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2014 – 2016 Implementation Strategy

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2014 – 2016 Implementation Strategy The MISSION of Holyoke Medical Center Holyoke Medical A Member of Valley Health Systems Center is to serve the health needs 2014 – 2016 of the community Implementation in a high quality and efficient Strategy manner. for 2013 Community Health Needs Assessment Holyoke Medical Center • 575 Beech Street, Holyoke MA 01040 • 413.534.2500 • WWW.HOLYOKEHEALTH.COM Introduction This implementation strategy describes how Holyoke Medical Center plans to address significant community health needs in 2014 through 2016. These needs were identified in the 2013 Community Health Needs Assessment (CHNA) published and made widely available to the public on August 29, 2013. The 2013 CHNA and this implementation strategy were undertaken to understand and address community health needs, and in accordance with proposed Internal Revenue Service (IRS) regulations pursuant to the Patient Protection and Affordable Care Act of 2010. Final guidance as to the content and format of these documents has not been issued by the IRS. This implementation strategy outlines the significant community health needs described in the CHNA that Holyoke Medical Center plans to address in whole or in part. Holyoke Medical Center may amend this implementation strategy as circumstances warrant. For example, certain needs may become more pronounced and merit enhancements to the described strategic initiatives. Alternately, other organizations in the community may decide to address certain community health needs included here. This plan and its strategies may be refocused to account for such changes in the community landscape. Holyoke Medical Center plays a critical role in providing healthcare services and community benefit throughout Holyoke, Chicopee, South Hadley, Granby, Easthampton, Southampton, West Springfield and Belchertown, serving an aggregate population of 180,000. While the work described in the implementation strategy focuses on addressing significant health needs identified in the CHNA, other essential health programs also will continue. For more information on Holyoke Medical Center’s additional programs and services, please visit www.holyokehealth.com. 2 About Holyoke Medical Center The MISSION of Holyoke Medical Center is to serve the health needs of the community in a high quality and efficient manner. What started as a 40‐bed hospital in 1893 has grown to be a 198‐bed facility with 1,200 employees. Each year Holyoke Medical Center admits more than 7,500 patients, while the Emergency Department currently experiences an annual volume of more than 45,000 visits. Holyoke Medical Center is a member of Valley Health Systems, Inc. in Holyoke. Holyoke Medical Center, in collaboration with the Coalition of Western Massachusetts Hospitals, conducted a community health needs assessment in the early part of 2013. The survey was conducted because the hospital wants to understand better community health needs and to develop an effective implementation strategy to address priority needs. Please click here to view the findings of the community health needs assessment. (http://www.holyokehealth.com/uploadedFiles/Holyoke%20Medical%20Center%20CHNA%205 %2022%2013%20Final.pdf) 3 2013 Community Health Needs Assessment Summary Holyoke Medical Center is a member of the Coalition of Western Massachusetts Hospitals (Coalition) which also includes Baystate Medical Center, Mercy Medical Center, Baystate Franklin Medical Center, Baystate Mary Lane Hospital, Cooley Dickinson Hospital, and Wing Memorial Hospital. The Coalition hospitals collaborated in preparing their CHNAs. Federal regulations require that tax‐exempt hospitals provide and report community benefits to demonstrate that they merit exemption from taxation. As specified in the instructions to IRS Form 990, Schedule H, community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. Community benefit activities or programs seek to achieve objectives, including: improving access to health services, enhancing public health, advancing increased general knowledge, and relief of a government burden to improve health. The full 2013 Community Health Needs Assessment report conducted by Holyoke Medical Center is available at www.holyokehealth.com. Definition of the Community Served The HMC community, which contains 18 ZIP codes in 13 towns in Hampshire and Hampden counties, benchmarks favorably on a number of health indicators. However, health status and access problems are present. The community is aging and diversifying, driven by growth in elderly and in Asian, Black, and Hispanic (or Latino) populations. Holyoke has a comparatively large Hispanic (or Latino) population, while Chicopee, East Longmeadow, and