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August 16, 2016 TO: Board of Health DEPARTMENT

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August 16, 2016 TO: Board of Health DEPARTMENT Memorandum Date: July 29, 2016 Order Date: August 16, 2016 TO: Board of Health DEPARTMENT: Health & Human Services PRESENTED BY: Karen Gaffney & Dr. Rick Kincade AGENDA ITEM TITLE: IN THE MATTER OF ADOPTING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE 2016 – 2019 COMMUNITY HEALTH IMPROVEMENT PLAN I. MOTION In the Matter of Adopting the Community Health Needs Assessment and the 2016 – 2019 Community Health Improvement Plan. II. AGENDA ITEM SUMMARY The Board of Health is being asked to review the Community Health Needs Assessment (CHNA) and the Community Health Improvement Plan (CHIP) for the period 2016 – 2019 and to approve Plan acceptance and implementation. III. BACKGROUND/IMPLICATIONS OF ACTION A. Board Action and Other History The Board of County Commissioners, sitting as the Board of Health, adopted both the Community Health Assessment (CHA) and the 2013–2016 Community Health Improvement Plan (CHIP) via BO 13-06-25-1 BOH. The CHA was an attempt to interpret data related to the health of the community. The CHIP represented a communitywide plan to improve the health issues/disparities identified via the CHA. The Board of Health and the BCC have been involved in the development of priorities and strategies related to the implementation of the 2013 – 2016 CHIP, including incorporating the CHIP strategies in the current County Strategic Plan. The BOH/BCC have received both ongoing updates of the CHIP implementation 2 and have been strategic partners in advancing CHIP priorities, particularly identifying six specific areas for work by Lane County. The current 2015-2016 Community Health Needs Assessment (CHNA) and the 2016-2019 CHIP have been produced through collaboration among Lane County Public Health, PeaceHealth Oregon Region, Trillium Community Health Plan, and the United Way of Lane County – the Live Healthy Lane partnership. The CHNA represents an attempt to not only assess, based on the “numbers”, but also to engage with and listen to the public regarding their concerns related to healthier living. The new CHIP represents input from over 200 organizations and 3,000 County residents. B. Policy Issues By state law, the Local Public Health Authority is responsible for assuring activities necessary for the preservation of health or prevention of disease in the area under its jurisdiction. A critical element of those duties is a clear assessment of the needs in the community, and a plan for addressing the priority needs. Lane County Public Health is charged with the performance of the core public health functions* and of the level of assessment and policy development required to assure the public’s health. The coalition collaborating to conduct the CHNA and to formulate the new CHIP have invested effort in ensuring that the public was informed about and involved in the processes related to gather data and proposing priority areas. *ORS 431.416 defines 5 required services: http://www.oregonlaws.org/ors/431.416 CLHO recognizes the ten PH functions found on page 40 of the attached CHIP. C. Board Goals The CHNA/CHIP supports Priority 1 – the promotion of a safe and healthy County. D. Financial and/or Resource Considerations The CHNA/CHIP process does not represent a plan development that seeks specific funding. No resources nor funding are requested by means of this process. Upon acceptance of the documents presented today, or a revised CHIP, the CHNA/CHIP will serve to guide programs developed by the County and its community partners, writ large, in seeking to adjust services and outreach to address the challenges identified as part of this assessment/plan development and to direct resources to better assist in reaching the goals set forth. E. Health Implications The Health Implications of all considered goals and strategies were assessed and 3 examined throughout the CHNA/CHIP process. The best summation of the Health Implications can be found in pages 26 through 32 of the attached CHIP. F. Analysis Community Health Needs Assessment The complete CHNA is attached to this agenda item. The CHNA was not conducted to just tabulate the state of health in Lane County, but to provide a view of the challenges and general factors facing residents, with an end to reducing health disparities, promoting health equity and improving the overall population health. The Mobilizing for Action through Planning and Partnerships (MAPP) framework was selected as the planning framework because of its strong emphasis on community input. MAPP is a nationally-recognized community- driven process to aid organizations in the development of health needs assessments. The results brought by such an assessment then provides the framework in which the Community – residents, care providers, governing bodies, services providers and non-governmental organizations – can develop a strategic vision that leads to the identification of goals to be pursued in the betterment of the health environment. The Assessment includes four specific assessments: Community Themes and Strengths, Community Health Status, Forces of Change, and Local Public Health System. Each assessment addresses a unique element, and together the results drive the priority setting for the Community Health Improvement Plan. This process produced acknowledgement that Lane County offers a high quality of life, but with easily identified disparities. There was broad-based recognition that the County must strive to be an inclusive community, to promote a strong economy that affords equitable opportunities to all and that achieving these goals requires coordinated responses to huge challenges, faced not just in Lane, but throughout the United States. Community Health Improvement Plan The CHIP process sought to interpret the needs identified in the CHNA, recognizing the negative impact of health disparities and the social determinants faced by lower-income and/or marginalized communities/populations. The CHIP has resulted in the identification of two, community and partner-endorsed goals and seven strategies, as follows: GOALS: • Increase economic and social opportunities that promote healthy behaviors. • Increase healthy behaviors to improve health and well-being. These goals recognize the importance of income, education level, neighborhood, race/ethnicity and the myriad of familial, social and personal factors in determining health, while also emphasizing the need to foster individual and 4 community actions/environments that promote good health. STRATEGIES: • Support economic development by investing in workforce strategies that provide sustainable family wage jobs. • Encourage a range of safe and affordable housing opportunities, including the development of integrated and supportive housing. • Assure availability of affordable healthy food and beverages in every community. • Strengthen cross-sector collaborations and align resources to improve the physical, behavioral, and oral health and well-being of our communities. • Encourage organizations across multiple sectors to integrate health criteria into decision-making, as appropriate. • Encourage the implementation of programs to promote positive early childhood development and safe/nurturing environments. • Support the implementation of evidence-based preventive screening and referral policies and services by physical, behavioral, and oral healthcare and social service providers. Of course, the ability of all community partners and the County to follow these strategies will be constrained by limited resources and funding. Each agency, governmental entity, service provider and community organization will focus on areas that best align to their strengths, priorities and areas. The intent of the plan development is not to dictate a path, but to provide an over-arching framework within which many efforts can contribute to well-defined goals, while reducing duplication and promoting collaboration, thereby multiplying the impact of these community-wide efforts. Just as with the prior CHIP, H&HS will seek opportunities to report to the Board of Health, to elicit their direction, and that of the County Administrator, in directing County resources, across all departments to these goals and their supporting strategies. Each succeeding assessment/analysis/plan will build upon, learn from and then inform the next CHIP. The CHIP was adopted by the PeaceHealth Board and the Trillium Board of Directors during their regular meetings in July. The Lane County Public Health Advisory Committee review the Plan at their July meeting, and unanimously voted to recommend approval by the Board of Health. G. Alternatives/Options 5 1. Accept the CHNA/CHIP as presented and approve its adoption. 2. Request revisions to the CHNA/CHIP, as enumerated to staff, providing conditional approval of the Plan, once those changes have been completed. 3. Give direction for additional study and drafting. IV. RECOMMENDATION Staff recommend approval of the current Community Health Needs Assessment and the 2016-2019 Community Health Improvement Plan. V. TIMING/IMPLEMENTATION If adopted, the CHIP will provide the strategic framework for a great deal of the work of the Department of Health & Human services and will assist in the prioritization of resource(s) allocation. VI. FOLLOW-UP Health & Human Services will continue to consult with the BOH/BCC and to engage the local coalition partners in formulating and directing the CHIP implementation. VII. ATTACHMENTS Board Order 2015-2016 CHNA 2016-2019 CHIP 6 BEFORE THE BOARD OF COMMISSIONERS OF LANE COUNTY, OREGON SITTING AS THE LANE COUNTY BOARD
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