2017 Washington County Community Health Improvement Plan September 2017
Live Well Washington County Letter from the Division Manager Washington CountyPublicHealthDivisionManager Tricia Mortell health. Thesepartnershipsmakeadifference inourcommunity. Thank youtothemanypartnersfocusedonsupporting andimprovingindividualcommunity tell ourstoryandtrackprogress. framework willincorporatelocalmeasuresimportanttocommunitypartnersandthosethathelpus progress. Thesemeasureswillevolveovertimetomeetourchangingcommunityconditions.Our together aroundwhatdriveshealthaswellstudyandreportonbroadmeasurestotrackour and spiritualfactors.”Useofthisframeworkwillhelpusasacommunitytalkaboutcome the sumofmanyparts,addressinginterdependencesocial,economic,physical,environmental Well-being aspartofourCHIP. TheRWJFframework“reflectsavisionofhealthandwell-beingas adopting theRobertWood JohnsonFoundation’s (RWJF)FrameworkforaCultureofHealthand To acknowledgethemanyactionsneededtodevelopandsupportahealthycommunity, weare where peoplelive,learn,workandplayhasatremendousimpact. has shownthathealthandwell-beingaregreatlyinfluencedbymanycomplexfactors the outcomeofendeavorsandactivitiespartnersacrossmanysectorsourcommunity. Research just abouttheworkofpublichealthandproductsthisCHIP. Improvingcommunityhealthis • Our CHIPprioritiesareto: apply atrauma-informedlenstotheCHIPwork. The foundationalgoalsfortheCHIParetoreducehealthdisparities,improveequityand on thesediscussions,theCHIPprioritieswereselected. thoughts aboutinformationintheCHAalongwithwhattheirorganizations’prioritieswere.Based vision fortacklingimportanthealthissues.Morethan100diverseorganizationssharedtheir The CHIPwasdevelopedthroughover12monthsofworkacrossthecommunitytocreateashared upon theprogresswe’vemadesinceour2014CHIP. Health Assessment(CHA)conductedbytheHealthyColumbiaWillametteCollaborative.Italsobuilds health improvementplan(CHIP).ThiswasinformedbythemostrecentregionalCommunity T • • It ismypleasuretosharewithyouanupdate Dear CommunityPartner: ackling theseprioritiesisimportantforWashington County, butimprovingcommunityhealthisnot
Prevent ChronicConditions. Improve behavioralhealthoutcomes,includingmentalhealth,suicideandaddictions. Improve accesstohealthcare,includingprimarybehavioralandoralservices. Live Well Washington County Washington Well Live , ourcommunity 2 | Table of Contents
I. Acknowledgments...... 3
II. Executive Summary...... 4
III. Demographics and Social Determinants of Health...... 6
IV. Culture of Health and Well-being...... 9
V. CHIP Priority Areas a. Overview...... 11 b. Foundational Goals: Health Equity & Disparities...... 12 c. Priority 1: Access to Care...... 13 d. Priority 2: Behavioral Health...... 14 e. Priority 3: Chronic Conditions...... 15
VI. CHIP Structure & Committees a. Overview...... 16 b. Committee Objectives...... 17 c. Tracking and Implementation...... 19
Table of Contents Table VII. Appendices a. CHIP Planning Process...... 20 i. Community Health Assessment...... 22 ii. Input from Washington County Community Partners and Stakeholders...... 26 iii. Health Equity Planning...... 29
b. 2014 CHIP: Achievements and evaluation from the last cycle...... 30 i. Progress and success stories...... 30 ii. Overview of the CHIP evaluation...... 31
c. List of partners that provided input to CHIP...... 32
d. Sources and references...... 33
e. Detailed committee work plans...... 33
2017 Community Health Improvement Plan for Washington County I. Acknowledgments Legacy Health Kaiser Permanente Jewish Family&ChildServices HomePlate Youth Services Home InsteadSeniorCenter Hillsboro SchoolDistrict Hillsboro PoliceDepartment Hillsboro EducationCenter Healthy SchoolsProgram Healthier Generation Health ShareofOregon Forest GroveSchoolDistrict FamilyCare Health Family ForwardOregon Elders inAction Domestic Violence Resource Center Community Action Clackamas County Cedar HillsHospital Catholic Charities Cascade Academy Care Oregon Boys andGirlsClubs Boys andGirlsAid Borland FreeClinic Beaverton SchoolDistrict Beaverton FullGospelChurch Asian Health&ServiceCenter Adventures WithoutLimits Adelante Mujeres Washington CountyCHIPOrganizations Minority Communities Leticia V Public HealthServices Dick Stenson–Consumerof Kristine Rabii–HospitalRepresentative Rachel Parker–Youth Representative Lou Ogden–ElectedOfficial Sebastian Lawler–CPORepresentative David Eppelsheimer–FaithRepresentative Tom Engle–ConsumerofPublicHealthServices Eileen Derr–LicensedHealthCareProfessional Larry Boxman–PublicSafetyRepresentative Underserved/Minority Communities Nicole Bowles–PersonRepresenting Robin Bousquet–BusinessRepresentative Board ofCommissioners): Public HealthAdvisoryCouncil(Appointedbythe Gwyn Ashcom,MPH,MCHES Eva Hawes,MPH,CHES Kimberly Repp,PhD,MPH Amanda Garcia-Snell,MPH Tricia Mortell,RD,MPH Rose Sherwood,MPH Erin Jolly, MPH Authors andContributors itela –PersonRepresentingUnderserved/
Westside Transportation Alliance Washington CountySheriff’s Office Washington CountyProbation&Parole Washington CountyLandUseandTransportation Washington CountyKids Washington CountyJuvenileServices Washington CountyHousing Services Washington CountyHealth andHumanServices Washington CountyCooperative LibrarySystem Washington CountyAdministrative Office Voices SetFree Virginia GarciaMemorial HealthCenter Veterans AssociationMedicalCenter University ofPortland Tuality Healthcare Tuality HealthAlliance Tualatin Tomorrow Committee Tualatin Together Coalition Tualatin Hills ParkandRecreationDistrict Tri County911 Program Tigard-Tualatin SchoolDistrict Tigard Turns theTide Tigard PoliceDepartment The IntertwineAlliance Southwest CommunityHealthCenter Sherwood SchoolDistrict Sherwood RegionalFamilyYMCA Sequoia MentalHealthServices,Inc. Senior HealthInsuranceBenefitsAssistanceProgram Safe Families Rose CityGeropsychology Providence Health&Services Project AccessNOW Pacific University Oregon StateUniversityExtensionService Oregon PediatricSociety Oregon OralHealthCoalition Oregon HealthandScienceUniversity Oregon DepartmentofHumanServices Oregon CommunityHealthWorker Association Seasonal, andEarlyHeadStart Oregon ChildDevelopmentCoalitionMigrant, NW CounselingAssociates Northwest RegionalEducationServiceDistrict Neighborhood HealthCenter National UniversityofNaturalMedicine National AssociationforMentalIllness Multnomah County Morrison Child&FamilyServices Monika’s House Migrant HeadStart Metro West Ambulance,Inc. Meals onWheels Lutheran CommunityServicesNW Lines forLife LifeWorks Northwest Acknowledgments |3 4 | Executive Summary
THE MANY partnerships focused on improving community conditions to support individual and community health can “make a difference.
