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2012-2014 Action Plan, Setting Goals and Strategies for the Top Three Priority Areas – Access to Care, Behavioral Health, and Healthy Weight

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2012-2014 Action Plan, Setting Goals and Strategies for the Top Three Priority Areas – Access to Care, Behavioral Health, and Healthy Weight Howard County Local Health Improvement Coalition: 2012‐2014 Wrap-Up Report Introduction The Howard County Local Health Improvement Coalition (LHIC) was formed in 2011 as part of the Department of Health and Mental Hygiene’s State Health Improvement Process (SHIP). The coalition’s mission is to identify and reduce health disparities and achieve health equity among Howard County residents. Using local health data and input from stakeholders from throughout the County, the coalition developed the 2012-2014 Action Plan, setting goals and strategies for the top three priority areas – Access to Care, Behavioral Health, and Healthy Weight. The coalition then formed work groups to implement each area of the plan. This report details the progress made toward the 2012-2014 Action Plan. The report is divided based on the three work groups that were created to implement the Action Plan. Each work group focused on a specific priority that was targeted for improvement. The report also provides a highlight of the current LHIC’s 2015-2017 Action Plan. Priority Area: Access to Care The focus of the Access to Care Workgroup is to address Priority #1 from the 2012-2014 Local Health Improvement Action Plan: Increase access to health care. Summary of Activities Prenatal Care Program As a result of the work group’s recommendation, Healthy Howard, Inc., created a Prenatal Care Program which provided services, including transportation for prenatal care, for undocumented Latina women. The program ran from December 2012 to December 2014 and served a total of 108 Latina women. Kaiser Bridge Plan The Kaiser Bridge Plan partnership was designed to help those who cannot afford health care coverage due to an unexpected change in job status or income and for individuals who would not be eligible for any other public or private health care program. In 2013, a total of 157 Howard County residents were enrolled in the Bridge program. Community Awareness on the Affordable Care Act The Door to HealthCare held five community forums in September of 2013, one in each District. More than 29 presentations were given to the community at large and to organizations. Between June 2013 and October 2014, the Door held more than 250 events to disseminate information on how to get affordable health insurance through the Affordable Care Act. For the full report of the 2012-2014 Access to Care Work Group, see Appendix I. 1 Priority Area: Healthy Weight The focus of the Healthy Weight Workgroup is to address Priority #2 from the 2012-2014 Local Health Improvement Action Plan: Enable people of all ages to achieve and maintain a healthy weight through healthy eating and physical activity. Summary of Activities School Health Policy Members of the Healthy Weight work group served on the committee to revise the Howard County Public School System’s Policy 9090, Wellness Through Nutrition and Physical Activity, which went into effect July 1, 2014. This policy has been graded an “A” for comprehensiveness and a “B” for strength by the Yale University Rudd Center for Food Policy and Obesity. Physician Education The Healthy Weight group, along with the Childhood Obesity Prevention Project, worked together to create a Childhood Obesity Prevention Toolkit and distribute almost 200 copies to Howard County healthcare providers serving children. They also conducted two successful CME events that each educated approximately 40 providers on the issue of childhood obesity. Howard County Unsweetened Campaign The group helped to promote the Howard County Unsweetened Campaign that promotes better beverage choices. As a result on this campaign, in the past year, sales of top soda brands have dropped 4.1 percent in Howard County versus a decline of 1.3 percent nationally. In addition, based on a preliminary analysis, it appears that soda consumption is declining in Howard County at two to three times the national rate. Other Efforts The group supported the Healthy Eating and Active Living (HEAL) Zone to promote the Cooking Matters at the Store Tour, efforts to establish a community garden within the Zone and use of the Roving Radish program. For the full report of the 2012-2014 Healthy Weight Work Group, see Appendix II. Priority Area: Behavioral Health The focus of the Behavioral Health Work Group is to address Priority #3 from the 2012-2014 Local Health Improvement Action Plan: Expand access to behavioral health resources and reduce behavioral health emergencies. Summary of Activities Behavioral Health Services Survey In mid-2012 and again in early 2013, the work group attempted to conduct a survey to assess the capacity of and need for behavioral health services in Howard County. The survey had three components: a survey of behavioral health providers to capture the capacity of services; a survey