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Presentation Slides from the November 14, 2019 Community WELCOME DOUG JACKSON VIRGINIA DEPARTMENT OF HOUSING & COMMUNITY DEVELOPMENT TODAY WE’LL Explore how NRV Community Health Assessment findings relate to your work. Learn how other communities are making strategic investments to address identified needs Contribute ideas, experiences, and energy to improve health and well being in the NRV. WELCOME + INTRODUCTION BILL FLATTERY CARILION CLINIC WELCOME + INTRODUCTION STEPHEN CHANDLER LEWIS GALE COMMUNITY HEALTH ASSESSMENT ASHLEY HASH CARILION NEW RIVER VALLEY MEDICAL CENTER COMMUNITY HEALTH ASSESSMENT MICHELLE BRAUNS COMMUNITY HEALTH CENTER OF THE NEW RIVER VALLEY SYSTEMS AT WORK DOUG JACKSON VA DHCD SYSTEMS AT WORK TAKEAWAYS SYSTEMS AT WORK JESSICA WIRGAU COMMUNITY FOUNDATION OF THE NEW RIVER VALLEY SYSTEMS AT WORK DOUG JACKSON VA DHCD SYSTEMS AT WORK TAKEAWAYS WEIGHING IN BY MOVING ABOUT WEIGHING IN BY MOVING ABOUT 1 Which of the CHA priorities do you perceive to be the greatest barrier for your clients/citizens? GREATEST BARRIER A. Access to Care B. Affordable, Safe Housing C. Child Abuse / Domestic Violence D. Culture: Healthy behaviors not a priority E. Lack of knowledge of resources F. Poverty / low avg. household income G. Substance Use H. Transportation WEIGHING IN BY MOVING ABOUT 2 If we could address one priority area, which one do you think would have the greatest impact on our region? GREATEST IMPACT A. Access to Care B. Affordable, Safe Housing C. Child Abuse / Domestic Violence D. Culture: Healthy behaviors not a priority E. Lack of knowledge of resources F. Poverty / low avg. household income G. Substance Use H. Transportation WEIGHING IN BY MOVING ABOUT 3 Which priority do you think there is the greatest energy to work on? GREATEST ENERGY A. Access to Care B. Affordable, Safe Housing C. Child Abuse / Domestic Violence D. Culture: Healthy behaviors not a priority E. Lack of knowledge of resources F. Poverty / low avg. household income G. Substance Use H. Transportation SYSTEMS AT WORK JEFF DINGER GILES COUNTY SYSTEMS AT WORK JEFF DINGER GILES COUNTY SYSTEMS AT WORK TAKEAWAYS SYSTEMS THINKING SYSTEMS THINKING mycorrhizal networks SYSTEMS THINKING SYSTEMS THINKING SYSTEMS SYSTEMS THINKING SEEING The glaringly obvious only glares at you after you see it. First Steps Information Sharing Network Shared Resources Service Delivery Joint Planning 2016 2019 SYSTEMS SYSTEMS THINKING SEEING SYSTEMS THINKING The network as part of a system, actively engaging in the system by understanding it. LEARNING TOGETHER SYSTEMS THINKING The network as part of a system, actively engaging in the system by understanding it. LEARNING TOGETHER SYSTEMS SYSTEMS THINKING SEEING SYSTEMIC SYSTEMS THINKING SYSTEMS THINKING Get it at donnellameadows.org SYSTEMS THINKING Learn to read causal loops at systemsandus.com SYSTEMS THINKING But what are we trying to identify in the system? • Overlooked resources • Feedback patterns • Missed perspectives • Environmental inputs • Nontraditional partners • Leverage points • Norms • Policy implications • Patterns • Synthesis over analysis • New frames of reference • Complexity! SYSTEMS THINKING Learn to read causal loops at systemsandus.com “We’re disrupting how we think about the community.” Jessica Wirgau “Then we get them all together. Chris McKlarney BARRIERS & LEAPS LUNCH DR. NOELLE BISSELL, M.D. NEW RIVER HEALTH DISTRICT KEYNOTE SPEAKERS DR. NANCY WELCH, M.D. CHESAPEAKE HEALTH DEPARTMENT DANIELLE PORZIG HEALTHY CHEASAPEAKE Healthy Chesapeake A Unique Partnership for Addressing Population Health Needs New River Presentation| November 2019 Danielle Porzig, MPH, Healthy Chesapeake CARE Program Manager Nancy Welch, MD, MHA, MBA, Chesapeake Health District Director 12/18/2019 Declining community health status drove the formation • Chesapeake City had declined to 44th per the annual Virginia RWJF County Health Rankings • Recent joint Community Needs Assessment conducted by the health department and hospital indicated specific focus areas for improvement • Data analysis showed large disparities in segments of our community What are the most important HEALTH-RELATED ISSUES for our entire community? Options Response Percent Count • Now it is 37 Mental health (depression, anxiety, stress) 92 60.9 Aging 73 48.3 Clean & healthy environment 65 43.0 Nutrition (healthy food and eating habits) 59 39.1 Obesity 58 38.4 Disabilities (physical, intellectual, sensory, 53 35.1 developmental) Chronic Diseases (such as heart disease or diabetes) 52 34.4 Alcohol and drug abuse 50 33.1 Infectious diseases (such as flu or tuberculosis) 40 26.5 Healthy babies and mothers 36 23.8 Dental health (healthy teeth) 36 23.8 Immunizations 31 20.5 Tobacco Use 29 19.2 Sexually transmitted diseases 25 16.6 Accidental injuries 14 9.3 Data Shows Large Disparity