problem Statement: The number of individuals involved in 13 Excessive Drinking M excessive drinking of alcoholic beverages needs to decline.
Problem Statement: A determination is needed to identify and 17 Motor Vehicle Injury implement actions to reduce the number of motor vehicle M injuries. Problem Statement: A determination is needed to identify and 18 Premature Deaths implement actions to reduce the number of residents dying M prior to age 75. Problem Statement: A determination is needed to identify and 19 Self Described Health Status implement actions to reduce the number of residents perceiving M their health status to be less than good. Problem Statement: A determination is needed to identify and Physical Environmental 21 implement actions to continue to improve the local physical M Factors environment. Problem Statement: A determination is needed to identify and 22 Unintentional Injury implement action to reduce the number of unintentional M injuries among area residents. NOTE: Leading indicator is an action which predicts problem change and is within the ability of the organization to enact NOTE: Hospital Role or Action may include multiple actions L, C, A, E, M or O but at least one must be specified. H actions are not appropriate for need with this priority.
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By definition, the needs identified as LOW Priority and for which TRH holds LOW RESPONSIBILITY for implementation are needs the hospital will monitor but otherwise not address. Reasons for this response:
Actions required are beyond the mission of TRH;
TRH can be more effective applying its resources to higher priority needs;
The hospital does not possess the expertise necessary for substantive positive improvement;
Actions contemplated for implementation fall more appropriately to the responsibility of others;
Other than providing encouragement, implementation efforts for some needs require appropriate actions by individuals modifying their personal habits rather than a response by an organization or the Health System; and
The best use of TRH resources is to focus on resolving or improving higher priority needs rather than attempting to respond to everything with small, perhaps ineffective, efforts23. The intended resource allocation by priority:
High Priority Community Health Needs where TRH holds high responsibility for implementation – $491,000;
High Priority Community Health Needs where TRH holds low responsibility for implementation – $60,000;
Low Priority Community Health Needs where TRH holds high responsibility for implementation – $0;
Low Priority Community Health Needs where TRH holds low responsibility for implementation – $0; and
Total budget for providing services that address the needs identified in the Needs Assessment = $551,000.24
23 Reference Schedule H (Form 990) Part V Section B 7 24 Reference Schedule H (Form 990) Part V Section B 6. f
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APPENDICES
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Appendix A 620 Community Responses to Community Health Need Survey Questions What is your opinion about the following health and mental health issues in your community?
Interpretation – We asked survey participants to offer free text response to several questions and interpreted their responses by developing “Word Clouds”. Word Clouds are analytical tools which give greater visual prominence to words appearing more frequently in the source text. This information visualization establishes a portrait of the aggregate responses, presenting the more frequently used terms with greater text size and distinction in the visual depiction. Common article word (i.e. “a,” “the,” etc.), non-contextual verbs (i.e. “is,” “are,” etc.) and similar words used when writing sentences are suppressed by this application. In the above visualization, survey participants responded to the question “What is the most important health or medical issue”? Answers initially focused on financial issues, insurance, high coverage, affordable and cost. A second set of issues focused attention on mental concerns, obesity and obtaining needed medical care.
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After the open question, we posed two multiple choice questions. Listed were potential health needs with the question, “What is your opinion about the following medical and mental health issues in your community?”
100% 90% 80% 70% 60% 50% 40% 75% 30% 53% 53% 51% 48% 44% 44% 39% 38% 20% 35% 28% 10% 25% 22% 21% 18% 0%
Major Issue Moderate Issue Minor Issue Not an Issue No Opinion/Don't Know
Four needs were identified by respondents as a “Major Issue.” In descending order, the major needs were: I. Not having health insurance; II. Teen birth rate or teen pregnancy; III. Mental health issues; and IV. People making unhealthy food choices.
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The next response was to a continued list of potential needs.
100% 90% 80% 70% 60% 50% 40% 64% 59% 30% 51% 47% 46% 43% 20% 29% 10% 0%
Major Issue Moderate Issue Minor Issue Not an Issue No Opinion/Don't Know
Major mental health related issues were: I. Youth drug use; II. Adult substance abuse; and III. Youth alcohol use. Additional comments were added to the questions:
Again, finance issues come to the forefront of concern.
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Survey question #4 was “What is your opinion about these other possible community problems?”
100% 90% 80% 70% 60% 50% 40% 60% 57% 30% 48% 44% 38% 36% 20% 28% 25% 20% 10% 14% 9% 0%
Major Issue Moderate Issue Minor Issue Not an Issue No Opinion/Don't Know
Concerns about poverty and Meth lab site cleanup were identified as major issues by respondents.
Question #5 asked; “During the last two years do you perceive there to be a problem needing to be addressed?”
100% 90% 80% 70% 60% 50% 40% 63% 61% 58% 30% 44% 20% 40% 36% 34% 32% 10% 0%
YES I perceive problems NO I do not see concerns No Opinion
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A majority of respondents cited observed problems with indivdual and family health concerns, healthy living and availability of healthcare resources. When asked to establish a priority ranking among the classification of health needs, responses were: 1. Individual and Family Needs; 2. Healthcare Availability; 3. Healthy Living; 4. Public Health; 5. Emergency Preparedness; 6. Safety; 7. Particular Group Needs; and 8. Environmental Facotrs.
Additional comments to the identification of problems and the priority among the problems result in the above two word bubbles. The interpretation of the written comments indicate a need for people to access health care; problems occur with the availability of resources and the affordability of services. Specific concerns revolve around emergency, mental health (including abuse), children and exercise.
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Question #7 asked about the existence of problems within the respondent’s household. Results indicate problems are typically not in the personal household but are observed or perceived to exist elsewhere in the community.
100% 11% 11% 13% 16% 19% 15% 25% 18% 18% 90% 14% 80% 27% 25% 70% 40% 47% 54% 60% 59% 50% 49% 65% 40% 30% 20% 27% 24% 21% 20% 10% 15% 11% 9% 7% 6% 0%
Major Issue Moderate Issue Minor Issue Not an Issue No Opinion
Question #8 asked about specific potential problems in the household. None of the topics offered as potential problem areas rose to the level of being a major concern.
100% 14% 15% 14% 15% 22% 90% 80% 70% 50% 54% 60% 63% 60% No Opinion 50% 68% Not an Issue 40% Minor Issue 30% Moderate Issue 20% Major Issue 16% 10% 10% 7% 6% 3% 0% Not having Living in Not having Experiencing Breathing enough housing that enough room a mold or problems money to pay needs major in your house mildew from heating for housing repairs for the people problem in with wood who live your house there
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Question #9 presented another list of potential problems. Again, no topic presented as a major problem from the responses.
100% 90% 24% 20% 25% 31% 30% 34% 37% 33% 80% 38% 70% 60% 40% 34% 50% 48% 50% 44% 41% 41% 47% 40% 41% 30% No Opinion 20% Not an Issue 10% 12% 12% 12% 11% 11% 9% 8% 7% 6% 0% Minor Issue Moderate Issue Major Issue
Question #10 asked about taking personal responsibility for specific tobacco, alcohol and drug issues. In general, respondents are taking personal responsibility in the following areas:
100% 90% 80% 70% 47% 60% 63% 8% 50% 72% 40% 61% 30% 20% Not Sure / Does not Apply 10% No 0% Yes
Question #11 asked about the respondent’s use of specific services. Only in regard to having a mental health advisor do less than a majority have a resource.