The Community Health Improvement Plan organizations and public health partners to (CHIP), Live Well Washington County, improve alignment in our community. The is a strategic community work plan that CHA includes population data and robust defines how Washington County Public community engagement to ensure that Health (WCPH) and community partners both are reflected in the prioritization of will come together to develop a culture health issues to inform the CHIP. The process of health and to address priority health also included a review of the priorities with issues identified by a comprehensive community stakeholders to gather input on assessment of local Washington County how to address these health priority areas. data. Many factors affect the health Social determinants of health, such as II. Executive Summary of individuals and communities. The complexity of these factors makes it income and employment opportunities, essential to work collaboratively with education, environmental conditions, social many partners across sectors to address support networks and access to health care the unique needs of the community. In services, are complex and best addressed addition, Washington County’s diversity through a communitywide approach. The and changing demographics increase the leadership of community partners is vital need for cross-sector strategic partnerships to improving health and is demonstrated to improve health. The CHIP addresses the through their strategies and programs that social and environmental determinants of work toward achieving this overarching health by engaging partners from across goal. To foster these strong partnerships the community to tap in to expertise, and to highlight the critical role of knowledge and resources. community partners to improve health outcomes in Washington County, WCPH The community health assessment (CHA) is has adopted the Robert Wood Johnson the basis for development of the CHIP. The Foundation Culture of Health framework as 2016 CHA was conducted in partnership the foundation for the 2017 CHIP. with regional hospitals, coordinated care
2017 Community Health Improvement Plan for Washington County Executive Summary | 5
WCPH evaluated the 2014 CHIP areas based on gap areas in the participants discussed issues to ensure continuous quality community, areas with fewer related to race, advantage and improvement and also to make existing efforts, where there are privilege; practiced implementing sure we are building on past opportunities to build on existing the equity tool on case study successes with this update. Over momentum, and areas that examples; and applied the tool to the past three years, collaborative stakeholders have identified as identify the foundational goals for CHIP committees have been priorities based on input from the the CHIP and three priority areas. meeting regularly to implement populations they serve. These are the areas where the health improvement strategies 2017 Washington County CHIP will based on the 2014 CHIP work plan. Using this input and the CHA data, lead and coordinate efforts in the The committees have achieved the CHIP Steering Committee county. The foundational goals successes and made significant and WCPH Management Team for the CHIP are to reduce health progress in developing stronger came together for two half-day disparities, improve health equity, partnerships across community facilitated sessions to apply an and apply a trauma-informed lens organizations. The new structure equity lens to the CHIP. The to the CHIP work. will build on these achievements. Themes from the evaluation process included improving PRIORITIES alignment between partners’ • Improve access to health care, including primary care, missions and the CHIP; engaging behavioral health and oral health services diverse and non-traditional partners; ensuring accessible and • Improve behavioral health outcomes, including mental health, regularly scheduled meetings; suicide and addictions providing community partners • Prevent chronic conditions with technical assistance and capacity-building opportunities; and supporting collaboration COMMITTEES among partners. The 2017 CHIP is comprised of the following committees that will implement strategies to address the three priorities: In an effort to ensure that the CHIP meets the greatest needs • CHIP Steering Committee in Washington County, WCPH • Access to Care Committee gathered input from a broad • Cross Sector Navigation Committee range of community stakeholders. Through this process, over 100 • Older Adult Behavioral Health Committee diverse Washington County • Healthy Communities Committee (Chronic Conditions and organizations and stakeholders Built Environment) reviewed local data and gave • Suicide Prevention Council input into the structure and priorities for the Washington • Adverse Childhood Experiences (ACEs) Collaborative
County CHIP. This data was used The detailed work plan and implementation strategies for each committee are to identify and prioritize focus included as an appendix to the 2017 CHIP. 6 | Demographics and Social Determinants of Health
The changing demographics of the county and the impact that complex social issues have on health illustrate the need for cross-sector strategic partnerships to improve health. From 2010- 2016, Washington County experienced a population growth of nine percent. As of 2016, 582,779 people lived in the county. Along with this growth came an increase in diversity: The foreign- born population increased 11 percent from 2005-2014, while the Hispanic/Latino population increased 67 percent from 2000 to 2010. The proportion of foreign-born people in Washington County is 17 percent.
Figure 1: Race and ethnicity in Washington County and Oregon III. Demographics and Social Determinants of Health
2017 Community Health Improvement Plan for Washington County
Demographics and Social Determinants of Health | 7
Washington County has a relatively young population, Hispanic/Latino (of any race) are the second-largest with a median age of 36.5 years. Approximately 64 population. Almost one quarter (24%) speak a percent of the population is between 18-64 years of language other than English at home. Following English age, and 11 percent are 65 years of age or older. The and Spanish, the top three languages spoken at home racial and ethnic population is predominantly white, in Washington County are Chinese (1%), Vietnamese non-Hispanic/Latino (68%). People identifying as (1%), and Korean (1%),
Figure 2: Languages spoken at home in Washington County
Washington County Oregon Language spo en at home AC
pea only nglish panish or panish Creole Chinese ietnamese orean ther sian anguages ther In i languages agalog apanese erman Hin i ra i ussian
otal 8 | Demographics and Social Determinants of Health
SOCIAL DETERMINANTS OF HEALTH AND EQUITY
Income and Socioeconomic Status Housing Socioeconomic status (SES) is a strong predictor of Affordable housing is defined as spending less than health and well-being. Although Washington County 30 percent of a family’s income on rent or house has a median income of $70,447, which is the highest payments. When a family spends more than 30 percent in the Portland Metro region, we also face issues of of its income on housing, the family can experience poverty. Approximately 11 percent of individuals are financial strain that makes it difficult to afford other living in poverty in the county, including 13 percent basic needs such as food, heating and health care. of children (18 years or younger) and 25 percent Washington County and the Portland Metropolitan of Hispanic/Latino residents. Over 11 percent of Region are experiencing rising housing costs and households have received SNAP (food assistance) declining vacancy rates, resulting in a shortage of benefits in the past 12 months. housing affordable for lower-income households. Employment Nearly half (48%) of Washington County renters pay The ability to secure and maintain a job can have at least 30 percent or more of income on housing and long-lasting effects on the health of people and almost one in four (23%) homeowners do. Households families. Having a job that pays a living wage can that earn 50 percent or less of the median family allow a person to live in safer neighborhoods, buy income have the hardest time finding affordable healthier food, and afford health insurance and housing in Washington County. medical care. Based on 2015 estimates, approximately six percent of Washington County residents ages 20-64 are unemployed.
