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22 Report Cover Template Howard County General Hospital Community Health Needs Assessment and Implementation Strategy June 30, 2016 Howard County General Hospital TABLE OF CONTENTS CONTENTS PAGE I. Introduction .............................................................................................................................. 1 II. Service Area and Population a. Overview ....................................................................................................................... 2 b. The Community We Serve ............................................................................................ 3 III. Approach and Methodology a. Primary Data ................................................................................................................. 7 b. Secondary Data ............................................................................................................. 8 c. Local Health Improvement Coalition ............................................................................ 9 d. Health Experts ............................................................................................................... 9 IV. Key Community Priorities a. Access to Affordable Care ........................................................................................... 11 b. Behavioral Health ........................................................................................................ 11 c. Healthy Aging .............................................................................................................. 12 d. Healthy Weight, Exercise and Nutrition ...................................................................... 12 e. Other Identified Needs ............................................................................................... 12 V. Implementation Strategy ........................................................................................................ 13 Appendices Appendix A: Community Resource Inventory .............................................................................. 20 Appendix B: Howard County Health Assessment Survey, 2014 .................................................... 23 ii Howard County General Hospital I. Introduction With the enactment of the Patient Protection and Affordable Care Act (PPACA) on March 23, 2010, tax-exempt hospitals require community health needs assessments (CHNA) and implementation strategies, which are approaches and plans to actively improve the health of communities served by health systems. These strategies provide hospitals and health systems with the information they need to deliver community benefits that can be targeted to address the specific needs of their communities. Coordination and management strategies, based upon the outcomes of a CHNA and implementing strategies, can improve the impact of hospital community benefits. To adhere to the requirements imposed by the IRS, tax-exempt hospitals and health systems must: • 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 a description of 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 facility 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 impact 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/health system and an explanation of their qualifications. 3. A description of how the hospital took into account input from persons who represent the broad interests of the community served by the hospital. 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. 1 Howard County General Hospital 6. A description of the needs identified that the hospital intends to address, the reasons those needs were selected, and the means by which the hospital will undertake to address the selected needs. The 2016 CHNA process for Howard County General Hospital (HCGH) included the collection and analysis of primary and secondary data. Both public and private organizations, such as faith-based organizations, government agencies, educational systems and health and human services entities were engaged to assess the needs of the community. Primary data, gathered from more than 2,000 participants via an extensive phone survey in the Howard County Health Assessment Survey (HCHAS) and completed in 2014 was used for this report. Through interaction with a broad array of Howard County stakeholders, the survey results assessed health related behaviors and risk factors among the adult population in Howard County. Secondary data from local, state and federal sources provided essential information, insight and knowledge on a broad range of health and social issues and a resource inventory was compiled to assess the availability of services to residents in Howard County. Collecting and examining information about different community aspects and behaviors help explain and identify factors that influence the community’s health. The action plan developed for the county by the Local Health Improvement Coalition (LHIC) guided the creation of the Implementation Strategy for HCGH. More information on data gathering and analysis is included in section III. This report is a summary of primary and secondary data collected throughout the CHNA, the methodology used, the resulting identified key prioritized needs and an action plan (Implementation Strategy) addressing those needs. II. Community Benefit Service Area The Hospital defines its Community Benefit Service Area (CBSA) using the twenty-five ZIP codes contained within the geographic boundaries of the Howard County jurisdiction as set forth by the Maryland Department of Planning and Zoning. U.S. Census-designated cities (CDP) within the boundaries of Howard County include Columbia, Ellicott City, Elkridge, Jessup, and Savage. The combination of HCGH’s status as the only acute care hospital in Howard County and the natural boundaries of the Patapsco and Patuxent rivers provide a level of “containment” of the local population for seeking health care and other services. In FY 2015, of HCGH’s total patient discharges approximately 68% (13,587 of 19,969) resided in the CBSA1, further supporting the definition of the Howard County jurisdiction as the Hospital’s CBSA. Map 1 below highlights the CBSA. 1 HSCRC and Johns Hopkins Medicine Business Planning and Market Analysis, 2015 2 Howard County General Hospital Map 1: Overall Community Benefit Service Area – 2015 Study Area Map Howard County Zip Codes: 20701, 20723, 20759, 20763, 20777, 20794, 20833, 21029, 21036, 21042, 21043, 21044, 21045, 21046, 21075, 21076, 21104, 21163, 21723, 21737, 21738, 21771, 21784, 21794, 21797 Howard County is an affluent, educated and healthy community inhabited by 307,260 residents. Demographic projections estimate that the County will increase in population, as well as age overall, growing and graying. Between 2010 and 2035, the overall population is estimated to increase by 26.6%. During the same time period, those ages 50 and older will increase by 60.7%, which is more than double the aging rate for the total county population. An estimated 38% of county residents will be 50 or older by 2035. 2 This will be of particular importance as this population will be more likely to develop chronic diseases and potentially consume more health dollars. Howard County is also a diverse community, with higher rates of foreign born residents as compared to the state overall (18.2% versus 14%) and higher rates of languages other than English spoken in the home as compared to the rest of Maryland (22.5% versus 16%). 2 Maryland Department of Planning population projections, 2013. 3 Howard County General Hospital Tables 1-5 below offer snapshots of key county demographics, including population breakdowns by sex, age, race and ethnicity, educational attainment, and household income for Howard County, the Columbia census-designated place (which accounts for nearly a third of County residents), Maryland, and the nation. Based on the population demographics below, it is notable that Howard County has higher educational attainment and higher household income than compared to Maryland as a whole. Also, the racial/ethnic makeup of Howard County differs from Maryland in that the percentage of the population that is Black/African American is lower than for Maryland, whereas the percentage of the population that is Asian & Pacific Islander is higher than for Maryland. The Columbia CDP,
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