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100% 90% 13% 80% 26% 28% 70% 60% 67% 50% Don't Know 76% 40% 63% 61% 30% No 20% 20% 10% Yes 0% Do you Do you Do you Do you have a have a have an have a primary primary eye care mental care care provider? health doctor? dentist? counselor?
About half of respondents in the last 2 years leave the County to receive health care with Kalamazoo being the destination and surgery being the most frequent sought service.
Don't Know / Don't Remember, 3.8%
YES, 47.3%
NO, 48.9%
On a scale of 1 to 10, with one the worst and 10 the best, respondents cited an average of 6.84 in evaluating their personal health. Over 62% reported not having family financial problems accessing health services. The vast majority of respondents cited little change in the community during the last
Proprietary Three Rivers Health Community Health Needs Assessment Three Rivers, Michigan Page 73 year, other than a worse economy. Subjects who responded (532 of 620) reported being in poor health an average of 4.9 days during the preceding month. Those responding (551 of 620) to questions about being in poor mental health during the last month offered this as true an average of 4.9 days. Over 95% of respondents had children in their household. While the survey was not designed to be statistically representative of the population, responses were obtained from all age groups, under 18 to over 65. However, 45% of respondents were between the ages of 35 to 54 and 65% were female. Over 85% of responses were from white, non-Hispanic individuals. Only 11.7% of respondents had less than a high school education. All economic groups were represented, with the largest percentage (26%) having a household income between $50,000 and $99,999. Regarding employment status, 49% of respondents were employed full time, 10% were retired, 11% were disabled and 7% were unable to work. While 20% of respondents either did not have health insurance or did not know if they did, 45% lacked employer provided health insurance.
As a final question to offer any additional comments, 77 respondents offered the above comments, interpreted as people in the county need help in obtaining good health care insurance.
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Conclusions from Public Input to Community Health Need Assessment 620 area residents responding to our earlier survey of community health needs said: Leading issues seem to be related to lack of affordable health insurance coverage and the cost of medical care; mental health issues; obesity; and, lack of access to needed services. Responses noted four topics as their most serious concerns. 1. No health insurance was a major concern to 75% of responses; 2. Teen birth/pregnancy was a major concern to 53% of responses; 3. Mental health issues were a major concern to 53% of responses; and 4. Unhealthy food choices/obesity was a major concern to 51% of responses. Mental health issues have a focus on adult alcohol and drug abuse as well as youth alcohol and drug abuse. Meth and Meth lab cleanup are specific drug related concerns. A problem with school bulling also was a noted concern. Individual, Family and healthy living concerns comments evolve about payment concerns, unhealthy eating, and the lack of fitness and obesity concerns. A couple of comments were submitted in Spanish one of which was translated as "I want you to know that I, as Hispanic cannot pay for consultations. I have nothing else to tell. I have nothing!” Other than the mentioned substance abuse, obesity and pregnancy concerns no other specific disease or condition was frequently mentioned.
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Appendix B – St. Joseph County Compared to National Peer Counties25
25 http://communityhealth.hhs.gov
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St. Joseph County Peer Group is #18
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Peer Counties
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St. Joseph County Performance Compared to Peer Counties and National Averages
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Summary Measures of Health
Measures of Birth and Death
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Environmental Health Factors
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Preventative Service Use
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Risk Factors for Premature Death
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Observation of St. Joseph County Compared to National Set of “Peer” Counties St. Joseph County appears Unfavorable compared to peer and national averages in the following areas:
Births to Women under 18;
Births to Unmarried Women;
No Care in First Trimester;
Infant Mortality;
White non Hispanic Infant Mortality;
Hispanic Infant Mortality;
Neonatal Infant Mortality;
Post-neonatal Infant Mortality;
Breast Cancer (Female);
Colon Cancer;
Coronary Heart Disease;
Motor Vehicle Injuries; and
Suicide. Compared to the same “peer” counties, St. Joseph County was observed to perform better than its peers but inferior in comparison to national averages among none of examined metrics.
Lung Cancer; and
Stroke. Comparing St. Joseph County to better than national average performance, but unfavorable in comparison to its peers in the following brought forward the following list of potential community needs:
Very Low Birth weight(< 1500 grams). Compared the performance of St. Joseph County to both its peers and to national averages generated favorable findings in the following areas:
Low Birth Wt. (<2500 g);
Premature Births (<37 weeks);
Births to Women age 40-54; and
Unintentional Injury.
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In summary, the St. Joseph County Peer Comparisons indicate:
Births to Women under 18, Births to Unmarried Women, No Care in First Trimester, Infant Mortality, White non Hispanic Infant Mortality, Hispanic Infant Mortality, Neonatal Infant Mortality, Post-neonatal Infant Mortality, Breast Cancer (Female), Colon Cancer, Coronary Heart Disease, Motor Vehicle Injuries, Suicide are potential concerns comparing St. Joseph to its Peer Counties and to national rates;
Very low birth weight is a condition where St. Joseph compares unfavorable to its peers; and
Environmental factors and infectious disease present as minor concerns, meeting most standards.
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Appendix C – St. Joseph County Compared to All Other Michigan Counties26 Health Outcomes
St #1 MI #82 MI Indicator Joseph Goal County County County Mortality
Premature Death (aggregate years lost prior to age 75 per 100,000) 8,814 5,564 4,601 10,723 Morbidity
Poor/Fair Health (self reported evaluation) 21% 9% 9% 20% Poor physical health days (# days in last month, self reported) 3.8 2.9 2.9 4.8 Poor Mental health days (# days in last month, self reported) 3.5 2.5 2.5 5.2 Low Birthweight (% live births <2,500 grams) 7.1% 6.3 6.3 8.4
26 www.communityhealthrankings.org
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Health Factors
Indicator St #1 MI #82 MI Joseph Goal County County County Health Behaviors Adult Smoking 25% 15% 25% 30% Adult Obesity (BMI > 30) 30% 25% 30% 30% Binge Drinking (self reported in last 30 days) 13% 8% 13% 15% Motor Vehicle Crash Death Rate (deaths / 100,000) 26 12 26 27 Chlamydia rate (cases / 100,000) 233 83 233 132 Teen Birth Rate (Teen [age15 – 19] births per1,000) 59 22 59 50
Indicator St #1 MI #82 MI Joseph Goal County County County Clinical Care Uninsured Adults (% of population under 65 without insurance) 15% 13% 15% 13% Primary Care Provider Rate (primary care physicians per 100,000) 1198:1 631:1 1198:1 2023:1 Preventable Hospital Stays (ambulatory sensitive admissions/ 1000 Medicare 82 52 82 109 Enrollees) Diabetic Screenings (% diabetic Medicare patients HbA1c tested) 78% 89% 78% 84%
Mammography Screening(% of female Medicare enrollees that receive mammography 69% 74% 69% 65% screenings)
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Indicator St #1 MI #82 MI Joseph Goal County County County Social & Economic Factors High school graduates (% of ninth graders graduating in 4 yrs) [2 times more influential in ranking than other factors] 80% 92% 85% 75%
Some college (% of adults 25-44 with some post secondary education) [2 times more 45% 68% 66% 46% influential in ranking than other factors] Unemployment (% 16+ adults unemployed and looking for work) [4 times more 14.6% 5.3% 12.3% 16.5% influential in ranking than other factors] Children in poverty (% of children <18 living in poverty) [4 times more influential in 21% 11% 9% 32% ranking than other factors] Inadequate social support 18% 14% 14% 25% Children in single-parent households 26% 20% 17% 29% Homicide rate (deaths per 100,000, age adjusted) [2 times more influential in ranking 344 100 185 190 than other factors] Physical Environment Air pollution particulate matter days (Annual unhealthy days) 2 0 4 2 Air pollution ozone days (Annual unhealthy days) 0 0 8 0 Access to healthy foods (Availability of food stores) 89% 92% 85% 100% Access to recreational facilities (facilities per 100,000) 13 17 11 10
Observations from St. Joseph County compared to all other Michigan counties, in terms of Community Health Needs In general, St. Joseph County health status compared unfavorably among Michigan Counties. It ranks 70th in Healthy Outcomes (with 1st being the best) among the 82 ranked counties. Among the various Health Factors analyzed, St. Joseph County scores better, ranking 58th among the 82 ranked counties. Physical Environmental Factors are positive influences on overall county rankings as all measures are below State averages and many have achieved or surpassed goal benchmarks. Clinical factors are not a serious depressing factor in scoring the rankings. Uninsured rates, preventable hospital stays, diabetic screening rates and mammography use all are basically at the state average. Improvement is possible but would have little impact on improving the ranking of St. Joseph County. The highest ranked positive influence among the health status factors is the lack of low birth weight babies. St. Joseph County performance is better than average among Michigan counties and it is close to achieving desired national benchmarks. Premature deaths, deaths prior to age 75, shows a three year trend of increasing values. This means an increasing number of young residents are dying. Twenty-four percent of the population self describe their health status as "Poor" or "Fair". This is almost double the rate for the State of Michigan.