Education The percentage of the population (age 25 years and over) with a high school diploma or equivalency in Washington County is over 90 percent, and more than one in three people (43%) have a bachelor’s degree or higher. However, when examined by ethnicity, disparities are present in graduation rates. Only 60 percent of our Hispanic/Latino population has a high school diploma, in comparison to 96 percent of the non- Hispanic white population.
Sources: Portland State University Population Research Center (PSU PRC). Accessed at http://www.pdx.edu/prc/ American Community Survey, 2015 single year estimates
2017 Community Health Improvement Plan for Washington County Culture of Health and Well-being | 9
Adapting the Robert Wood Johnson living wage jobs; racism, discrimination Foundation (RWJF) Culture of Health and stigma; safe, accessible and affordable framework, the CHIP will highlight the housing; and support for people with leadership and activities of many community behavioral health challenges. partners that are critical to ensuring good A culture of health reflects a vision of health health across Washington County. and well-being as the sum of many parts, The 2016 CHA identified priority health addressing the interdependence of social, behaviors that can be affected by policies, economic, physical, environmental and systems and environmental factors in the spiritual factors. The framework emphasizes community but can also be modified with collaboration and supports discussion a communitywide, collaborative approach, between individuals, organizations in the for example: lack of prenatal care, teen private and public sectors, and communities marijuana use and binge drinking. The representing a range of social, demographic CHA also identified community needs in and geographical characteristics. This underserved populations — many of these framework will capture the many actions depict the interconnectedness of health and needed to develop and support a healthy importance of cross-sector efforts, including: community and address these complex connected communities; pathways to issues to improve health in our community.
Transportation Chronic Suicide Equity and Prevention Disease Inclusion Prevention
Housing Washington County Pathways to Built Living Wage Environment Jobs Culture of and Physical Health and Conditions
Healthy Well-Being Substance Use Behaviors
Access to Care Mental Connected Early Health Communities Learning IV. Culture of Health and Well-being IV.
WCPH 4.2017 10 | Culture of Health and Well-being
COMMUNITY DASHBOARD Use of the Culture of Health framework assists the RWJF developed the following action areas and community in talking about and coming together drivers that will be used to guide development of the around what drives health. WCPH and the Vision Action Washington County Culture of Health and Well-being Network are partnering to create a community-wide dashboard. The CHIP steering committee is responsible dashboard. This dashboard will include a variety of for reviewing these measures, identifying ways to measures that help collectively tell the story of what the share them with the community, and identifying community is doing to address important health issues opportunities for the CHIP to coordinate and facilitate and track progress on common goals. WCPH conducted collaboration across sectors. stakeholder interviews and a survey process to gather input on the most relevant measures across the community to include in the dashboard. The survey was sent to community partners and internal Washington County departments. General themes identified in the survey that will inform the dashboard include access, affordability, housing, education and health care.
ACTION AREAS DRIVERS Mindset and Expectations Making Health a Shared Value Sense of Community Civic Engagement
Number and Quality of Partnerships Fostering Cross-sector Collaboration Investment in Cross-Sector Collaboration to Improve Well-being Policies that Support Collaboration
Built Environment / Physical Conditions Creating Healthier, Social and Economic Environment More Equitable Communities Policy and Governance
Access Strengthening Integration of Consumer Experience and Quality Health Services and Systems Balance and Integration
Enhanced Individual and Community Well-Being Improved Population Health, Managed Chronic Disease and Reduced Toxic Stress Well-being and Equity Reduced Health Care Costs Health Status
2017 Community Health Improvement Plan for Washington County 2017 CHIP Priorities | 11
Through over a year of planning, described in Appendix A, Washington County Public Health The foundational goals of and community partners identified foundational the CHIP are to: goals, priorities and committee objectives for the • Reduce health disparities 2017 Washington County CHIP. These strategic • Improve health equity areas are based on community health assessment • Use a trauma-informed data, stakeholder input, review of health disparities lens and gaps in current efforts in the community and application of an equity lens process. These are the areas where the CHIP will lead and coordinate efforts in the county.
THE PRIORITIES FOR THE 2017 CHIP ARE TO:
1. Improve access to health care, including primary care, behavioral health services and oral health services Measures: • Increase percent of population with regular provider • Increase number of providers (primary, mental health, oral health) per population • Increase adults with insurance
V. CHIP Priority Areas V. 2. Improve behavioral health outcomes, including mental health, suicide and addictions Measures: • Decrease suicide count by year and age-adjusted rate • Reduce drug- and alcohol-induced deaths • Decrease teen alcohol and drug use • Decrease depression rates
3. Prevent chronic conditions Measures: • Decrease percent of population with low healthy food access • Increase percent of adults with adequate fruit and vegetable consumption • Increase percent of adults who engage in regular physical activity 12 | 2017 CHIP Priorities
oun ational oals uity an Health isparities Health isparities are preventa le ifferen es in health out omes e perien e y populations ho may have greater o sta les ase on fa tors li e ra e ethni ity gen er a ility an in ome Health isparities result from multiple fa tors in lu ing poverty ina e uate a ess to health are an e u ational ine uities Washington County Pu li Health is ommitte to improving health e uity y uil ing on ommunity strengths an a ressing isparities to ensure all people have the same opportunity to e healthy
Poverty an mployment u ation o ioe onomi status is a strong pre i tor of health an u ation is a ma or pre i tor ell eing he a ility to se ure an maintain a o an have of health out omes at an long lasting effe ts on the health of in ivi uals an families in ivi ual ommunity an Having a o that pays a living age an allo a person to live in so ial level isparities in safer neigh orhoo s uy healthier foo an affor health e u ation an health are insuran e an me i al are losely lin e he less e u ation people have the higher their levels of ris y lmost one in four 22 ehaviors for e ample Washington County resi ents earning an smo ing lo levels of in ome un er 2 000 are uninsure physi al e er ise hi h an lea to negative health out omes ore than one uarter 2 of our Hispani atino resi ents earn less than 2 000 year Hispani atino youth an foreign orn youth have isproportionally lo high s hool gra uation rates in u ation tatus y thni ity Washington County