of primary care providers to determine the providers’ assessment of the need for services; and, a survey of urgent care providers to capture capacity of services and interest in participating in a coordinated system of behavioral health care. While there was a good response from the behavioral 2 health providers, PCPs and Urgent Care centers had a very low response rate. The work group attempted to reach out to the PCPs and Urgent Care centers again in February of 2013, but, again, with very poor response. The work group has tabled this effort. Behavioral Health Hospital Use Data Analysis In October 2012, the work group decided to do some data analysis around hospital utilization by Howard County residents for behavioral health and substance use diagnoses. The group felt that identifying the high utilizers of these services by diagnosis, age, race, ethnicity, and zip code would help inform the process of determining interventions to address the LHIC priority of reducing behavioral health emergencies. The analysis was repeated with 2013 data and was put into a presentation for the Howard County Behavioral Health Task Force. Raising Awareness As part of the work group’s on-going efforts, members share information about events, activities, and services in meetings and on social media. Members are able to forward information to the LHIC staff, who send them on to the Health Department’s Public Information Officer to post on the Health Department’s and the LHIC’s Facebook pages. Information is also shared via the bi-weekly LHIC Digest. Behavioral Health Continuum of Care With the help of LHIC staff, the work group is now compiling a behavioral health continuum of care and identifying gaps in services in the county. Other Efforts The work group also began an effort to bring Mental Health First Aid Training to the county and began discussing an educational campaign regarding emotional wellness. The first aid training began in FY2015. The emotional wellness campaign is still in the discussion phase. For the full report of the 2012-2014 Behavioral Health Work Group, see Appendix III. 3 APPENDIX I LHIC Action Plan Tracking Tool – 2012-2014 Summary - Access to Care Priority 1a) Reduce proportion of people who reported there was a time in the last 12 months they could not afford to see a doctor. Goals County African Hispanic White Asian American Baseline 7.2% 12.8% * 4.1% * 2014 5.8% 7.2% 3.2% * * Goal Measure (Data SHIP #39 SHIP #39 SHIP #39 SHIP #39 SHIP #39 Source) (BRFSS) (BRFSS) (BRFSS) (BRFSS) (BRFSS) 2014 7.6% 8.3% 6.6% Note: 2014 SHIP data for Howard County uses aggregate BRFSS data for 2011-2013. * * SHIP 2014 5.7% 8.0% 1.6% 5.0% 7.9% Note: Small sample sizes for subgroups may make data unreliable. Hispanic: 42; Other: 79; Asian: 174. HCHAS 10/5/2015 Access to Care Page 1 of 5 LHIC Action Plan Tracking Tool – 2012-2014 Summary - Access to Care Strategies Action Steps 1A. Identify and reduce barriers to access to existing services 1. Health Literacy program (Door w/University of MD Extension, MHBE.) - Western Region. The Door such as lack of knowledge/information, language barriers, to HealthCare Western Region is working with the University of Maryland Extension, MHBE, and the transportation and barriers for specific populations such as Maryland Women’s Coalition for Health Care Reform on “My Smart Choice Health Insurance© seniors, low-income residents, etc. Consumer Workbook” and other materials that will help people get and use health insurance. Materials were created by the University of MD Extension and University of Delaware Extension. Healthy Howard is member of the Maryland Rural Health Association and works closely with the Association on outreach to the rural community. HHI also works with Health Care for All, creating partnerships to avoid duplication of effort. 2. Healthy Howard's Prenatal Coordination Program provided services, including transportation for prenatal care, for undocumented Latina women. The program ran from December 2012 to December 2014 and served a total of 108 Latina women. 3. Through a grant from the Horizon Foundation, MARTTI (My Accessible Real Time Trusted Interpreter) was piloted with Chase Brexton, Healthy Howard, and HCGH. • MARTTI provided interpretation for 39 languages, including American Sign Language • The top five most commonly interpreted languages were Spanish (46%); Korean (16%); Chin (11%); Mandarin (7%); and, American Sign Language (5%) 4. Healthy Howard's Re-entry Health Services Program started 10/2012 and has served a total of 353 clients. In partnership with the Laurel Multi Service Center, the program created a community office to serve clients who have been released from incarceration. 5. The Horizon Foundation met with Health Care for the Homeless to see if they could offer services to the Day Resource Center (pre-ACA). As a FQHC, they would need to apply for an expansion/scope of work. Follow up conversations were not continued (post ACA). 6. Healthy Howard established the Door to HealthCare Western Region program in 2013 to connect residents of the 6 Western Region counties to health insurance.
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