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Lack of healthy behavior is the leading factor depressing the St. Joseph Health Factor ranking. The rate of smoking, 26% of adults, is a driver for scoring low. Motor Vehicle deaths are more than double the State rate. Teen birth rates are among the worse in Michigan. Adult obesity and physical inactivity are at about the Michigan averages but could improve. Excessive drinking and Sexually Transmitted diseases are beneficial influences on scoring because of their low rates.
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Appendix D – Leading Causes of Death27
St. Joseph County Cause of Death Heart Disease – ranked #9 of 83 counties, having 262.1 deaths per thousand, above Michigan average of 221.5 and national average of 190.9 Cancer – ranked #26 of 83 counties, having 197.6 deaths per thousand, above Michigan average of 187.3 and national average of 178.4 Stroke – ranked #44 of 83 counties, having 47.5 deaths per thousand, above Michigan average of 44.3 and national average of 42.2 Chronic Lung Disease – ranked #50 of 83 counties, having 43.6 deaths per thousand, equal to Michigan average and above national average of 40.8 Accidents – ranked #9 of 83 counties, having 51.4 deaths per thousand, above Michigan average of 36.2 and above national average of 40 Diabetes – ranked #9 of 83 counties, having 37.6 deaths per thousand, above Michigan average of 26.3 and above national average of 22.5 Alzheimer’s – ranked #68 of 83, having 14.6 deaths per thousand, below Michigan average of 22.2 and national average of 22.7 Influenza and Pneumonia – ranked #53 of 83 counties, having 16.7 deaths per thousand, above the Michigan average rate of 15 and national average of 16.2
27 Leading Causes of death obtained from http://www.worldlifeexpectancy.com/usa/michigan-health-profile
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Nephritis/Kidney Disease – ranked #36 of 83 counties, having 14.1 deaths per thousand, below the Michigan average of 14.9 and the national average 14.6 Suicide – ranked #53 of 83 counties, having 11.5 deaths per thousand, above the Michigan average rate of 11 and the national average of 11.3 Liver Disease – ranked #56 of 83 counties, having 7.8 deaths per thousand, below the Michigan average of 9.1 and the national average of 9.1 Blood Poisoning – ranked #7 of 83 counties, having 10 deaths per thousand, above the Michigan average of 9 but below the national average of 11 Hypertension/Renal – ranked #57 of 83 counties, having 4.7 deaths per thousand, below the Michigan average of 7.1 and the national average of 7.4 Parkinson’s disease – ranked #36 of 83 counties, having 7.4 deaths per thousand, above the Michigan average of 7.1 and the national average of 6.4 Homicide – ranked #58 of 83 counties, having 1.3 deaths per thousand, below the Michigan average of 7.1 and the national average of 6.1 St. Joseph age adjusted death rates for ten leading causes by gender28
28http://www.mdch.state.mi.us/pha/osr/chi/Deaths/leadadj/ADJCO.asp?DxId=1&CoName=St.%20Joseph&CoCod e=75 and responds in part to IRS 990 Part V B 1 f
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Appendix E – St. Joseph County Selected Additional Health Status Factors29 Male Life Expectancy has increased since the 1987 value of 71.6 Years
Female Life Expectancy has increased since the 1987 value of 78.7 Years
29 http://www.healthmetricsandevaluation.org/tools/data-visualization/life-expectancy-county-sex-and-race-us-1987- 2007
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Palliative Care Programs (programs to relieve pain, symptoms, and stress of serious illness) are available in St. Joseph County30
Counties with Palliative Care Programs There is not a Palliative Care Program in St. Joseph County
30 www.getpalliativecare.org
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Area Hospice Locations
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Designated Professional Shortage Areas31
St. Joseph County includes a Medically Underserved Area.
31 Source: http://datawarehouse.hrsa.gov
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St. Joseph County Stroke Death Rate Exceeds State and National Rates32
32 http://apps.nccd.cdc.gov/giscvh2/Results.aspx
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St. Joseph County Heart Disease Death Rate Approaches the National Rate and is below the Michigan Average33
33 http://apps.nccd.cdc.gov/giscvh2/Results.aspx
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Prevalence of Diabetes for Total Population 30 and over34
St. Joseph County
Data is drawn from the Behavioral Risk Surveillance System and analyzed in this display. On a relative basis, the 2008 estimated prevalence of diabetes in St. Joseph County is in the fifth lowest decile group.
34 http://www.healthmetricsandevaluation.org/tools/data-visualization/diabetes-prevalence-county-us-maps
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Selected Medical Personnel Supply Compared to Surrounding Counties
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Business Patterns35
Pattern Indicators Total Number of physician offices 22 Number of physician offices per 1,000 population 0.35 Number of dentist offices per 1,000 population 0.24 Number of dentist offices 15 Number of drug stores 11 Number of drug stores per 1,000 population 0.18
35
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Observations from the other statistical data examinations 1. Male and Female life expectancy has increased, with male expectancy improving faster. 2. No PALLIATIVE CARE programs exist in St. Joseph County but three HOSPICE programs exist. 3. Parts of the County, primarily served by Three Rivers Health, are DESIGNATED MEDICALLY UNDERSERVED. 4. STROKE death rates exceed the Michigan average and note DIABETES as a moderate comorbidity, while HYPERTENSION has a high incidence of being a comorbid condition. 5. HEART DISEASE while being the leading cause of death, as a rate of death, is below the state average. Multiple comorbidities occur "moderately" or have a "fair incidence". 6. DIABETES prevalence among the population age 30 and over is about average, being in the fifth of ten deciles.
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Appendix F – St. Joseph County Service Area Population Characteristics36 Definition of Area Served by the Hospital Facility37 Sturgis Hospital and Three Rivers Health, in conjunction with QHR, have defined its combined service area as the following ZIP codes: 49030 – Burr Oak 49042 – Constantine 49072 – Mendon 49032 – Centreville 49091 – Sturgis 49099 – White Pigeon 49040 – Colon 49093 – Three Rivers This service area comprises virtually all of St. Joseph County, Michigan.