0 Hispani atino 0 White non Hispani 0 o in five 0 20 Hispani atino stu ents o not gra uate high s hool 10 ompare to
0 one in t enty five ess than High s hool ome ollege a helor s egree high s hool gra uate or asso iate s or higher non Hispani or e uivalen y egree hite stu ents
healthy ommunity ares for the vulnera le istening session parti ipant
ugust 2017 2017 Community“ Health Improvement Plan for Washington County 2017 CHIP Priorities | 13
Priority 1 ess to Health Care ess to primary are ehavioral health mental health an a i tion servi es an oral health are priorities ase on an assessment of Washington County ata arriers to a ess in lu e issues relate to availa ility of servi es in ifferent languages a ess to transportation a ess to health insuran e overage an or for e apa ity of the health are systems in Washington County
ninsure in Washington County in 201 7 of all resi ents of hil ren 2 2 1 of Washington County of people ith less than of Hispani atino resi ents spea a a high s hool gra uation resi ents language other than nglish at home isparities in a ess to are an result in isproportionate ur en ility to navigate the of health are osts an negative out omes that oul have een health are system is a prevente ith a ess to insuran e an primary are arrier to a essing are that omes up in Washington County ommunity surveys entists erving Washington Comple ity of the health are County esi ents in 201 system an limite servi es in languages other than nglish 1 entist for 1 12 resi ents ontri ute to a ess issues for many populations he ratio for regon is 1 provi er per 1 00 people
he num er of people ea h Primary Care Provi ers erving me i al provi er serves an Washington County esi ents in 201 have an impa t on the uality of are in an area 200 1 primary are provi er for 1 0 1 resi ents vi en e evie reporte he ratio for regon is 1 provi er per 1 070 people that states ith a lo er patient to primary are e i al provi ers are an important fa tor in the physi ian ratio have etter overall health of a population Having appropriate health out omes in lu ing a essi le an high uality me i al are an improve e rease an er heart health prevent isease an e ten lives isease an stro e mortality
here is a la of larity ith health are systems the people ma ing e isions are not representative of the people a essing the servi es e have to ump through hoops for servi es istening session parti ipant “ ugust 2017 14 | 2017 CHIP Priorities
Priority 2 ehavioral Health ental Health i tions ehavioral health issues in lu ing mental health an su stan e use emerge as priority health issues in the ommunity health assessment his in lu e al ohol an rug in u e eath su stan e use epression sui i e an a ess to mental health servi es
ui i e ess to ental Health ervi es th lea ing ause 1 mental health provi er of eath in 201 for 1 people in Washington County he ratio for regon is one provi er per 2 0 people his represents a severe shortage of mental health provi ers in the ounty male eaths for ea h epression female eath 22 of Washington County a ults of Washington County a ults report ever eing tol on e i ai have a urrent here is one sui i e every they ha epression iagnosis of epression ays l ohol se 20 2 of a ults report of riving eaths of th inge rin ing involve al ohol gra ers an 11th gra ers ha a sui i e attempt in rug in u e eath the past 12 months rug in u e eath as the 11th lea ing ause of eath in 201 u stan e se 1 2 ehaviors su h as su stan e of 11th gra ers report using of 11th gra ers report use or misuse ontri ute mari uana in the past 0 ays as al ohol use an 1 to a person s overall health o of th graders ari uana report inge rin ing status an are asso iate use at a young age is asso iate l ohol onsumption hile ith poorer health ith rain amage poorer the rain is still eveloping out omes espe ially health out omes an in rease an ause long term in youth su stan e use into a ulthoo rain amage
nyone ho has een homeless no s that it is li e eing in om at If you re out there for a long time you get post traumati stress isor er istening session parti ipant
ugust 2017 2017 Community“ Health Improvement Plan for Washington County 2017 CHIP Priorities | 15
Priority Chroni Con itions ortality ue to hroni iseases an ontri uting fa tors have een i entifie as priority health issues in assessments of Washington County ata in lu ing heart isease hroni lo er respiratory iseases fruit an vegeta le onsumption an physi al a tivity Community on itions that ontri ute to these health out omes ere also prioriti e in lu ing a ess to healthy foo a ess to affor a le an safe housing an ommunity esign to support physi al a tivity
uilt nvironment Health ehaviors population s health an e a versely affe te y fa tors that omprise the uilt environment su h as poor air or ater uality su stan ar housing on itions la of a ess to nutritious foo fe safe pla es to e er ise rea y a ess to fast foo an angerous traffi on itions ruit an vegeta le onsumption an physi al foo esert is a lo in ome area here the population has oth a tivity ere among the top physi al an e onomi arriers to a essing healthy foo 10 health ehavior priorities i entifie through the Community Health ne in five 20 ssessment of the ensus tra ts in Washington County are foo eserts e er than 1 in a ults an youth reporte a of a ess to affor a le housing ontri utes to poor eating or more servings of living on itions that an lea to hroni isease fruit an vegeta les a ay of renters live in unaffor a le housing e er than an 2 of homeo ners spen more than 1 in 0 of in ome on housing youth are physi ally a tive
Chroni isease an health out omes sthma an o esity ere among the top ten hroni on itions e perien e y Washington County resi ents here are evi en e ase poli y an pla e ase solutions that an improve these on itions
ore than 1 in ore than youth have ever ha asthma an of a ults are o ese or over eight 1 in 10 urrent a ults have asthma
healthy ommunity is one here a large per entage of people in the ommunity have a ess to the material resour es they nee to e healthy istening session parti ipant “ ugust 2017 16 | 2017 CHIP Structure
The CHIP is comprised of a steering committee and six community committees responsible for implementing strategies to address the three priorities. The committeesWashington have aligned organizational County goals and developed collaborative approaches to address these common priorities. The CHIP is developed using evidence-based bestCommunity practices and a collective Health impact approach Improvement to identify mutually reinforcing Plan collaborative activities. Each committee eveloping has developed aa detailed Culture work of plan Health included an in Appendix Well eing E.
