Commmunnity HHealt hh Neee ds AA ssesssment Essenttia Healthh West, F Fargo, Noorth Dak oo ta June 18, 2013 \ , Essentia Health Here with you \\~ Essentia Health Here with you Essentia Health West, Fargo, ND Community Health Needs Assessment Table of Contents Executive Summary ......................................................................................................................... iv 1. Introduction ................................................................................................................................ 6 2. Community Served by the Hospital Facility ................................................................................ 9 2.1. Description/Definition and Determination ......................................................................... 9 2.2. Demographics ................................................................................................................... 10 2.3. Additional Demographic Data ........................................................................................... 16 3. Process and Methods Used to Conduct the Assessment ......................................................... 17 3.1. Sources and Dates of the Data and Other Information Used in the Assessment ............ 17 3.2. Analytical Methods Applied/Process Used to Identify Community Health Needs .......... 21 3.3. Information gaps that impact ability to assess the health needs of the community served by the hospital facility ........................................................................................... 21 3.4. Coordination with Other Hospitals and Collaboration with Other Organizations ........... 22 3.5. Contracted Third Parties ................................................................................................... 23 4. Community Health Profile ........................................................................................................ 24 5. Input from Persons Who Represent the Broad Interests of the Community Served by the Hospital Facility ................................................................................................................. 37 5.1. When and How These Persons Were Consulted .............................................................. 37 5.2. Organizations Consulted ................................................................................................... 37 5.3. Individuals with Special Knowledge of or Expertise in Public Health ............................... 38 5.4. Federal, Tribal, Regional, State, or Local Health or Other Departments or Agencies with Current Data or Other Information Relevant to the Health Needs of the Community ........................................................................................................................ 38 5.5. Individuals Who are Leaders, Representatives, or Members of Medically Underserved, Low‐Income, and Minority Populations and Populations with Chronic Disease Needs .. 38 6. Community Health Needs Identified Through the CHNA ......................................................... 39 6.1. Process and Criteria Used in Prioritizing the Needs ......................................................... 39 6.2. Standardization and Prioritized Description of Identified Health Needs ......................... 39 7. Existing Healthcare Facilities and Other Resources Within the Community Available to Meet the Community Health Needs Identified Through the CHNA ................................. 42 7.1. Process for Identifying and Prioritizing Resources/Services to Meet the Community Health Needs ..................................................................................................................... 42 8. Making the CHNA Report Widely Available to the Public ........................................................ 42 References .................................................................................................................................... 43 Acknowledgments ......................................................................................................................... 44 Appendix A – Implementation Strategy ....................................................................................... 45 Appendix B – Intervention Protocols for First Health Need ......................................................... 53 Appendix C – Compendium of Resources ..................................................................................... 72 i \\~ Essentia Health Here with you Essentia Health West, Fargo, ND Community Health Needs Assessment List of Figures Figure 1. Population Health Links ACOs, PCMHs, and Community Benefit (CHNA).................... 6 Figure 2. Institute of Medicine Community Health Improvement Process................................. 8 Figure 3. Intervention Timeline ................................................................................................... 9 Figure 4. Hospital Location ........................................................................................................ 10 Figure 5. UWPHI County Health Rankings Social and Economic Factors Ranks, Cass County .. 14 Figure 6. UWPHI County Health Rankings Social and Economic Factors Ranks, Clay County... 15 Figure 7. UWPHI County Health Rankings Model...................................................................... 19 Figure 8. UWPHI County Health Rankings Health Outcomes Ranks, Cass County .................... 24 Figure 9. UWPHI County Health Rankings Health Outcomes Ranks, Clay County .................... 25 Figure 10. UWPHI County Health Rankings Health Behaviors Ranks, Cass County..................... 26 Figure 11. UWPHI County Health Rankings Health Behaviors Ranks, Clay County ..................... 27 Figure 12. UWPHI County Health Rankings Clinical Care Ranks, Cass County ............................ 31 Figure 13. UWPHI County Health Rankings Clinical Care Ranks, Clay County............................. 31 Figure 14. UWPHI County Health Rankings Physical Environment Ranks, Cass County ............. 35 Figure 15. UWPHI County Health Rankings Physical Environment Ranks, Clay County.............. 35 List of Tables Table 1. Population Demographics for States Where Essentia Health Has a Presence........... 11 Table 2. Population Demographics for States Where Essentia Health Has a Presence Stratified by Geographic Locale (Rural/Non‐Rural) .................................................... 12 Table 3. Population Demographics for States Where Essentia Health Has a Presence Stratified by Race/Ethnicity ........................................................................................ 13 Table 4. UWPHI County Health Rankings Social and Economic Factors Data .......................... 15 Table 5. Cass and Clay County Demographic Data................................................................... 17 Table 6. UWPHI County Health Rankings Health Outcomes Data............................................ 25 Table 7. UWPHI County Health Rankings Health Behaviors Data ............................................ 27 Table 8. Population Risk Factors and Disease Status for States Where Essentia Health Has a Presence................................................................................................................... 28 Table 9. Population Risk Factors and Disease Status for States Where Essentia Health Has a Presence Stratified by Geographic Locale (Rural/Non‐Rural).................................. 29 Table 10. Population Risk Factors and Disease Status for States Where Essentia Health Has a Presence Stratified by Race/Ethnicity...................................................................... 30 Table 11. UWPHI County Health Rankings Clinical Care Data .................................................... 32 Table 12. Population Health Service Information for States Where Essentia Health Has a Presence...................................................................................................................... 32 ii \\~ Essentia Health Here with you Essentia Health West, Fargo, ND Community Health Needs Assessment Table 13. Population Health Service and SES Information for States Where Essentia Health Has a Presence Stratified by Geographic Locale (Rural/Non‐Rural)........................... 33 Table 14. Population Health Service and SES Information for States Where Essentia Health Has a Presence Stratified by Race/Ethnicity............................................................... 34 Table 15. UWPHI County Health Rankings Physical Environment Data..................................... 36 Table 16. Examination of a Specific Health Issue: The Case of Smoking................................... 36 Companion Reports 2012 Greater Fargo‐Moorhead Community Health Needs Assessment of Residents 2012 Greater Fargo‐Moorhead Community Health Needs Assessment of Community Leaders iii \\~ Essentia Health Here with you Essentia Health West, Fargo, ND Executive Summary Executive Summary Innovis Health, LLC, doing business and hereafter referred to as Essentia Health West, is required to conduct a Community Health Needs Assessment (CHNA) and adopt an implementation strategy to meet the community health needs identified through the CHNA at least once every three years. The following document and past and future activities described therein serve to meet that requirement. The implementation strategy included in Appendix A was approved by the Essentia Health West Region Board of Directors on May 30, 2013. The majority of