MOUNT CARMEL EAST 6001 EAST BROAD STREET COLUMBUS, OHIO 43213 mountcarmelhealth.com COMMUNITY BENEFIT ASSESSMENT AND IMPLEMENTATION PLAN 2013-2016 COMMUNITY BENEFIT ASSESSMENT AND IMPLEMENTATION PLAN PAGE 1 Mount Carmel Health System Community Health Needs Assessment Implementation Plans Accepted by the Mount Carmel Health System Board of Trustees as a Component of the Community Benefit Plan and Approved on May 15, 2013 Contents 1. Mount Carmel Health System a. Our Purpose and Overview b. The Community We Serve;Area Demographics 2. Assessment, Methodology and Findings a. Link to the HealthMap 2013 (Franklin County Health Needs Assessment) b. Community Benefit Advisory Board c. Mount Carmel Health Community Benefit System-wide Strategies Goals 3. Facility Specific Overview 4. Community Benefit Reporting (Link to Community Benefit Report) 5. Specific Facility Response to Finding 6. Unaddressed Identified Needs 7. Attachments a. Data Sources b. Anticipated Partners MOUNT CARMEL EAST COMMUNITY BENEFIT ASSESSMENT AND IMPLEMENTATION PLAN PAGE 2 Mount Carmel Health System OUR PURPOSE AND OVERVIEW Mount Carmel Health System was founded in 1886 by two area physicians and the Sisters of the Holy Cross with the mission to help the poor and underserved. Presently a part of CHE- Trinity Health, it is one of the largest Catholic healthcare organizations in the United States. Located in Columbus, Ohio with a target service area that includes all of Franklin County it serves a population of about 800,000 with 1,350 inpatient beds.We employ more than 8,000 employees, and have 1,500 physicians and nearly 900 volunteers. MCHS includes Mount Carmel East, Mount Carmel West, Mount Carmel St.Ann’s, Mount Carmel New Albany Surgical Hospital, Diley Ridge Medical Center, and community based ambulatory centers,Women’s Health, Physical Rehab and Cancer. MCHS exists to improve the health of our communities by providing compassionate care and service to people in time of illness and suffering. Mission We serve together in Trinity Health, in the spirit of the Gospel, to heal body, mind and spirit, to improve the health of our communities, and to steward the resources entrusted to us. Vision Inspired by our Catholic faith tradition,Trinity Health will be distinguished by an unrelenting focus on clinical and service outcomes as we seek to create excellence in the care experience. Trinity Health will become the most trusted health partner for life. Values Respect Social Justice Compassion Care of the Poor and Underserved Excellence MOUNT CARMEL EAST COMMUNITY BENEFIT ASSESSMENT AND IMPLEMENTATION PLAN PAGE 3 THE COMMUNITY WE SERVE; AREA DEMOGRAPHICS Franklin County County Health Rankings and Roadmaps http://www.countyhealthrankings.org/app/ p y g g pp Rank Franklin National (of 88) County Error Margin Ohio Benchmark* Health Outcomes 58 Mortality 56 Premature death 7,870 7,694-8,046 7,457 5,317 Morbidity 64 Poor or fair health 14% 13% - 16% 15% 10% Poor physical health days 3 - 7 3.3 - 4.0 3.6 2.6 Poor mental health days 4 3.6 - 4.3 3.8 2.3 Low birth weight 9.4% 9.2 - 9.5% 8.6% 6.0% Health Factors 41 Health Behaviors 47 Adult Smoking 21% 19 - 23% 22% 13% Adult Obesity 31% 29 - 33% 30% 25% Physical inactivity 25% 23 - 27% 27% 21% Excessive drinking 19% 17 - 21% 18% 7% Motor vehicle crash death rate 9 8 - 9 11 10 Sexually transmitted infections 703 422 92 Teen birth rate 45 44 - 46 38 21 Clinical Care 11 Uninsured 15% 14 - 16% 14% 11% Primary care physicians** 1,065:1 1,348:1 1,067:1 Dentists** 1,317:1 1,928:1 1,516:1 Preventable hospital stays 70 68 - 73 79 47 Diabetic screening 85% 83 - 87% 83% 90% Mammography screening 60% 58 - 62% 63% 73% Social & Economic Factors 52 High school graduation** 83% 78% Some college 69% 61% 70% Unemployment 7.6% 8.6% 5.0% Children in poverty 27% 24 - 29% 24% 14% Inadequate social support 19% 17 - 21% 20% 14% Children in single-parent households 39% 37 - 40% 34% 20% Violent crime rate 537 332 66 Physical environment 46 Daily fine particulate matter 13.5 13.3 - 13.7 13.4 8.8 Drinking water safety 0% 2% 0% Access to recreational facilities 10 10 16 Limited access to healthy foods** 6% 6% 1% Fast food restaurants 59% 55% 27% * 90th percentile, i.e., only 10% are better. ** Data should not be compared with prior years due to change in definition. Note: Blank values reflect unreliable or missing data. MOUNT CARMEL EAST COMMUNITY BENEFIT ASSESSMENT AND IMPLEMENTATION PLAN PAGE 4 Area Demographics, continued Columbus, Ohio 788,696 people live in Columbus.The racial demographics of our patients follow the same composition as our community with the majority of the population, 73 percent, Caucasian; African American patients are the second highest number at 21 percent, followed by Hispanic at 1 percent.All other races make up the