teering Comm P itt HI ee C CROSS SECTOR Prevent NAVIGATION Improve Chronic COMMITTEE Access to Path ays o el Conditions Implementation Care
ACCESS TO CARE COMMITTEE HEALTHY Primary Care ehavioral COMMUNITIES Health an ral Health COMMITTEE Chroni Con itions an uilt nvironment Guided by EQUITY AND TRAUMA-INFORMED PRINCIPLES OLDER ADULT BEHAVIORAL HEALTH SUICIDE COMMITTEE PREVENTION n iety an epression COUNCIL Community Coor ination ero ui i e Implementation atality evie ADVERSE CHILDHOOD EXPERIENCES (ACEs) COLLABORATIVE Community areness an Implementation of rauma Informe pproa hes
VI. CHIP Structure & Committees Improve Behavioral Health Outcomes
Washington County Pu li Health has a opte the o ert Woo ohnson oun ation Culture of Health an Well eing frame or to gui e the CHIP an rive the important partnerships nee e to evelop an support a healthy ommunity in Washington County
Please email CHIP o ashington or us ith any uestions 2017 Community Health Improvement Plan for Washington County 2017 CHIP Structure | 17
THE SIX COMMITTEES AND STEERING COMMITTEE ARE DESCRIBED BELOW:
CHIP STEERING COMMITTEE
The CHIP Steering Committee includes a representative from each of the committees, along with other partners focused on implementing equity and trauma-informed care objectives across the CHIP committees. The steering committee is responsible for tracking and coordinating Culture of Health strategies, including a community dashboard with metrics selected by partners to help tell the story of community health in Washington County. The steering committee will use the evaluation of the 2014 CHIP, described in Appendix B to inform improvements in this new cycle. Steering Committee Objectives: • Integrate and coordinate sharing and partnerships across CHIP committees • Implement trauma-informed care and equity approaches across CHIP committees • Implement and track Culture of Health and Well-being goals across CHIP committees
ACCESS TO CARE COMMITTEE
The Access to Care Committee includes partners from hospitals, health care systems, federally qualified health care centers, safety net clinics, behavioral health service providers, oral health organizations, public health and behavioral health leadership, emergency medical services, and culturally-specific community-based organizations. The objectives are focused on improving access to and integration of primary care, behavioral health and oral health for residents of Washington County. Access to Care Objectives: • Improve access to and utilization of primary care, mental and behavioral health services and oral health services
CROSS-SECTOR NAVIGATION COMMITTEE
The Cross-Sector Navigation Committee was formed to implement the evidence-based Pathways community coordination model in Washington County. The national Pathways approach involves referring eligible participants and their families to a community health worker (CHW). The CHW works directly with the family to assess social determinants of health and provide navigation and closed loop referrals to needed resources. The navigation includes selecting a number of specific defined pathways that, when bundled together, achieve the selected outcome. This committee is focused on increasing CHW workforce in Washington County and coordinating services and resources. Cross-Sector Navigation Objectives: • Support coordination between direct service providers and community-based organizations to improve access to care for specific priority populations (physical, behavioral, oral health) • Increase capacity for community health worker (CHW) workforce in Washington County
OLDER ADULT BEHAVIORAL HEALTH COMMITTEE
The Older Adult Behavioral Health Committee is focused on identifying and implementing innovative strategies to treat and prevent depression and anxiety in older adults in Washington County. Washington County Disability, Aging and Veteran Services, in partnership with Washington County Behavioral Health, is providing support and resources to community partners to implement strategies. The committee is focused on identifying, implementing and evaluating those efforts. Older Adult Behavioral Health Objectives: • Prevent and treat anxiety and depression in older adults by cultivating and strengthening a community that supports the aging process. 18 | 2017 CHIP Structure
HEALTHY COMMUNITIES COMMITTEE The Healthy Communities Committee is comprised of organizations focused on improving access to healthy food and opportunities for physical activity, reducing tobacco use, improving programs for people living with chronic disease, and addressing built environment and place-based issues that impact chronic disease. The committee’s objectives are focused on supporting health in all policies and increasing access to and awareness of affordable, healthy food, physical activity and chronic disease self- management opportunities. Healthy Communities Objectives: • Increase access to and awareness of affordable and healthy food, physical activity and chronic disease self-management opportunities through educational programs and resources. • Identify opportunities to incorporate health into community design processes and policies to support (1) access to healthy and affordable food, (2) opportunities for physical activity and (3) access to tobacco-free environments. • Develop and maintain infrastructure to support implementation of committee objectives.
SUICIDE PREVENTION COUNCIL The Suicide Prevention Council objectives and strategies are based on the 2012 National Strategy for Suicide Prevention, with the goal of preventing suicide in Washington County. The vision of the council is “Zero is possible” in alignment with the national Zero Suicide approach. The Council is comprised of behavioral health service providers, community-based organizations, law enforcement, medical examiners, emergency medical services, private practice mental health providers, public health and faith leaders. The objectives are focused on integrating and coordinating suicide prevention activities across multiple sectors, reducing access to lethal means, promoting suicide prevention as a core component of health care services, and evaluating the impact and effectiveness of suicide prevention interventions. A subcommittee reviews suicide fatalities to inform local prevention efforts. Suicide Prevention Objectives: • Promote responsible media reporting of suicide, accurate portrayals of suicide and mental illness in the entertainment industry, and the safety of online content related to suicide. • Integrate and coordinate suicide prevention activities across multiple sectors and settings. • Promote efforts to reduce access to lethal means of suicide among individuals with identified suicide risk. • Develop, implement and monitor effective programs that promote wellness and prevent suicide and related behaviors. • Promote suicide prevention as a core component of health care services. • Evaluate the impact and effectiveness of suicide prevention interventions and systems and synthesize and disseminate findings.
ADVERSE CHILDHOOD EXPERIENCES (ACES) COLLABORATIVE The Adverse Childhood Experiences (ACEs) Collaborative includes both an internal committee and an external community committee. The internal committee is focused on implementing trauma-informed strategies across Washington County Health and Human Services. The community committee is made up of early childhood experts, education partners, health care partners, community-based organizations and mental health organizations. The group focuses on sharing lessons learned, increasing awareness of trauma-informed strategies, providing technical assistance to assist organizations in implementing trauma-informed practices, and identifying ways to implement a trauma-informed lens across the other CHIP committees. ACEs Objectives: • Coordinate information sharing and sharing lessons learned across organizations. • Provide technical assistance for implementing trauma-informed care practices. • Implementation of trauma-informed lens across CHIP committees in partnership with Steering Committee. See Appendix E for detailed work plans with strategies and activities, time-framed targets, responsible partners, alignment with national and state priorities and needed policy changes. 2017 Community Health Improvement Plan for Washington County Implementation and Tracking | 19
IMPLEMENTATION AND TRACKING The detailed CHIP work plans are attached in Appendix E. The work plans are living documents that include specific IMPROVING activities and tasks for each participant. Progress and updates to activities will be tracked quarterly using the work plan tracking community spreadsheet. Overall implementation of the CHIP will be tracked by the CHIP Steering Committee. The committee will review the health work plans and measures of success to track progress across the is the outcome of “endeavors and activities of CHIP objectives. Each year, the committees will review the work plan to identify partners any changes, including any changes to the CHIP objectives or across many sectors of our community. strategies. Annual progress reports will be developed by each committee to highlight successes, progress on objectives, and identify any opportunities for quality improvement for the coming year. 20 | Appendices
Appendix A CHIP PLANNING PROCESS WCPH used an adapted version of the MAPP (Mobilizing for Action through Planning and Partnerships) model in both the community health assessment process and in CHIP planning. The process included community input, quantitative data, stakeholder input about the current public health system and upcoming changes that may impact the current environment.
Community Health Assessment
Gathered feedback from community partners
Culture of Health stakeholder interviews and survey
Health equity planning
CHIP priority areas, committees and objectives VII. Appendices
The Community Health Assessment (CHA) is table discussions and surveys to gather input the basis for development of the CHIP. The on the focus of the CHIP. After the event, CHA includes population data and robust WCPH staff presented the CHA at numerous community engagement to ensure that community meetings and gathered input both are reflected in the final prioritization on the direction of the CHIP. WCPH also of health issues. The process also included conducted stakeholder interviews and a a review of the priorities with community survey process. See Appendix C for full list of stakeholders to gather input on the participants. approach to address these health priority After gathering this input, the WCPH areas. management team and the CHIP steering To ensure the CHIP focuses on areas committee participated in a facilitated process that are strategic for the Washington to apply the WCPH equity lens to the CHIP County community (e.g., gap areas in the and to develop the CHIP priority areas. Each community, areas with fewer existing efforts, of these processes is described in detail below. areas where there are opportunities to 2016 Community Health Assessment build on existing momentum, and areas that stakeholders have identified as priorities Washington County Public Health is a member based on input from the populations they of the regional community health assessment serve), WCPH reviewed the CHA data and group, Healthy Columbia Willamette gathered input from a broad range of Collaborative (HCWC). HCWC is a unique community stakeholders. public-private partnership that includes 15 hospitals, four health departments and two Washington County hosted a CHA release coordinated care organizations (managed event with over 80 community partners. At Medicaid organizations) in Clackamas, the event, WCPH epidemiologists presented Multnomah and Washington counties in the CHA data, and there were facilitated Oregon, and in Clark County, Washington.
