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Community Health Needs Assessment LCMC Health – Touro Infirmary Table of Contents

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Community Health Needs Assessment LCMC Health – Touro Infirmary Table of Contents October 2018 Community Health Needs Assessment LCMC Health – Touro Infirmary Table of Contents INTRODUCTION 3 TOURO INFIRMARY PRIMARY SERVICE AREA 5 METHODOLOGY 13 KEY COMMUNITY NEEDS 23 PRIORITY 1: BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE) 25 PRIORITY 2: HEALTH LITERACY 39 PRIORITY 3: ACCESS TO CARE 53 CONCLUSION 60 APPENDIX A: GENERAL DESCRIPTION OF LCMC HEALTH & TOURO INFIRMARY 62 APPENDIX B: OVERALL NEW ORLEANS REGION COMMUNITY DEFINITION 62 APPENDIX C: PRIMARY AND SECONDARY DATA OVERVIEW 69 APPENDIX D: COMMUNITY STAKEHOLDER INTERVIEWEES 88 APPENDIX E: COMMUNITY ORGANIZATIONS AND PARTNERS 90 APPENDIX F: WORKING GROUP MEMBERS 95 APPENDIX G: TRUVEN HEALTH ANALYTICS 96 APPENDIX H: REGIONAL GROUPINGS 98 APPENDIX I: TRIPP UMBACH 99 LCMC Health - Touro Infirmary 2 Introduction LCMC Health is a Louisiana-based, not-for-profit healthcare system serving the needs of the people of Louisiana, the Gulf South, and beyond. LCMC Health currently manages award-winning hospitals including Children’s Hospital New Orleans, Touro Infirmary, New Orleans East Hospital (NOEH), University Medical Center New Orleans (UMCNO), and West Jefferson Medical Center. Founded in 1852, Touro Infirmary is New Orleans’ only community based, non-profit, faith-based hospital. For more than 165 years Touro has had a special place in the heart of the community, providing high quality, compassionate healthcare to the New Orleans community. As a full-service hospital, Touro offers medical, surgical, intensive care, obstetric, skilled nursing inpatient services, inpatient and outpatient rehabilitation services and a 24-hour Emergency Department. As an adult, acute care hospital, Touro offers comprehensive healthcare services at every stage of life, from delivering the second most babies in the state for any single hospital to providing cardiac, cancer and rehabilitation care in a warm and healing environment. The Patient Protection and Affordable Care Act (PPACA), which went into effect on March 23, 2010, requires tax-exempt hospitals to conduct community health needs assessments (CHNA) and implementation strategies to improve the health and well-being of residents within the communities served by the hospital(s). These strategies created by hospitals and institutions consist of programs, activities, and plans that are specifically targeted toward populations within the community. The execution of the implementation strategy plan is designed to increase and track the impact of each hospital’s efforts. Tripp Umbach was contracted by Metropolitan Hospital Council of New Orleans (MHCNO) to conduct a CHNA for East Jefferson General Hospital, LCMC Health, Ochsner Health System, HCA Healthcare (Tulane Medical Center), Slidell Memorial Hospital, and St. Tammany Parish Hospital.1 The overall CHNA involved multiple steps that are depicted in Chart 1. Additional information regarding each component of the project, and the results, can be found in the Appendices section of this report. The CHNA process undertaken by LCMC Health, along with East Jefferson General Hospital, HCA Healthcare (Tulane Medical Center), Ochsner Health System, Slidell Memorial Hospital, and St. Tammany Parish Hospital, with project management and consultation by Tripp Umbach, included input from representatives of the community served by the hospital facilities, including those with special knowledge of public health issues and data related to underserved, hard-to-reach, vulnerable populations; and representatives of vulnerable populations served by each hospital. Tripp Umbach worked closely with Working Group members to oversee and accomplish the assessment and its goals. This report fulfills the requirements of the Internal Revenue Code 501(r)(3), established within the PPACA, requiring that nonprofit hospitals conduct CHNAs every three years. 1 Tripp Umbach worked closely with Working Group members composed of hospital administration leaders from participating hospitals and health systems. A complete Working Group member listing can be found in Appendix F. LCMC Health - Touro Infirmary 3 Data from government and social agencies provide a strong framework and a comprehensive view to the overall CHNA. The information collected, which includes socioeconomic information, health statistics, demographics, and mental health issues, is a snapshot of the health of residents in Southern Louisiana. The CHNA report is a summary of primary and secondary data collected for Touro Infirmary. The requirements imposed by the IRS for tax-exempt hospitals and health systems include the following: ➢ Conduct a CHNA every three years. ➢ Adopt an implementation strategy to meet the community health needs identified through the assessment. ➢ Report how it is addressing the needs identified in the CHNA and describe needs that are not being addressed, with the reasons why. The Department of the Treasury and the IRS require a CHNA to include: 1. A description of the community served by the hospital facilities and how the description was determined. 