36 All population values obtained from Thomson Market Planner 37 Responds to IRS Form 990 (h) Part V B 1 a
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Population Characteristic St. Joseph County Michigan USA
2011 Total Population 61,553 9,880,029 309,038,999
2016 Total Population Estimate 60,268 9,809,157 321,675,045
2011-2016 % Population Change -1.5% -0.7 4.1%
2011 Median Age 37.5 41.6 38.2
2011 Median Household Income $43,327 47,115 $55,993
% of Total Pop 14.5% 13.9% 13.2%
Population 65+ % Proj. Change 9.4% 12.1% 15.5%
% of Total Pop 18.0% 19.5% 20.1%
Females 15-44 % Proj. Change -3.5% -4.1% -0.7%
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Demographics Expert 2.7 2011 Demographic Snapshot Area: St Joseph County, MI Level of Geography: ZIP Code DEMOGRAPHIC CHARACTERISTICS Selected Area USA 2011 2016 % Change 2000 Total Population 63,047 281,421,906 Total Male Population 30,560 30,086 -1.6% 2011 Total Population 61,553 310,650,750 Total Female Population 30,993 30,542 -1.5% 2016 Total Population 60,628 323,031,618 Females, Child Bearing Age (15-44) 11,102 10,716 -3.5% % Change 2011 - 2016 -1.5% 4.0% Average Household Income $52,024 $67,529
POPULATION DISTRIBUTION HOUSEHOLD INCOME DISTRIBUTION Age Distribution Income Distribution USA 2011 USA Age Group 2011 % of Total 2016 % of Total % of Total 2011 Household Income HH Count % of Total % of Total 0-14 13,296 21.6% 13,374 22.1% 20.2% <$15K 3,170 13.5% 12.9% 15-17 2,617 4.3% 2,459 4.1% 4.2% $15-25K 2,916 12.4% 10.8% 18-24 5,278 8.6% 5,392 8.9% 9.7% $25-50K 7,623 32.5% 26.6% 25-34 7,596 12.3% 7,277 12.0% 13.3% $50-75K 5,394 23.0% 19.5% 35-54 16,147 26.2% 14,530 24.0% 27.6% $75-100K 2,319 9.9% 11.9% 55-64 7,706 12.5% 7,847 12.9% 11.7% Over $100K 2,013 8.6% 18.3% 65+ 8,913 14.5% 9,749 16.1% 13.3% Total 61,553 100.0% 60,628 100.0% 100.0% Total 23,435 100.0% 100.0%
EDUCATION LEVEL RACE/ETHNICITY Education Level Distribution Race/Ethnicity Distribution USA USA 2011 Adult Education Level Pop Age 25+ % of Total % of Total Race/Ethnicity 2011 Pop % of Total % of Total Less than High School 2,380 5.9% 6.3% White Non-Hispanic 54,035 87.8% 64.2% Some High School 4,123 10.2% 8.8% Black Non-Hispanic 1,360 2.2% 12.1% High School Degree 16,390 40.6% 28.9% Hispanic 4,550 7.4% 16.1% Some College/Assoc. Degree 12,125 30.0% 28.3% Asian & Pacific Is. Non-Hispanic 361 0.6% 4.6% Bachelor's Degree or Greater 5,344 13.2% 27.7% All Others 1,247 2.0% 3.0% Total 40,362 100.0% 100.0% Total 61,553 100.0% 100.0%
2011 Household Income 2011 Households Median HH Income $15,000- $25,000- $35,000- $50,000- $75,000- Median Description 2011 2016 2011 2016 <$15,000 $24,999 $34,999 $49,999 $74,999 $99,999 $100,000+ Home Value St Joseph County, MI 23,435 23,160 $43,327 $43,631 13.5% 12.4% 13.6% 18.9% 23.0% 9.9% 8.6% $101,054 Michigan 3,821,015 3,807,992 $47,115 $47,511 12.9% 11.5% 11.8% 16.2% 20.5% 12.1% 15.0% $123,657 USA 116,862,305 121,514,932 $47,774 $48,858 12.9% 10.8% 11.1% 15.5% 19.5% 11.9% 18.3% $163,136
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Service Area Population Health Status Analysis According to the Aggregate Composition of Demographic Characteristic Segments Demand as % of Demand as % of Health Service Topic % of Population Health Service Topic % of Population National Effected National Effected Weight / Lifestyle Heart BMI: Morbid/Obese 108.9% 28.2% Routine Screen: Cardiac Stress 2yr 93.6% 22.1% Vigorous Exercise 97.9% 49.9% Chronic High Cholesterol 99.9% 22.0% Chronic Diabetes 108.2% 11.5% Chronic High Blood Pressure 106.4% 27.7% Healthcare Cost Changes: Lifestyle 103.2% 19.6% Chronic Heart Disease 109.8% 8.7% Healthy Eating Habits 89.2% 24.4% Obstetrical / Pediatric Very Unhealthy Eating Habits 97.1% 3.2% Birth 93.5% 4.1% Emergency Service Pediatric Asthma 93.7% 5.2% Emergency Room Use 105.8% 35.2% Pediatric Care 98.8% 26.2% Urgent Care Use 98.3% 22.9% OB/Gyn 1+ Visit 91.8% 39.5% Pulmonary Routine Services Chronic Asthma 100.3% 9.7% FP/GP: 1+ Visit 107.6% 72.1% Tobacco Use: Cigarettes 111.9% 29.2% Annual Physical 97.6% 65.0% Chronic Allergies 101.5% 26.0% Other Cancer Ambulatory Surgery last 12 Months 106.8% 20.6% Mammography in Past Yr 98.3% 80.2% Chronic Migraine 104.0% 12.6% Cancer Screen: Colorectal 2 yr 98.8% 25.3% Miscellaneous Cancer Screen: Pap/Cerv Tst 2 yr 96.5% 64.9% Healthcare Cost Changes: Insurance 107.2% 18.4% Routine Screen: Prostate 2 yr 98.7% 33.6% Health Info Svcs: 3+ Use 95.9% 38.9% Cancer Screen: Skin Test 2 yr 82.5% 10.8% Charitable Contrib: Hosp/Hosp Sys 100.4% 24.0% Orthopedic Charitable Contrib: Other Health Org 97.0% 37.8% Chronic Lower Back Pain 109.1% 28.9% Healthcare Cost Changes: Utilization 103.2% 19.2% Chronic Osteoporosis 104.2% 10.3% HSA/FSA: Employer Offers 90.9% 28.5% Emerging Topic Sports Injury 80.0% 10.3% Seek Info to Judge Quality of 87.1% 39.0% Provider/Fac Interpretation – Areas boxed in and bolded red indicate a statistically significant adverse demand from the national average. Areas boxed in and bolded blue indicate a statistically significant beneficial demand from the national average. Observations relevant to assessing community health needs include:
The most adverse finding is tobacco usage is 12% above average, impacting 29% of the population;
Almost 9% more of the population is morbidly obese than average. Chronic diabetes should be about 8% higher than the national average. Chronic high blood pressure is 6% above average while chronic heart disease is almost 10% above average. Chronic low back pain is 9% above average. Not unexpectedly, health eating habits are almost 11% below the national average and use of stress testing also is about 6% below average. Cancer skin testing is 18% below average;
Emergency room usage is almost 6% above average while OB/GYN usage is about 8% below average. Family medicine physician usage is 7.6% above average. Ambulatory surgery usage is almost 7% above average;
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Births and pediatric asthma both are about 6% below average; and
7% more than average changed their health insurance recently while 9% fewer employers offer a health care savings account. Seeking information to evaluate provider quality is 13% below average. Vulnerable Populations38
% of Vulnerable Populations Include People Who Total Population Have no high school diploma (among adults age 25 and older) 8,817 14.3% Are unemployed 2,772 4.5% Are severely work disables 1,384 2.2% Have major depression 3,774 6.1%
Are recent drug users(within past month) 4,571 7.4%
12.8% 8.4% 9.5% 10.9%
12.2% 9.0% 10.6% 10.1% 9.1%
14.0% 12.5% 13.4% 14.6%
15.5% 10.3%
38 Reference 990 Part V B 1 f
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Observations from the demographic analysis
The service area comprises of 18,858 households and 14.1% of the residents of the age 65 or more in St. Joseph County, Michigan. The elderly population is slightly higher than the percent of the population the elderly comprise in the state or in the national population;
The population of the area is estimated to be 50,662 and by 2016 should be 49,952, giving St. Joseph a -1.4% decrease in population, compared to Michigan’s -0.7%;
The area is dominantly white; all minorities comprise only 13.0% of the population;
The population segment comprising “Women of childbearing age” is slightly lower than state and national rates at 18.1%, 19.5% and 19.9%, respectively;
The indication of a High incident of chronic diabetes unfortunately agrees with the prior observation of a low use of diabetic screening by St. Joseph County residents. It appears this risk factor is not an artifact of obese residents, rather it may relate, in part, to poor eating habits what also occurs at an excessive rate among residents;
Chronic high blood pressure and heart disease along with a low rate of routinely taking advantage of cardiac stress testing all agree with Heart disease as the leading cause of death;
Low demand for cancer screening agrees with Cancer being among the leading causes of death in the County;
The high smoking rate again appears as a prevalent adverse health factor; and
The population is reluctant to show responsibility for their own health and does not take advantage of resources for obtaining health information.
