Drake Center Community Health Needs Assessment May 2013 Table of Contents Community Health Needs Assessment Requirement ................................................................................. 3 Executive Summary ...................................................................................................................................... 4 UC Health Mission, Vision and Values ......................................................................................................... 7 Community Health Needs Assessment Overview and Methodologies ...................................................... 8 Drake Center .................................................................................................. Error! Bookmark not defined. Appendix A – Community Served Definition ............................................................................................. 25 Appendix B – Community Health Resources ............................................................................................. 26 Page 2 of 89 Community Health Needs Assessment Requirement According to the Patient Protection and Affordable Care Act (PPACA), all tax-exempt hospitals must conduct a Community Health Needs Assessment (CHNA) once every 3 years. A CHNA is a written document developed for a hospital that includes a description of the community served by the hospital; the process used to conduct the assessment including how the hospital took into account input from community members including those with special knowledge of or expertise in public health; identification of any persons with whom the hospital has worked on the assessment; and the health needs identified through the assessment process. The CHNA written report must include descriptions of the following: • The community served and how the community was determined • The process and methods used to conduct the assessment including sources and dates of the data and other information as well as the analytical methods applied to identify community health needs • How the organization took into account input from persons representing the broad interests of the community served by the hospital, including a description of when and how the hospital consulted with these persons or the organizations they represent • The prioritized community health needs identified through the CHNA as well as a description of the process and criteria used in prioritizing the identified needs • The existing health care facilities and other resources within the community and available to meet community health needs The CHNA requirement also includes that hospitals must adopt an Implementation Strategy to meet the community health needs identified through the assessment. An Implementation Strategy is a written plan that addresses each of the community health needs identified through a CHNA. The plan must include the following: • List of the prioritized needs the hospital plans to address and the rationale for not addressing other needs • Actions the hospital intends to take to address the chosen health needs • The anticipated impact of these actions and the plan to evaluate such impact (e.g. identify the data sources you will use to track the plan’s impact) • Identify the programs and resources the hospital plans to commit to address the health need • Describe any planned collaboration between the hospital and other facilities or organizations in addressing the health need. A CHNA is considered conducted in the taxable year that the written report of its findings, as described above, is adopted by an authorized body of the hospital and made widely available to the public. The Implementation plan is considered implemented on the date it is approved by the governing body. Conducting the CHNA and approval of the Implementation Strategy must occur in the same fiscal year. CHNA compliance is reported on IRS Form 990, Schedule H. Page 3 of 89 Executive Summary The Community Health Needs Assessment (CHNA) is a requirement of all tax exempt (501(c)(3)) hospitals beginning with fiscal year 2013. As part of the IRS Form 990, Schedule H, individually licensed not-for-profit hospitals are required to assess the health needs of their community, prioritize the health needs, and develop implementation plans for the prioritized health needs they have chosen to address UC Health has been working with Truven Health Analytics (formerly the Healthcare Business of Thomson Reuters) since October 2012 on completing the CHNA for four (4) of the UC Health facilities: University of Cincinnati Medical Center, West Chester Hospital, UC Health Surgical Hospital and Drake Center. Truven Health used inpatient data to define the community served for the UC Health hospitals. With the exception of UC Health Surgical Hospital, the community served for each hospital was defined as the counties that comprise up to 80% of inpatient discharges. UC Health Surgical Hospital shares a community served definition with West Chester Hospital given shared operations. As a part of the health needs assessment, Truven Health evaluated the demographics of the community served by each of the hospitals. Some key demographic findings include: . Over the past 10 years, Hamilton County’s population decreased by 5 percent – it is the only UC Health county to lose population . Warren County’s population grew by nearly a third between 2000 and 2010 . Hamilton County has the largest number of disabled residents at more than 95,000 . The largest African American population in both size (205,952 people) and percentage (26%) is in Hamilton County . The Hispanic/Latino population in the region more than doubled between 2000 and 2010 – the largest percentage growth was in Butler County, which saw an increase from 1.4 % to 4% . Nearly 1 in 5 residents of Hamilton County live in poverty . Unemployment is lowest in Warren County In November 2012, members of the Truven Health team conducted interviews (both one-on-one and small group) and focus groups to take into account input from persons who represent the broad interests of the community served by the hospital (a CHNA requirement). As a part of this process, 37 interviews and 4 focus groups were conducted. Individuals interviewed included representatives of public health departments, such as Tim Ingram, Health Commissioner of Hamilton County Public Health Department, and Kelly Kohake, of the Cincinnati Health Department; representatives of local organizations, such as Peggy Nestor of the Hartwell Improvement Association, Mitchell Willis of Butler County United Way, Renee Harris of Center for Closing the Health Gap; other health care providers, such as Anna Alvarez, with Stay Well Home Health and Maddie Syzek of Su Casa Hispanic Center; and leaders and employees of UC Health familiar with community needs. During the interview process, the majority of individuals gave the current health status of the community a grade of “C” on an A-F scale. Much of this is attributed to obesity, lack of preventive Page 4 of 89 health efforts, lifestyle, chronic diseases and socioeconomic barriers. The need for more health education, mental health services as well as improved access to preventative care was identified as the top needs across all those interviewed. Not surprisingly, barriers to good health include access issues – especially in the areas of primary care and insurance coverage. The minority and elderly populations as well as people living in poverty were identified as those being most at risk. In addition to the qualitative feedback, quantitative health indicators were collected and analyzed to assess community health needs. Sixty-nine (69) indicators were evaluated for each of the counties in the UC Health communities served. Health indicators were defined to 13 distinct categories: Demographics Socioeconomic Leading Causes of Death Sexually Transmitted Access to Health Care Chronic Conditions Infections Maternal Health Mental Health Infectious Diseases Substance Abuse Obesity Oral Health Environmental Health For each health indicator, a comparison was made between the county level data and benchmarks. For UC Health, the State of Ohio health indicator scores were used as the comparative benchmark when available; in other cases alternative comparative benchmarks were used. Health needs were identified where the county indicator did not meet the comparative benchmark. In February 2013, Truven Health presented the findings of the community health needs assessment and facilitated the prioritization of health needs with representatives from UC Health. UC Health participants included: University of Cincinnati Medical Drake Center West Chester Hospital & UC Health Center • Brenda Ziegler - Administrative Surgical Hospital • Tony Condia – UC Health Vice Director, Drake Center • Grant Wenzel – WCH Director of President of External Affairs • Mary Beth Puryear – Drake Center Public Relations & Marketing • Marla Fuller – UC Health Director of Public Relations & • Sara Deem - Surgical Hospital Director of Community and Marketing Executive Director External Affairs • Laura Allerding – UC Health Director of Market Research and Planning The Prioritization Work Group selected criteria to help prioritize the health needs. The criteria selected included quick success (probability of quick success - is the problem “low-hanging fruit”?), hospital strength (extent to which initiatives that address the health issues can build on hospital existing strength and resources), and alignment (does the need align with current organizational