Gaps within the city 7 7 Health Opportunity Index (HOI) Factors also show big differences Low Health Opportunity = BAD VDH calculates a Health Opportunity Index, or HOI, which is a composite measure comprised of 13 indices that reflect a broad array of social determinants of health affecting the community. We are electing to work in low HOI areas initially where the impact opportunity is the greatest. Population Health Issues in Chesapeake • Food Insecurity There are an estimated 26,630 food insecure individuals in Chesapeake1 • Diabetes Prevalence At 15%, Chesapeake is 1.5 times the state average2 • Adult Obesity Prevalence 1 in 3 Chesapeake adults are obese3 • Aging There is an expected 114 percent increase in the population 65 years + projected by 20404 Source: 1 Feeding America: Map the Meal Gap 2018 2,3 Virginia Department of Health, 2015 4 Welden Cooper Population Center for Public Service, UVA How to address these community health needs? A small working group with two representatives from the City and two from Chesapeake Regional Medical Center, under the leadership of the Health Director strategized the development of a unique concept that eventually became Healthy Chesapeake, Inc. Community leadership buy-in critical • Inaugural interest meeting for development of Coalition led by Mayor Krasnoff and Health Director, Dr. Nancy Welch Broad Group of Initial Stakeholders Internal and External Focus Group Meetings = Initial Direction Coalition Strategic Planning Harbour North Focus Group Meeting Cambridge Square Focus Group Meeting Decision to establish a unique hybrid operating relationship • The Health Director serves as the public health advisor for the Board Chesapeake Health Department Director serves as Public Health Advisor The Healthy Chesapeake Executive Director is contracted and participates in strategic planning and liaisons with other Health Department units for integration opportunities Chesapeake Responds: Healthy Chesapeake Mission – Healthy Chesapeake is committed to building a culture of wellness that supports, sustains, and advocates for a healthier Chesapeake Vision – To be ranked the healthiest community in Virginia per the Robert Wood Johnson County Health Ranking Board – Board of Directors that provide the guidance and financial oversight of our program initiatives Coalition – Voluntary group of citizens, community agencies, city departments, faith-based organizations, health care providers, and others that collaborate on direct service delivery 501(c)(3) – Established and operational with an Executive Director reporting to the Board and administrative and programmatic staff that support the Coalition Strategy – Facilitate and provide support for population health programs and services developed and delivered by the Coalition in response to priorities identified by Community Needs Assessment, Chesapeake Neighborhood Quality of Life Study, Chesapeake Comprehensive Plans for Youth and 55 and Better, etc. 85 Unique Contractual Relationship with The Chesapeake Health District • Healthy Chesapeake, Inc. is designated by the Chesapeake Health District and approved by VDH as the population health manager to lead the response to Virginia’s Plan for Well Being. • Healthy Chesapeake, Inc. is charged with providing and ensuring: “…coordination and collaboration of all sectors of the community government, health care, education, businesses and community organizations including the faith based .. in working together to improve the conditions needed for people to be healthy.” Plan created by statewide multi- faceted taskforce to address population health issues in Virginia. MOU with Healthy Chesapeake • This Memorandum of Agreement between Chesapeake Health Department (CHD), and Healthy Chesapeake, Inc. (HCI), for the purpose of cooperation and coordination related to the implementation of strategic initiatives related to improvement of the population health of Chesapeake. • WHEREAS, in 2017 HCI was designated the population health manager for CHD with responsibility to implement the Plan for Wellbeing in Chesapeake. • CHD Responsibilities 1. Subject to appropriation for CHD budget and contingent on available non-designated funding, the CHD agrees to disburse funds in support for the operation of HCI and the delivery of population health programs and services. 2. The CHD Health Director shall serve as a non-voting Public Health Advisor to the board and coalition. Important Roles A unique hybrid/lateral structure is established by the corporate bylaws and outlines the operating process. Healthy Chesapeake Shared Mission Healthy Chesapeake Board Coalition Collective Impact Premise Uses the Collective Impact Model • The Coalition is a separate entity with its own chair and operating structure that includes work teams consisting
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