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Appendix G – Local Expert Priority Setting Process IRS Notice 2011 – 52 stipulates the following:
A description of how the hospital organization took into account input from persons who represent the broad interest of the community served by the hospital facility;
The report must identify [and include in the process] any individual providing input who has special knowledge of or expertise in public health by name, title, and affiliation;
The report must identify [and include in the process] any individual providing input who is a “leader” or “representative” of populations, Federal, tribal, regional, State, or local health or other departments or agencies, with … information relevant to the health needs of the community;
The report must identify [and include in the process] any Leaders, representatives, or members of medically underserved, low-income, and minority populations, and populations with chronic disease needs, in the community served;
The report may also consult or seek input from healthcare consumer advocates; nonprofit organizations; academic experts; local government officials; community-based organizations, including organizations focused on one or more health issues; health care providers, including community health centers and other providers focusing on medically underserved populations, low-income persons, minority groups, or those with chronic disease needs; private businesses; and health insurance and managed care organizations; and
A prioritized description of all of the community health needs as well as a description of the process and criteria used in prioritizing such health needs. This report meets this set of requirements by selecting individuals willing to provide us an evaluation and recommendation among the needs identified by the data being analyzed. The following individuals agreed to participate in the Community Health Need Assessment as Local Experts. Position Name E-Mail Address Employer
Theresa Christner Director, Health [email protected] Education/Health Promotion, Branch-Hillsdale-St. Joseph Community Health Agency
Doug Lockwood Adult Services Director, [email protected] CMHSAS of St. Joseph County
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Position Name E-Mail Address Employer
Robin Baker County Commissioner, [email protected] Health Dept board member
Rebecca Burns Director of Environmental [email protected] Health, Branch-Hillsdale-St. Joseph Community Health Agency
Kiel Musser District School Nurse, [email protected] Three Rivers Community Schools
Dr. Geetha Dhatreecharan Psychiatrist/Medical Director, [email protected] MD Community Mental Health & Substance Abuse Services of St. Joseph County
Cindy Underwood Director, [email protected] St. Joseph County DHS
Madonna Hilarides, RN Coordinator CSHCS-Vision [email protected] and Hearing, BHSJ CHA
JoAnn Wilczynski Prevention Services Director, [email protected] Branch Hillsdale St. Joseph CHA
Dr. Ashish Verma Physician, [email protected] Sturgis Hospital
Lynelle Thrasher Children's Clinical Director, [email protected] CMH St. Joseph County
Spencer Price Substance Abuse Services [email protected] Supervisor, CMHSAS-SJC
Jerry Solis Assistant Pastor, [email protected] Riverside Church
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Position Name E-Mail Address Employer
James Phillips, MD, MPH Medical Director, [email protected] BHSJ Community Health Agency
Heather Kerr, Director of DD and Medical [email protected] Clinic Services, Community Mental Health and Substance Abuse Services of St. Joseph Co.
Steve Todd Health Officer, [email protected] Branch-Hillsdale-St. Joseph Community Health Agency
Deana Strudwick Supervisor, [email protected] St. Joseph County ISD
Curtis Buchheit, M.D. Outpatient Medical Director, [email protected] Three Rivers Health
Matt Lori State Representative, [email protected] MI House of Representatives
Amy Brauer Coordinator, [email protected] Great Start Collaborative
BethAnn Perkins Principal, [email protected] Health Consulting Strategies, Inc.
Jose D Albarran VP, [email protected] Sturgis Bank & Trust Co
Lucinda Kujacznski Executive Director, [email protected] Riverside Health Clinic
Lynn Coursey Executive Director, [email protected] St. Joseph County Commission on Aging
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Position Name E-Mail Address Employer
Elizabeth O'Dell Executive Director, [email protected] CMHSAS-SJC
The opinions of the Local Experts were as follows: Question #1 – St. Joseph County Compared to all Michigan Counties
In general, St. Joseph County health status compared unfavorably among Michigan Counties. It ranks 70th in Healthy Outcomes (with 1st being the best) among the 82 ranked counties. Among the various Health Factors analyzed, St. Joseph County scores better, ranking 58th among the 82 ranked counties;
Physical Environmental Factors are positive influences on overall county rankings as all measures are below State averages and many have achieved or surpassed goal benchmarks;
Clinical factors are not a serious depressing factor in scoring the rankings. Uninsured rates, preventable hospital stays, diabetic screening rates and mammography use all are basically at the state average. Improvement is possible but would have little impact on improving the ranking of St. Joseph County;
The highest ranked positive influence among the health status factors is the lack of low birth weight babies. St. Joseph County performance is better than average among Michigan counties and it is close to achieving desired national benchmarks;
Premature deaths, deaths prior to age 75, shows a three year trend of increasing values. This means an increasing number of young residents are dying;
Twenty-four percent of the population self describe their health status as "Poor" or "Fair". This is almost double the rate for the State of Michigan; and
Lack of healthy behavior is the leading factor depressing the St. Joseph Health Factor ranking. The rate of smoking, 26% of adults, is a driver for scoring low. Motor Vehicle deaths are more than double the State rate. Teen birth rates are among the worse in Michigan. Adult obesity and physical inactivity are at about the Michigan averages but could improve. Excessive drinking and Sexually Transmitted diseases are beneficial influences on scoring because of their low rates. Agree with the above observations = 70.8% (17 experts) Disagree with some or all of the observations = 29.2% (7 experts)
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Comments
Everything sounds pretty accurate to me except for the "excessive drinking" being at a "low rate." That is not my perception of the level of alcohol consumption in this County. "Motor vehicle deaths are more than double the State rate"; does this high statistic have anything to do with "excessive drinking"? I would say there is a lot of "excessive drinking" in this County!