2017 Community Health Improvement Plan for Washington County Appendices | 21
HCWC’s vision is to: 1) align the efforts of hospitals, 2016 Community Health Needs public health, CCOs and residents of the communities Assessment Data Sources they serve to develop a shared, real-time assessment Health Status Assessment: of community health across the four-county region; 2) 1) Population data about health-related behaviors, eliminate duplicative efforts; 3) prioritize community morbidity and mortality health needs; 4) enable collaborative efforts to implement and track improvement activities across the 2) Medicaid data from local Coordinated Care four-county region; and 5) leverage collective resources Organizations (CCOs) about the most frequent to improve community health. conditions for which individuals on Medicaid sought care In the 2016 Community Health Assessment, health 3) Hospital data for uninsured people who were seen needs were identified through a comprehensive study in the emergency department with a condition of population, hospital, Medicaid and community data. that should have been managed in primary or The CHA identifies and describes the health status ambulatory care of the community, factors that contribute to health challenges, and existing assets and resources that Community Themes and Strengths: can be mobilized to improve the health status of the 1) Online survey about quality of life, issues affecting community. The assessment is intended to provide the community health, and risky health behaviors foundation for improving the health of the community. 2) Listening sessions with priority populations in the HCWC used a modified version of the Mobilizing for four-county region to identify community members’ Action through Planning and Partnerships (MAPP) vision for a healthy community, needs and existing model to conduct the 2016 CHA. The MAPP model strengths uses health data and community input to identify 3) An inventory of recent community engagement and prioritize community health needs. An equity projects in the four-county region that assesses lens, which is a tool used to improve planning and communities’ health needs. decision-making leading to more equitable outcomes, was applied in order to make improvements to the The graphic on the next page depicts the priority issues original 2013 assessment model and to better meet the that resulted from this process. needs of the community. The lessons learned from the first assessment led to the creation of a Community Engagement Workgroup to conduct community outreach and data collection, and a Prioritized Health Issues Group to bridge quantitative and qualitative data without losing community voice. 22 | Appendices
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2017 Community Health Improvement Plan for Washington County
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For 26 | Appendices
Input from Washington County Community Partners and Stakeholders WCPH releasedInput from the Washington 2016 CHA Countyin October Community at a community Partners event.and Stakeholders WCPH epidemiologists presented the data to over 80 community The gap between the number of partners.WCPH The releasedparticipant the list 2016 is attachedCHA in October in Appendix at a community C. The partners event. WCPH affordable“The gap betweenhousing the units number and theof then engagedepidemiologists in facilitated presented discussions the data about to over the 80 data community and gave partners. peopleaffordable on waithousing lists units is the and most the input onThe the participant CHIP priority list is areas. attached The in discussions Appendix C.included The partners the then alarmingpeople data on wait to us.lists As is thea Temporary most Emergency Shelter within the Severe followingengaged questions: in facilitated discussions about the data and gave input on the alarming data to us. As a Temporary CHIP priority areas. The discussions included the following questions: Weather Shelter System we have • Which health issues are most serious from their perspective? Emergency Shelter within the Severe Which health issues are most serious from their perspective? very limited capacity and resources. SeeingWeather the Shelter access System to housing we have very • What stood outWhat from stood the out data? from the data? limitedincrease capacity is andnecessary. resources. • Who should leadWho thisshould work? lead this work? Seeing–Community the access to Partner housing increase • Are there specificAre there areas specific where areas WCPH where should WCPH take should a leadership take a le role?adership“is necessary.” –Community Partner role?
Notes from theseNotes discussions from these were discussions used in the were next used steps in of the next “Social and economic factors of public steps of the CHIP planning process. Participants Social and economic factors of public healththe seem CHIP planning process. Participants were also provided a health seem to be the most to be the most challenging for our organizationsurvey towith questionswere also about provided the seriousness a survey with of different questions about challenging for our organization to address, but it is very much needed as it is ahealth critical issues basedthe seriousness on input from of different the populations health theyissues serve based address, but it is very much needed component of overall public health.and their organizationalon input fromcapacity the andpopulations engagement they on serve and as it is a critical component of overall –Community Partner different priorities.their organizational capacity and engagement on public health.” –Community Partner different priorities. Following the event, WCPH staff presented the report to Followingcommunity the event, partners WCPH throughout staff presented the county the report and gathered to community feedback partners on the throughout CHIP priority the areas. county Following and gathered feedbackpresentations, on the CHIP a priority link to the areas. same Following survey used presentations, during the CHA a link release to the event same was survey sent used to community during the CHA release “event waspartners. sent to The community combined partners.survey findings The combined and discussion survey themes findings helped and Washingtondiscussion themes County helpedidentify areasashingtonW Countyto identify lead and areas coordinate to lead communityand coordinate health community efforts and health areas toefforts support and or areas be a toresource support to or community be a resource to communitypartners. partners. Partners Partners ranked ranked each of each the ofcategories the categories with a 1,with 2 or a 3,1, with 2 or 33, being with assigned3 being assignedthe highest the highest priority.priority. The averages The averages are listed are below.listed below.
How serious is What is your How much of a Is your organization this issue for the organization's priority is this currently engaged in N=66 community you ability to impact issue for your work to address this serve? this issue? organization? issue? Sense of Community 2.45 2.12 2.30 2.10 Built Environment/ 2.66 1.78 2.31 2.07 Physical Conditions Social and Economic 2.63 1.82 2.36 2.04 Environment Access to Care 2.70 2.10 2.55 2.14 Mental/Behavioral 2.71 2.22 2.56 2.29 Health Consumer Experience 2.56 2.34 2.48 2.31 and Quality Substance Abuse 2.32 1.73 1.87 1.72
WCPH analyzed the survey results to find the gap between how serious an issue was ranked and overall organizational capacity to address that issue. Organizational capacity included the score for ability to impact, prioritization and current engagement. The highest gap scores in the following table indicate 2017 Community Health Improvement Plan for Washington County Appendices | 27
WCPH analyzed the survey results to find the gap between how serious an issue was ranked and overall organizational capacity to address that issue. Organizational capacity included the score for ability to impact, prioritizationareas that and are current considered engagement. serious forThe the highest community, gap scores but th inere the is following overall lower table capacity indicate for areas community that are consideredpartners serious to leadfor the that community, work. These but are there the areas is overall that potentially lower capacity make for sense community for WCPH partners to lead throughto lead that work. These arethe the CHIP areas process. that potentially make sense for WCPH to lead through the CHIP process.