remaining 5 percent. The surrounding population in zip code 43213 encompassing MCE is made up of 29,835 persons.The 2011 demographic description is as followed: Race/Ethnicity White - 55.7 % Black - 30.9 % Hispanic - 7.3 % Asian and Pacific Islander - 3.2 % Other - 2.9%3 Age Group 18 to 64 years – 63.9% Under 18 years – 23.3% 65 and over – 12.9% The average household income is $49,555, 27% lower than the national average. Due to this factor, the amount of individuals living below the poverty level is 21.4 %, 7.2 % higher than the state of Ohio.2 14 $49,500 12 $49,000 10 $48,500 8 $48,000 Millions 6 $47,500 4 $47,000 2 $46,500 0 $46,000 Median Household Income Total Population 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% Ohio 0% Individuals Living Individuals < 18 High School Franklin County Below Poverty years Living Graduate Level Below Poverty Level MOUNT CARMEL EAST COMMUNITY BENEFIT ASSESSMENT AND IMPLEMENTATION PLAN PAGE 5 HealthMap 2013 Community Need Index for Zip Code 43213 Health is not only defined as free of disease; it is something that is affected by education and income, along with other social needs, which are all determinants of health.The Community Need Index (CNI), developed by Catholic Healthcare West (CHW), in partnership with Thomson Reuters, helps organizations gain a better understanding of public health disparities for every zip code in the United States. This information empowers organizations to determine community benefit programming that will better serve its community. It is believed, with the correct resources to meet the needs of the community, unnecessary hospitalizations can be prevented, public health can be improved and the cost of health care can decline. CHW and Thomson Reuters identified five socio-economic barriers that quantify health access to communities: income, education, culture/language, insurance, and housing. Each barrier has been assigned a numerical score from 1 to 5. A score of 1 represents the least amount of socio-economic barriers (low need).A score of 5 represents the largest amount of socio- economic barriers (high need).The scores are averaged to obtain the final CNI score. The description of how each category was calculated has been italicized.The score for zip code 43213, location of MCE is in bold. Income (3) – percentage of elderly, children, and single parents living in poverty. Those with limited income have fewer visits to primary care due to decisions being made between paying a much needed bill or receiving care. Low income homes may not have insurance, or unable to pay associated costs if they do. Cultural/Language (5) – percentage of Caucasian/Non-Caucasian and the percentage of adults over the age of 25 with limited English. Those whose primary language is not English may not fully understand their medical situation, be confused on discharge instructions, may not be able to read medication labels or understand self-care instructions for chronic conditions. Education (2) – percentage of without high school diplomas. Lack of education can often lead to lack of employment and the lack of health insurance.Without health education, the ability to understand medical information or to recognize symptoms may be impacted. Insurance (4) – percentage of uninsured and the percentage of unemployed. Without health insurance, individuals may forego primary treatment which may lead to hospitalization due to chronic conditions. After hospitalization, those with injuries or chronic conditions may not continue medical care due to costs, which could increase recovery time. If problems persist, the uninsured may have difficulty obtaining health insurance in the future. Housing (5) – percentage renting housing. Increased use of rental housing is associated with transitory lifestyles, an unstable home and an environment unfavorable to health prevention. Most rental units are sub-standard, in high crime areas, lower quality schools and limited food choices and less recreational opportunities. Homelessness was not factored in this score. MOUNT CARMEL EAST COMMUNITY BENEFIT ASSESSMENT AND IMPLEMENTATION PLAN PAGE 6 Community need index (map showing color coded severity) The final CNI (3.8) - shows correlation between high need and high hospital utilization. Admission rates in high need areas were two times higher than low need areas in regards to pneumonia, congestive heart failure, and cellulitis.This may be due to the use of primary care or assistance in managing chronic diseases or conditions. Intercity hardship index The Intercity Hardship Index, calculated every ten years, is a comparative analysis of cities in the United States that have a population of 480,000 or more. It began with 55 cities in 1970 and has grown to include 86 cities that were incorporated in