I believe that uninsured rates and preventable hospitals are a depressing factor in the scoring rankings and if we improved these factors there would be a great impact on improving the rank;
I think access to care plays a bigger part in the equation. Further analysis would indicate that access may be associated with the teen pregnancy problem (no family planning provider) and low birth weight babies and infant mortality (inadequate prenatal care). It is an underlying factor that contributes to continuation of unhealthy behavioral choices;
Lack of primary care providers is not highlighted. This is a clinical factor;
Meth use and child neglect and abuse are also serious issues within the county;
Need more detail;
Our physical environment is not the same across the board for the residents of St. Joe County. Many families live in third world country standards. Many children are raised in/under a NEGETIVE!!! influence. Either due to a single parent home environment or a drug/alcohol, and or in sexually perverted homes. All these contribute to POOR physical;
There are inadequate, safe walking and biking trails within the county and therefore the physical environmental factor may not be a positive influence. Household income is a factor that leads to increases is teen birth rates, adult obesity and physical inactivity, etc.; and
We are passionately trying to turn this tide of poor performance – many interventions have been made. I'm anxious to see an update on the above next year. Question #2 – St. Joseph County Compared to Peer Counties
The federal government administers a process to allocate all counties into "Peer" groups, groups having similar social, economic and demographic characteristics. Health and wellness observations when St. Joseph is compared to its national set of Peer Counties and compared to national rates makes the following observations: UNFAVORABLE observations when compared to peers and national averages 1. BIRTHS TO WOMEN Under 18; 2. BIRTHS TO UNMARRIED WOMEN; 3. NO CARE IN FIRST TRIMESTER;
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4. INFANT MORTALITY; 5. WHITE NON-HISPANIC INFANT MORTALITY; 6. HISPANIC INFANT MORTALITY; 7. NEONATAL INFANT MORTALITY; 8. POST NEONATAL INFANT MORTALITY; 9. FEMALE BREAST CANCER; 10. COLON CANCER; 11. CORONARY HEART DISEASE; 12. MOTOR VEHICLE INJURIES; and 13. SUICIDE. SOMEWHAT A CONCERN observations as rates are unfavorable compared to peer counties: A. VERY LOW BIRTH WEIGHT [less than 1500 g]. SOMEWHAT A CONCERN observations as rates are unfavorable compared to national rates: I. LUNG CANCER; and II. STROKE. Potential conditions which are not a health need because performance is BETTER than Peers and National rates include: LOW BIRTH WEIGHT (<2500 grams); PREMATURE BIRTHS (<37 weeks); BIRTHS TO WOMEN AGE 40 – 54; and UNINTENTIONAL INJURY Agree with the above observations = 78.3% (18 experts) Disagree with some or all of the observations = 21.7% (5 experts) Comments
Although the premature birth rate appears better than peers and the national rates, in an analysis of the last three years of infant deaths, premature births is the number one cause (over 50% of the deaths);
Drug use, specifically meth which leads to child abuse/neglect and increased need for foster or kinship/grandparent assuming parenting responsibilities, often (in the case of grandparent
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kinship care) without court appointment or guardianship due to shame, perceived complexity of legal system and refusal of drug addicted parent to relinquish custody;
I believe our Low Birth Weight and Premature Births are higher then what this is reflective as;
It seems as though there should be some evaluation and comparison of our diabetes and obesity rate here;
No comment . . .; and
See comment on previous question. Question #3 – Primary Service Area Population Characteristics
The following areas were identified from a comparison of the service area to national averages: Adverse uses and rates compared to national norms brought forward the following issues impacting 10% to 24% of the population 1. Chronic diabetes; 2. Lack of healthy eating habits; 3. Not receiving a Cancer Screen Test in the last 2 years; and 4. Not receiving a routine Cardiac Screening Test in the last 2 years. 25% or more of the population: A. Has high use of PRIMARY CARE PHYSICIANS (72% of population); B. Has high use of EMERGENCY SERVICES (35% of the population); C. Has low use of OBSTETRIC PHYSICIANS (39% of the population); D. Has CHRONIC LOW BACK PAIN (29% of the population); E. Is MORBID/OBESE (28% of the population); and F. Has HIGH BLOOD PRESSURE (28% of the population). The most adverse finding, 11% above the national average, impacting 29% of the population was USE OF TOBACCO, CIGARETTES Agree with the above observations = 69.6% (16 experts) Disagree with some or all of the observations = 30.4% (7 experts) Comments
A number of patients do not have Primary Care Physicians/and or non compliant;
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Depending on how you define "healthy eating habits", as a rule, the food that is available and consumed in this County is very high in empty or un-needed calories: High Sugar & High Fat. I would say this County "lack(s) healthy eating habits";
Drug/substance abuse has not been adequately identified as a leading health issue. Look to court and jail population to further demonstrate need to apply resources to this concern;
I believe emergency services are used much more than 39% due to lack of health coverage;
I don't understand why high use of primary care physicians is an adverse use; unless this is pointing to the fact that few specialists are available to provide care;
I think that current percentages for Morbid/Obese might be higher than 28%;
I wonder how the data was collected for lack of healthy eating habits. It seems that it would affect a higher percentage of the population;
My feeling is that the use of tobacco is going down, but the rates of obesity and of the uninsured are going up; and
We need a better way of funding the screening colonoscopies – the desire is there from the providers and the patients – lack of insurance coverage especially in this area is a problem. I'd like to see more details on 4, A, D, and F above. Question #4 – Area Resident Summary Opinions 620 area residents responding to our earlier survey of community health needs said:
Leading issues seem to be related to lack of affordable health insurance coverage and the cost of medical care; mental health issues; obesity; and, lack of access to needed services;
Responses noted four topics as their most serious concerns: 1. No health insurance was a major concern to 75% of responses; 2. Teen birth/pregnancy were a major concern to 53% of responses; 3. Mental health issues were a major concern to 53% of responses; and 4. Unhealthy food choices/obesity were a major concern to 51% of responses.
Mental health issues have a focus on adult alcohol and drug abuse as well as youth alcohol and drug abuse. Meth and Meth lab cleanup are specific drug related concerns. A problem with school bulling also was a noted concern;
Individual, Family and healthy living concerns comments evolve about payment concerns, unhealthy eating, and lack of fitness and obesity concerns. A couple of comments were submitted in Spanish one of which was translated as "I want you to know that I, as Hispanic cannot pay for consultations. I have nothing else to tell. I have nothing!”; and
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Other than the mentioned substance abuse, obesity and pregnancy concerns no other specific disease or condition was frequently mentioned. Agree with the above observations = 100% (22 experts) Disagree with some or all of the observations = 0% (0 experts) Comments
I think, overall, the county health plans do an exceptional job of covering the "poorly insured". I'm very hopeful Teen Clinic will have a large positive impact on #1, #2, and #4;
Jobs, jobs, jobs;
Mental health issues including substance abuse; and
Sounds very accurate . . . Question #5 – Additional Community Health Need Assessment Considerations Additional observations of St. Joseph County found: 1. Leading causes of deaths, accounting for over 50% of all reasons are HEART DISEASE and CANCER 2. Male and Female life expectancy has increased, with male expectancy improving faster. 3. No PALLIATIVE CARE programs exist in St. Joseph County but three HOSPICE programs exist. 4. Parts of the County, primarily served by Three Rivers Health, are DESIGNATED MEDICALLY UNDERSERVED. 5. STROKE death rates exceed the Michigan average and note DIABETES as a moderate comorbidity, while HYPERTENSION has a high incidence of being a comorbid condition. 6. HEART DISEASE while being the leading cause of death, as a rate of death, is below the state average. Multiple comorbidities occur "moderately" or have a "fair incidence". 7. DIABETES prevalence among the population age 30 and over is about average, being in the fifth of ten deciles. Agree with the above observations = 100% (22 experts) Disagree with some or all of the observations = 0% (0 experts) Comments
Even an average rate is diabetes is not good, as this will surely rise with the obesity epidemic. Diabetes is automatic heart disease and lower life expectancy; and
No comment . . .