Focus Area Gap Scores Access to care 0.43 Mental and behavioral health 0.35 Substance abuse 0.55 Social and economic development 0.56 Sense of community 0.28 Built environment and physical conditions 0.61 Consumer experience and quality 0.18
Culture of Health Stakeholder Interviews and Survey Culture of Health Stakeholder Interviews and Survey The RWJFThe Culture RWJF Cultu of Healthre of Health framework framewo acknowledgesrk acknowledg thees many the ma actionsny action acrosss acr ao sscommunity a communi thatty th areat areneeded to developneeded and tosupport develop health. and support It emphasizes health. Itthe emphasizes collaboration the collabora and supportstion and discussion supports between discussion individuals, organizationsbetween in individuals,the private organizationsand public sectors, in the privateand communities and public sectors,representing and communi a range tiesof social, representi demographicng a and geographicalrange ofcharacteristics. social, demographic The dashboard and geographical will be one characteris of the waystics. The to facilitate dashboard this will collaboration. be one of the ways to facilitate this collaboration. To gather input on this framework and the proposed community dashboard concept, and to gauge community partnerTo interest, gather WCPHinput on leadership this framework conducted and the interviews proposed with community community dashboard stakeholders. concept, and to gauge community partner interest, WCPH leadership conducted interviews with community stakeholders. 1. What do you see as your organizational role related to improving community health (types of issues you are leading vs. supporting)? What efforts are you leading? 1. What do you see as your organizational role related to improving community health (types of 2. Do you have issuesmeasures/metrics you are leading related vs. supportin to this work?g)? What If so, efforts what areare you they/ leading? what types of things are you tracking? 3. In what ways2. Do could you Whaashingtonve measure Countys/metrics Health related and to Human this wo Servicesrk? If so, and what Washington are they/ what County types Public of th iHealthngs support yourare efforts? you tracking? 3. In what ways could Washington County Health and Human Services and Washington County 4. Are you interested in partnering to build this shared metrics system/ linking metrics across our organizations/ Public Health support your efforts? Culture of Health scorecard? 4. Are you interested in partnering to build this shared metrics system/ linking metrics across our The following areorg anizations/the themes Cultu that reemerged of Health from sco rectheard? interviews and community discussions about the CHA: Overall themes: Public Health Roles The following are the themes that emerged from the interviews and community discussions about the • ImplementCHA: collaborative, cross-sector approaches • Lead data collection, analysis, accessibility and • Use a collective impact approach availability • Focus Overallon strong themes: authentic partnerships • Remove barriers to support partners’ efforts Implement collaborative, cross-sector approaches • Include both a focus on youth and aging • Lead discussions on equity and social determinants of Use a collective impact approach health • Incorporate localFocus experiences, on strong authen creativetic partnershipsindicators and • Leadership role in ACEs, access to care, mental and intersectional Include data both a focus on youth and aging behavioral health including addictions issues, social • Support training Incorporate and workforce local experiences, development crea fortive indicators and intersectional data and economic development, safe and affordable partners Support training and workforce development forhousing, partners and suicide prevention • Focus on community health worker (CHW) role across CHIP committees 28 | Appendices
Access to Health Care Diversity and Equity Approaches • Focus on access to primary care, mental health and • Focus on health disparities for Hispanic/ Latino oral health populations • Incorporate trauma into equity approach (consider Adverse Childhood Experiences (ACEs) and issues related to trauma and culture) Trauma-Informed Care • Consider language and interpretation • Focus on ACEs, mitigating trauma, trauma • Involve bicultural/ bilingual staff stewardship • Focus on health literacy • Focus on care coordination, collaboration, measurement and tracking • Improve multicultural and multilingual materials and services • Include a focus on ACEs screening in health care settings, resilience training, domestic violence Housing
Built Environment and Chronic Disease • Focus on cost of living • Focus on policy • Focus on affordable housing, especially for aging population, those with mental illness and domestic • Lead conversation about health impacts for other violence victims sectors and settings • Improve data availability or analysis on homelessness Community Health Workers and Peers Mental and Behavioral Health • Incorporate role of community health workers and peers into committee strategies • Focus on insurance and access issues • In mental health strategies, include peers and people • Include focus on suicide prevention, substance use with lived experience and addictions issues, youth substance use • Consider county and CCOs partnership opportunities
Social Determinants of Health (Including Education and Employment) • Focus on education disparities; partner with schools on education disparity issues • Focus on pathways to living wage jobs and workforce development
2017 Community Health Improvement Plan for Washington County Appendices | 29
Equity Planning Process WCPH has adopted an equity policy and equity lens tool. To ensure this tool was fully utilized in developing the updated CHIP, the CHIP Steering Committee and WCPH Management Team came together for two half-day facilitated sessions to discuss race, advantage and privilege; to practice implementing the equity tool on case study examples; and to apply the tool to a review of community health assessment data and community partner input to identify the CHIP priority areas. The facilitator, Maria Lisa Johnson, is a well- known and respected equity trainer and facilitator in the community.
On the first day, the group discussed common terminology, the history of racism in the United States and Oregon, and how these historical systems and structures remain today. The group discussed ways that During the facilitated process, the group used the the CHIP can help address these structures. The process WCPH equity lens tool to prioritize important health was focused on equity using a racial analysis. The issues in our community. There were health issue reasoning is that WCPH recognizes that racial inequity profiles of each priority area. The profiles included CHA is one of the most entrenched inequities in our society. data, themes from community listening sessions and On the second day, the group applied these tools and community partner survey data. The group reviewed discussion to the CHA data and identified CHIP priority the profiles and discussed questions about which health areas based on this lens. issue community residents would say is the biggest The objectives for the facilitated process were to: problem; which issues receive the most and least focus, local action or funding; and which issues do the • Develop a collective analysis of where we are as participants in their current roles think are the biggest leaders with regard to diversity, equity and inclusion. problem. The participants then discussed the difference • Examine beliefs about race, advantage and justice opinions that are informed by proximity to the issues, and how these issues impact our communities and our perceptions, who we hear, who has access and who organizations. does not. The group then used this conversation, • Understand how the history of race in the United along with the CHA data and partner input, to identify States has shaped our perceptions and our practices. priority CHIP focus areas. The group also identified • Begin to recognize examples of personal, institutional critical lead and support roles for WCPH through review and structural racism in our community and in of disparity data and community inequities. The groups the media and how these examples impact our discussed and proposed priorities based on data to communities and organizations. advance health equity. • Explore strategies to further equity and inclusion. Through prioritization and use of an equity lens tool • Identify and practice tools and language to apply this the group prioritized the following: lens to the CHIP and WCPH programmatic work. 1. Access to care — including behavioral health services • Use community health assessment data, community 2. Built environment and physical conditions — partner input and equity lens tools to identify CHIP including policy, systems and environments priority areas and overall structure for CHIP work. 3. Mental health and behavioral health — including • Identify lead and support roles for WCPH in the CHIP. trauma-informed care 30 | Appendices
Appendix B 2014 CHIP: ACHIEVEMENTS AND EVALUATION FROM THE LAST CYCLE Over the past three years, collaborative CHIP committees have been meeting regularly to implement health improvement strategies based on the 2014 CHIP work plan. The committees have achieved successes and made significant progress in developing stronger partnerships across community organizations. The following is an overview of the progress and achievements from the past three years and a description of the evaluation process that informed the 2017 CHIP.