2. A description of the process and methods used to conduct the assessment. • A description of the sources and dates of the data and other information used in the assessment, and the analytical methods applied to identify community health needs. • A description of information gaps that affect the hospital organization’s ability to assess the health needs of the community served by the hospital facility. • Identification of organizations that collaborated with the hospital and an explanation of their qualifications. 3. A description of how the hospital organizations considered input from persons who represent the broad interests of the community served by the hospitals. In addition, the report must identify any individual providing input that has special knowledge of or expertise in public health. The report must also identify any individual providing input who is a “leader” or “representative” of populations. 4. A prioritized description of all of the community health needs identified through the CHNA, as well as a description of the process and criteria used in prioritizing such health needs. 5. A description of the existing health care facilities and other resources within the community available to meet the community health needs identified through the CHNA. 6. A description of the identified needs that the hospital intends to address, the reasons those needs were selected, and the means by which the hospital will undertake addressing the selected needs.2 2 The outcomes from the CHNA will be addressed through an implementation planning phase. LCMC Health - Touro Infirmary 4 Touro Infirmary Primary Service Area A comprehensive CHNA was completed for Touro Infirmary which began in early 2018. The primary service area for Touro Infirmary was defined by ZIP codes that contain a majority (80 percent) of inpatient discharges from the health care facility. In 2018, a total of 22 ZIP codes were identified for Touro Infirmary service area as containing a majority of inpatient discharges. The CNI information is represented in the below map as well as on the proceeding table (See Map 1 and Table 1). Data from Truven Health Analytics was supplied to gain a deeper understanding of community health care needs.3 The Community Needs Index (CNI), jointly developed by Dignity Health and Truven Health, assists in the process of gathering vital socioeconomic factors in the community. CNI is a strong indicator of a community’s demand for various health care services. The CNI data will be used to quantify the implementation strategy efforts and plans for Touro Infirmary. Map 1: Touro Infirmary – Study Area Note: Map is not to scale. Source: Truven Health Analytics 3 Truven Health Analytics, formerly known as Thomson Reuters, is a multinational health care company that delivers information, analytic tools, benchmarks, research and services to a variety of organizations and companies. Truven Health Analytics uses: Demographic data, poverty data (from The Nielsen Company) and insurance coverage estimates (from Truven Health Analytics) to provide Community Needs Index (CNI) scores at the ZIP code level. Additional information on Truven Health Analytics can be found in the Appendices. LCMC Health - Touro Infirmary 5 Table 1: Touro Infirmary – Study Area ZIP codes ZIP Code Parish 1. 70115 Orleans Parish 2. 70117 Orleans Parish 3. 70119 Orleans Parish 4. 70126 Orleans Parish 5. 70122 Orleans Parish 6. 70118 Orleans Parish 7. 70127 Orleans Parish 8. 70128 Orleans Parish 9. 70125 Orleans Parish 10. 70130 Orleans Parish 11. 70114 Orleans Parish 12. 70124 Orleans Parish 13. 70113 Orleans Parish 14. 70043 St. Bernard Parish 15. 70005 Jefferson Parish 16. 70131 Orleans Parish 17. 70116 Orleans Parish 18. 70058 Jefferson Parish 19. 70065 Jefferson Parish 20. 70003 Jefferson Parish 21. 70001 Jefferson Parish 22. 70056 Jefferson Parish LCMC Health - Touro Infirmary 6 Map 2: Touro Infirmary – 2017 CNI Map The CNI score is an average of five different barrier scores that measures various socio-economic indicators of each community using the source data. The five barriers are income, culture, education, insurance, and housing. A score of 1.0 indicates a ZIP code with the least need, while a score of 5.0 represents a ZIP code with the most need. Reviewing information related to LCMC Touro Infirmary’s primary service area, ZIP codes 70113, 70114, and 70117 had a 2017 CNI score of 5.0 (more socioeconomic needs); while, on the polar end ZIP codes 70005 (Metairie), and 70124 (New Orleans) had a CNI score of 2.8 and 2.0 respectively. Note: Map is not to scale. Source: Truven Health Analytics 2017 CNI Score 5.00 to 4.00 (High-socioeconomic barriers) 3.99 to 3.00 1.99 to 1.00 (Low-socioeconomic barriers) LCMC Health - Touro Infirmary 7 Table 2: Touro Infirmary – Study Area ZIP codes ZIP Code City Parish 2017 CNI Score 70113 New Orleans Orleans Parish, LA 5.0 70114 New Orleans Orleans Parish, LA 5.0 70117 New Orleans Orleans Parish, LA 5.0 70119 New Orleans Orleans Parish, LA 4.8 70126 New Orleans Orleans Parish, LA 4.8 70127 New Orleans Orleans Parish, LA 4.8 70116 New Orleans Orleans Parish, LA 4.6 70125 New Orleans Orleans Parish, LA 4.6 70043 Chalmette St.
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