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All the needs were then presented to the Local Experts with the following instructions: All identified issues are presented in alphabetical order. Please allocate points to identify which are needs, with heaver point allocations to needs you recommend as a priority 1. BIRTHS – TO WOMEN AGE 40 TO 54 not a concern, performance better than peers and national average; TO UNMARRIED WOMEN worse than peer and national average; NO CARE IN THE FIRST TRIMESTER worse than peers and national average; TEEN BIRTH RATE among the worst in Michigan; one of the top four major concerns by 53% of residents; worse than peers and national average; 2. BABY DEATHS – HISPANIC INFANT MORTALITY worse than peers and national average; INFANT MORTALITY worse than peers and national average; NEONATAL INFANT MORTALITY worse than peers and national average; LOW BIRTH WEIGHT BABIES are infrequent and a positive health status factor; better performance than peers and national averages; PREMATURE BIRTHS not a concern, performance better than peers and national average; POSTNEONATAL INFANT MORTALITY is worse than peers and national average; VERY LOW BIRTH WEIGHT somewhat a concern, adverse peer comparison; WHITE NON HISPANIC INFANT MORTALITY worse than peers and national average; 3. CANCER – second leading cause of death; CANCER SCREENING not adequate; BREAST CANCER worse than peers and national average; COLON CANCER worse than peers and national average; LUNG CANCER somewhat a concern, exceeds national average; MAMMOGRAPHY use at state average; 4. CORONARY HEART DISEASE- leading cause of death; values worse than peers and national average; but below state average as rate of death; SCREENING inadequate; 5. DIABETES – at national average but often a comorbidity for other conditions; impacts 11% of the population; DIABETIC SCREENING not a serious concern; 6. EXCESS DRINKING – not a concern from statistics, but public comments present an adult and adolescent concern; 7. HEALTH INSURANCE/UNINSURED – rates at state average but among the four top major concerns by 75% of residents; Spanish concerns are recorded; 8. HIGH BLOOD PRESSURE – impacts 28% of the population; a moderate comorbidity in stroke and heart disease conditions; 9. LOW BACK PAIN – impacts 29% of residents; 10. MENTAL HEALTH – one of the top four concerns by 53% of residents; METH related problems and bullying;
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11. MOTOR VEHICLE INJURY- almost double state rate; worse than peers and national average; 12. OBESITY/PHYSICAL INACTIVITY – at Michigan average, impacts 29% of residents; LACK OF HEALTHY EATING HABITS an abnormal finding impacting 24% of the population; UNHEALTHY FOOD CHOICES are the fourth highest concern by 53% of residents; 13. PALLIATIVE CARE – programs do not exist in County but three HOSPICE programs are available; 14. PHYSICAL ENVIRONMENTAL FACTORS – do not appear a concern as it has a positive influence on health status; 15. PREMATURE DEATHS – is increasing but may result from other factors; LIFE EXPECTANCY increased; 16. PHYSICIAN – PRIMARY USE high; EMERGENCY USE high; OBSTETRICS USE low; northern St. Joseph designated MEDICALLY UNDER SERVED; 17. SEXUALLY TRANSMITTED DISEASE – not a concern; 18. SELF DESCRIBED HEALTH STATUS – 24% of the population describe their status as “Fair” or “Poor”; 19. SMOKING – driving low health status score factor; negative factor deviating most from national norms; impacts 29% of residents; 20. STROKE – deaths exceed Michigan average; somewhat a concern as exceeds national average; 21. SUICIDE – worse than peers and national average; 22. UNINTENTIONAL INJURY – not a concern, rate better than peer and national norms; 23. Points Reserved to address ideas presented below (the following comments were entered. Where topics and point allocations were considered the same as one of the preceding needs, any allocated points were combined with the appropriate need):
. Smoking;
. Needs more Specialty Medical professionals;
. Lack of access to dental care;
. Substance Abuse;
. Poorly worded question – as outpatient medical director, my focus would be on areas I can impact;
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. Substance abuse/meth; and
. Racial and class disparities in health and access to care. The result from the point allocation process is shown on the following page. Percent of # Exp e rts Point Break Cumulative High vs. Allocated Total Priority Ranking of Community Health Needs Allocating From Higher Allocated Low Points Allocated Po ints Priority Points Priority Points 10. MENTAL HEALTH 13 239 12.6% 12.6% 2. BABY DEATHS 12 226 11.9% 13 24.4% 7. HEALTH INSURANCE / UNINSURED 15 216 11.3% 10 35.8% 12. OBESITY / PHYSICAL INACTIVITY 14 158 8.3% 58 44.1% 1. BIRTHS 11 143 7.5% 15 51.6% 16. PHYSICIAN 11 128 6.7% 15 58.3% 3. CANCER 12 109 5.7% 19 64.0% 19. SMOKING 11 104 5.4% 5 69.4%
5. DIABETES 12 96 5.0% 8 74.5% HighPriority 4. CORONARY HEART DISEASE 12 90 4.7% 6 79.2% 21. SUICIDE 9 63 3.3% 27 82.5% 13. PALLIATIVE CARE 9 44 2.3% 19 84.8% 6. DRINKING 8 41 2.1% 3 86.9% 20. STROKE 8 41 2.1% 89.0% 17. SEXUALLY TRANSMITTED DISEASE 9 35 1.8% 6 90.9% 8. HIGH BLOOD PRESSURE 8 35 1.8% 92.7% 11. MOTOR VEHICLE INJURY 8 34 1.8% 1 94.4% 15. PREMATURE DEATHS 8 29 1.5% 5 95.9% 18. SELF DESCRIBED HEALTH STATUS 7 28 1.4% 1 97.4%
9. LOW BACK PAIN 7 23 1.2% 5 98.6% LowPriority 14. PHYSICAL ENVIRONMENTAL FACTORS 6 13 0.7% 10 99.2% 22. UNINTENTIONAL INJURY 7 12 0.6% 1 99.8% Local Expert Added Need - Lack of access to dental care 1 3 0.2% 9 100.0% T o ta l 19 1,900 100.0% Note: One Local Expert allocated their points equally to all potential need topics. The results were dichotomized into two groups defined as “High Priority” and “Low Priority”. The criteria used for allocating a need into the High Priority as opposed to the Low Priority were employed in the following sequence of decisions:
The rank order established by the Local Expert point allocation totals could not be changed;
In the development of implementation planning, if a proposed implementation action would be directed to responding to multiple needs, then the individual needs could be merged with the final ranking being the sum of the Local Expert given point allocations for the individual needs (this did not occur in this project);
The desired result was to have the High Priority identified needs represent a majority of the points being allocated. Operationally this criterion was satisfied if the aggregate points of all High Priority needs exceeded 50% of the allocated points;
The desired result was to have the High Priority identified needs represent needs as identified by a majority of the Local Experts who were allocating points. Operationally this criterion was satisfied if 10 or more Local Experts allocated any points to the need; and
The break point between High Priority and Low Priority was an examination of results to determine where there was a sizable gap in the total allocated points from one need to the