2014-2017 Access to Integrated Care Achievements: 2014-2017 Suicide Prevention Council Achievements: The Access to Integrated Care Committee is committed The Suicide Prevention Council addresses and to improving access to quality, affordable, culturally coordinates countywide suicide prevention efforts. responsive health care across Washington County. The The council has a network of engaged stakeholders committee is comprised of key partners from across the including mental health providers, first responders, health care system and has achieved the following: educators, the faith community, community based • Provided regular opportunity for information sharing organizations, hospitals, government organizations, and networking survivors of suicide loss, law enforcement and other concerned citizens. Achievements include the following: • Developed access to care and oral health assessment reports • Awarded Garrett Lee Smith suicide prevention grant • Coordinated funding proposal for safety net providers • Hired full-time suicide prevention coordinator (focus on uninsured) • Developed regional partnerships to implement • Collaborated on successful grant proposal for Safety GetTrainedToHelp.com to provide free suicide Net Capacity Grant to provide services to uninsured prevention trainings in the community children • Partnered with LifeWorks Northwest to implement • Developed and implemented pediatric oral health Zero Suicide initiative toolkit • Implemented Suicide Fatality Review committee • Developed older adult behavioral health workgroup • Hosted national suicide prevention speakers and and facilitated community summit experts to discuss topics like lethal means restriction, • Initiated Pathways model process the nature and causes of suicidal behavior
2014-2017 Chronic Disease Prevention Achievements: The Chronic Disease Prevention Committee focuses on community-based chronic disease prevention strategies. The committee has a network of stakeholders including community-based nonprofits, government and health care organizations. Achievements include the following: • Increased collaboration and resources for partners • Submitted collaborative funding proposal • Increased knowledge of policy among partner organizations • Developed new partnerships with health care (Veggie Rx, Rx Play, educational classes)
2017 Community Health Improvement Plan for Washington County Appendices | 31
Evaluation of 2014 CHIP Washington County Public Health evaluated the 2014 CHIP to identify ways to integrate partnership, collaboration and community feedback into the Community Health Improvement Plan (CHIP) vision and mission. Surveys, community listening sessions and interviews were conducted with community and partner organizations between July 2015 and June 2017. Key themes that emerged from the evaluation fell into three categories: content, structure and roles. Content themes include CHIP and organizational priorities, focal areas, and the gap in community services to community needs. Structure themes include findings related to logistics, convening style, facilitation and use of tools in the CHIP process. Role themes include initial community partner perspectives regarding opportunities for leadership and community support from Washington County.
Content Themes: Role Themes: • Continue to improve alignment of the CHIP strategic • Support community organizations with technical plan with partner organizations’ missions and assistance and capacity building. activities. • Support and facilitate collaboration, partnership and • Continue to encourage non-traditional and diverse networking. community partners to participate and collaborate. • Lead broad community awareness of and diverse • Ensure that there are multiple opportunities for participation in CHIP. involvement through broad strategic goals and • Lead the Community Health Assessment data process, structured activities. reporting and distribution.
Structure Themes: Washington County Public Health used the evaluation • In-person quarterly meetings are beneficial for findings, in conjunction with the 2016 Community schedule constraints, networking and relationship Health Assessment, to inform strategic planning and building. equity planning to inform the updated CHIP. This • Ensure easy and accessible methods for community process was designed to ensure quality improvement, partners to share information and update each other a continued collaborative approach and continued in a timely manner. alignment with community needs and priorities. Washington County will continue working toward an • CHIP committee facilitation is collaborative and effective balance of a long-term strategic vision with accessible for diverse partner needs. structured objectives that will provide opportunities for varying levels of community involvement and participation. 32 | Appendices
Appendix C In addition to the CHIP partners listed in the introduction, the following partners provided input in the priorities and objectives for the 2017 CHIP:
211info Nurse-Family Partnership Advisory Board Adelante Mujeres NW Counseling Associates Beaverton Child Welfare Oregon Community Health Workers Association Bienestar Oregon Health and Science University CareOregon Oregon Project Independence Cascadia Behavioral Healthcare Oregon Public Health Division Centro Cultural Oregon State University Extension Service Coalition of Communities of Color Pacific University CODA Recovery Center Portland Veterans Administration Health Care System Community Action Organization Project Access NOW Community Housing Fund Providence Health & Services DHS: Aging & People with Disabilities Regional Prevention Promotion Partnership Doernbecher Westside Pediatrics Saint Child Domestic Violence Resource Center Sequoia Mental Health Services Inc. Early Learning Washington County Sherwood School District FamilyCare Health Plans Southwest Community Health Center Forest Grove School District Tri-County 911 Service Coordination Program Hillsboro Chamber of Commerce Tuality Healthcare Hillsboro Early Childhood Center Virginia Garcia Memorial Health Center Hillsboro School District Vision Action Network Inukai Family Boys & Girls Club and Voices Set Free Youth Advisory Council Washington County Consolidated Jewish Family & Child Service Communications Agency Legacy Health Washington County Cooperative Library Services LifeWorks NW Washington County Disability, Aging and Luke Dorf Veteran Services Lutheran Community Services NW Washington County Children, Youth and Families Division Mental Health Provider Association Washington County Housing Services Morrison Child and Family Washington County Human Services National Alliance on Mental Illness of Washington County and Multnomah County Washington County Public Health Neighborhood Health Center Washington County Sheriff’s Office Northwest Regional Education District Western Psychology
2017 Community Health Improvement Plan for Washington County Appendices | 33
Appendix D Appendix E SOURCES Detailed work plans for each committee will be developed in fall 2017. Introduction Robert Wood Johnson Foundation, Culture of Health, Measuring What Matters, 2015
Demographics Portland State University Population Research Center (PSU PRC). Accessed at http://www.pdx.edu/prc/ American Community Survey, 2015 single year estimates
Equity and Health Disparities American Community Survey, 2015
Access to Health Care American Community Survey, 2015 County Health Rankings, 2014 and 2015
Behavioral Health Vital Statistics, 2015 County Health Rankings, 2014 and 2015 Behavioral Risk Factor Surveillance System, 2010-2013 Oregon Healthy Teens, 2013-2015
Chronic Conditions American Community Survey, 2015 Behavioral Risk Factor Surveillance System, 2010-2013 US Department of Agriculture, Economic Research Service, USDA - Food Access Research Atlas: 2010-2015