South Hadley have higher percentages of residents aged 65+. Hampshire County is growing at a slightly faster rate than Hampden County. Hampden County reports comparatively low graduation rates and comparatively high rates of disability, particularly among youth. These factors can contribute to poverty, health care access barriers, and poor health. Additional observations of the 2013 CHNA: Population (2012): 464,416 High poverty rates 4 Higher crime rates than the Commonwealth of Massachusetts Disparities for Black and Hispanic (or Latino) residents More likely to be living in poverty Higher stroke, heart disease, diabetes, and cancer mortality rates. Significant Health Needs Identified The 2013 CHNA identified a number of significant health needs in the community. Those needs are summarized below. A complete description of these health needs — including the community input taken into account, the data analyzed, and the prioritization methods used — can be found in the 2013 CHNA report available at http://www.holyokehealth.com. Access to Care • Lack of Affordable and Accessible Medical Care • Need for Culturally Sensitive Care • Need for Increased Integration and Coordination of Health and Human Services Dental Health • Lack of Access to Dental Care Health Behaviors • High Rates of Alcohol (Hampden County) and Drug Use • High Rates of Unsafe Sex (Hampden County), Teen Pregnancy, and Chlamydia (Hampden County) Maternal and Child Health • Prevalent Infant Health Risk Factors (e.g., smoking during pregnancy, births to women age 40‐54) • Pediatric Disability (Hampden County) Mental Health • Lack of Access to Mental Health Services and Poor Mental Health Status Morbidity and Mortality • High Rates of Diet and Exercise‐Related Diseases and Mortality (e.g., obesity, diabetes, heart disease) • High Rates of Asthma 5 • Racial and Ethnic Disparities in Disease Morbidity and Mortality (e.g., breast and prostate cancer, chronic liver disease, stroke) ( Hampden County) Physical Environment • Poor Community Safety (e.g., homicide and other violent crimes) • Poor Built Environment and Environmental Quality (e.g., air quality, presence of food deserts) Social and Economic Factors • Basic Needs Insecurity: Financial Hardship, Housing, and Food Access • Low Educational Achievement 6 Significant Health Needs the Hospital Will Address Identified Need: • High Rates of Asthma Asthma Initiatives Holyoke Medical Center (HMC) has identified that 689 children were seen in our Emergency Department in the last year for asthma related illnesses. According to our most recent Community Health Needs Assessment, 36% of the population in Holyoke is Latino, the majority of who are Puerto Rican. Compared to the White population, asthma prevalence is higher in children who are Puerto Rican. In general, this disadvantaged at‐risk population experiences above average rates of Emergency Department visits. (Holyoke Medical Center Community Health Needs Assessment, May 2013). According to the most recent estimates from the U.S. Census Bureau, 40.3% of Holyoke families with children under 18 years of age live below the Federal poverty level. For female‐headed households with children under 5, this figure rises dramatically to 81.3%. Therefore, almost half of all Holyoke children live in poverty. Despite the higher rates of the disease, access to medical care for asthma is often lower among minority and disadvantaged populations. There is a strong possibility that many days are missed from school by this population due to poorly controlled asthma. Missing school contributes to lower graduation rates and the ability for this population to break out of the cycle of poverty. Holyoke Medical Center is proposing an intervention that will take place in our Emergency Department specifically with our pediatric asthma patients. During the initial encounter the patient/parent will be asked to answer the seven questions of the Childhood Asthma Control Test. The score will trigger interventions in the ED and referral to their primary care provider for disease specific follow up. This intervention model will trigger the pediatrician to institute an action plan for the child and parent that can be shared with community partners such as schools and afterschool programs. The Childhood Asthma Control Test is a widely used tool that helps the healthcare provider determine if the child's asthma symptoms are under control. The Asthma Control Test tool will help providers capture information such as days missed from school, ED visits for asthma exacerbations and identify triggers. The provider can then, with the parent, determine the best treatment. An educational program will be developed to target the parents of children with asthma that will include the importance of reducing triggers such
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