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next lower need. In the above table of results from the Local Experts, the largest point gap in the sequence occurs, 58 points, occurs between Need #12 (Obesity/Physical Inactivity) and Need #1 (Births). This was not determined to be the break point because the prior criteria of representing a majority of the total allocated points had not been satisfied. The second largest point gap in the sequence, 27 points, occurs between Need # 4 (Coronary Heart Disease) and Need #21 (Suicide). Since the accumulated point allocations for the rank order needs of Need #4, Coronary Heart Disease and prior needs represented 79.2% of all allocated points, the criterion was met for having the High Priority needs represent a majority of allocated points. Since the number of Local Experts allocating any points to the needs prior to Need#1, births, represented a majority of Local Experts issuing an opinion, this criterion was deemed to have been met. At this point the numeric reference to the needs was revised from an alphabetical sequence value to a rank order as determined by the Local Experts. Accordingly the following rank order of needs resulted. High Priority Needs 1. Mental Health – former #10; 2. Baby Deaths – former #2; 3. Health Insurance/Uninsured – former #7; 4. Obesity/Physical Inactivity – former #12; 5. Births – former #1; 6. Physician – former #16; 7. Cancer – former #3; 8. Smoking – former #19; 9. Diabetes – former #5; and 10. Coronary Heart Disease – former #4. Low Priority Needs 11. Suicide – former #21; 12. Palliative Care – former #13; 13. Drinking – former #6; 14. Stroke – former #20; 15. Sexually Transmitted Disease – former #17; 16. High Blood Pressure – former #8;
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17. Motor Vehicle Injury – former #11; 18. Premature Deaths – former #15; 19. Self Described Health Status – former #18; 20. Low Back Pain – former #9; 21. Physical Environmental Factors – former #14; 22. Unintentional Injury – former #22; and 23. Dental – no former reference number. This list was provided to the administrative team at each hospital for their use in determining if the hospital held a “High Responsibility” or a “Low Responsibility” in responding to each need. The determination of a need being a high or a low responsibility was made by comparing the need to the mission and vision of the hospital along with a determination if the hospital offered services or capabilities required to improve conditions represented by the need. Three Rivers Health made the following determinations: High Priority Needs where Three Rivers Health holds High Responsibility 1. Mental Health; 4. Obesity/Physical Inactivity; 9. Diabetes; 6. Physician; 7. Cancer; and 8. Smoking. High Priority Needs where Three Rivers Health holds Low Responsibility 2. Baby Deaths; 3. Health Insurance/Uninsured; 5. Births; and 10. Coronary Heart Disease. Low Priority Needs where Three Rivers Health holds High Responsibility 15. Sexually Transmitted Disease; 11. Suicide; 14. Stroke; 16. High Blood Pressure;
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20. Low Back Pain; and 23. Dental Health. Low Priority Needs where Three Rivers Health holds Low Responsibility 12. Palliative Care; 13. Drinking; 17. Motor Vehicle Deaths; 18. Premature Deaths; 19. Self Describes Health Status; 21. Physical Environmental factors; and 22. Unintentional Injury. Sturgis Hospital made the following determinations. High Priority Needs where Sturgis Hospital holds High Responsibility 2. Baby Deaths; 5. Births; 6. Physician; 7. Cancer; 9. Diabetes; and 10. Coronary Heart Disease. High Priority Needs where Sturgis Hospital holds Low Responsibility 1. Mental Health; 3. Health Insurance/Uninsured; 4. Obesity/Physical Inactivity; and 8. Smoking. Low Priority Needs where Sturgis Hospital holds High Responsibility 12. Palliative Care; 14. Stroke; and 16. High Blood Pressure. Low Priority Needs where Sturgis Hospital holds Low Responsibility 11. Suicide;
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13. Drinking; 15. Sexually Transmitted Disease; 17. Motor Vehicle Deaths; 18. Premature Deaths; 19. Self Describes Health Status; 20. Low Back Pain; 21. Physical Environmental factors; 22. Unintentional Injury; and 23. Dental Health.
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Appendix H Illustrative Schedule H (Form 990) Part V B Potential Response
Illustrative IRS Schedule H (form 990) Part V B39
Community Health Need Assessment Answers
1. During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (Needs Assessment)? If "No," skip to line 8 Illustrative Answer – Yes If “Yes,” indicate what the Needs Assessment describes (check all that apply): a. A definition of the community served by the hospital facility b. Demographics of the community c. Existing health care facilities and resources within the community that are available to respond to the health needs of the community d. How the data was obtained e. The health needs of the community f. Primary and chronic disease needs and health issues of uninsured persons, low-income persons and minority groups g. The process for identifying and prioritizing community health needs and services to meet the community health needs h. The process for consulting with persons representing the community’s interests i. Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs j. Other (describe in Part VI) Illustrative Answer – check a. through i. Answers available in this report are found as follows: 1. a. – See Footnotes #17 (page 10) & #37 (page 102) 1. b. – See Footnotes #18 (page 11), #19 (page 11), #20 (page 11) & #36 (page 102) 1. c. – See Footnote #21 (page 16) 1. d. – See Footnotes #10 (page 6), #25 (page 75), #26 (page 85), #29 (page 92), #30 (page 93), #31 (page 95), #32 (page 96), #33 (page 97), #34 (page 98) & #35 (page 100)
39 Questions are drawn from 12/15/2011 Draft Forms and may have changed at the time when the hospital is to make its 990 h filing
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1. e. – See Footnotes #15 (page 7) 1. f. – See Footnotes #13 (page 7), #26 (page 85), #27 (page 89), #28 (page 90) & #38 (page 106) 1. g. – See Footnote #16 (page 8) 1. h. – See Footnote #11 (page7) 1. i. – See Footnote #9 (page 6) 1. j. – No response needed 2. Indicate the tax year the hospital facility last conducted a Needs Assessment: 20 _ _ Illustrative Answer – 2012 See Footnote #1 (Title page) 3. In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted Illustrative Answer – Yes See Footnotes #12 (page 7), #14 (page 7) 4. Was the hospital facility’s Need Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI. Illustrative Answer – No 5. Did the hospital facility make its Needs Assessment widely available to the public? If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply) a. Hospital facility’s website b. Available upon request from the hospital facility c. Other (describe in Part VI) Illustrative Answer – check a. and b. The hospital will need to obtain Board approval of this report, document the date of approval and then take action to make the report available as a download from its web site. It also may be prudent to place a notice in a paper of general circulation within the service area noting the report is available free upon request. 6. If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
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a. Adoption of an implementation strategy to address the health needs of the hospital facility’s community b. Execution of an implementation strategy c. Participation in the development of a community-wide community benefits plan d. Participation in the execution of a community-wide community benefits plan e. Inclusion of a community benefit section in operational plans f. Adoption of a budget for provision of services that address the needs identified in the Needs Assessment g. Prioritization of health needs in its community h. Prioritization of services that the hospital facility will undertake to meet the needs in its community i. Other (describe in Part VI) Illustrative Answer – check a, b, f, g, and h. 6. a. – See footnote #22 (page 58) 6. b. – See footnote #22 (page 58) 6. f. – See footnotes #6 (page 4) and #24 (page 63) 6. g. – See footnote #16 (page 8) 6. h. – See footnote #16 (page 8) 7. Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs? Illustrative Answer – No Part VI suggested documentation – See Footnote #23 (page 63)
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