COMMUNITY HEALTH NEEDS ASSESSMENT

CLAY COUNTY MEDICAL CORPORATION, DBA

NORTH MISSISSIPPI MEDICAL CENTER-WEST POINT

September 2019

TABLE OF CONTENTS

I. BACKGROUND AND REGULATORY REQUIREMENTS OF COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). . . . . . . . . . . . . . . . . 2

II. OBJECTIVES AND METHODOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

III. ACTIONS TAKEN SINCE 2016 CHNA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

IV. NORTH MISSISSIPPI HEALTH SERVICES AT A GLANCE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

V. NMMC-WEST POINT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

VI. COMMUNITY HEALTH NEEDS SURVEY TOOL AND RESULTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 25

VII. IMPLEMENTATION STRATEGIES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

VIII. APPENDIX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

1

REGULATORY REQUIREMENTS OF COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)

The Patient Protection and Affordable Care Act (PPACA) of 2010 requires tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA). The CHNA is the process by which a non-profit hospital evaluates the health needs of the community it serves, e.g., diabetes, heart disease, lung disease, and the service area’s overarching resources, e.g., food, housing, poverty, etc. This assessment identifies our community strengths, needs, care gaps, assets and opportunities relative to the health of our residents.

Our subsequent implementation plan will describe our next steps. As a not-for-profit hospital system, we are required to conduct a CHNA every three years which includes identifying priorities and implementing strategies that will address the needs of those in our defined market.

This CHNA will help us develop strategies that will improve the health of our communities by:

Identifying chronic health issues and care gaps

Recognizing health disparities particularly associated with vulnerable populations

Highlighting community resources that are either available, lacking or underutilized

Understanding health needs from a population-based perspective

Implementing plans to address identified needs

2

OBJECTIVES AND METHODOLOGY

Federal regulations allow us to define the communities we serve based on the relevant facts and circumstances including the geographic locations served by our facilities. Our overall service area includes 20 Mississippi counties and four Alabama counties. This CHNA was compiled/assembled by the Strategy Department of North Mississippi Health Services (NMHS). Significant data from the below secondary sources were gathered, assessed, evaluated and analyzed with demographic and health indicators cited as appropriate:

U. S. Census Bureau

County Health Rankings

CDC

County Health Departments

Input from the community was received via informant interviews, standardized electronic surveys from key organizations/stakeholders, healthcare advocates/leaders, and interested community partners residing in the service areas served by North Mississippi Medical Center-West Point and the health system (see Appendix). Additionally, the Patient and Family Advisory Council members participated in the electronic survey process and provided ongoing input/support culminating in a prioritized list of community needs.

3

4

ACTIONS TAKEN SINCE 2016 CHNACommunity Activity in FY 2017 Approximate Number of Participants

Several members of the leadership team serve on different boards and participate in events associated with organizations (i.e.

Excel by 5, Main Street Association, Sally Kate Winter’s Family Resources, EMCC, MUW)

PFAC 10 members

Sponsored Blood drives – at least 4 times

Facility chef performed cooking demonstration at the local Food Market

Held Relay for Life and other cancer fundraiser

Held Annual Kid’s Fair in the Spring 550

Take A Swing at Cancer Golf Tournament

Columbus Air Force Base Community Partnership – Wings Over Columbus Trauma Outreach

Safe Sitter Class 15 teenagers

Prairie Arts Festival volunteering 12 staff members

Held Health Fair

Flu shots given 150

Mother Daughter Seminar (Drs. Baldwin & Brown) 50 mothers/daughters attended

Yokohoma Tire Tree Planting Ceremony Approx. 150 attendees

United Way Day of Caring – had volunteers and sponsored lunch 15

Christmas Parade – NMMC-West Point entered a float 30

Held live Disaster exercise in the community 50 - 75

Many sponsorships throughout the year

Diabetic Educator provided a healthy eating/diabetes presentation 2-3 times at the Community Counseling 20 – 30 attendees

CARES trainers 8 - 10

Upon request, provided speakers to different organization throughout the year

Wellness Center Director offered CPR and First Aid classes in the community On-going

Taught Yoga to children at Southside twice a week 100 - 125 students

5

ACTIONS TAKEN SINCE 2016 CHNACommunity Activity in FY 2018 Approximate Number of Participants

Several members of the leadership team serve on different boards and participate in events associated with organizations (i.e. Excel by

5, Main Street Association, Sally Kate Winter’s Family Resources, EMCC, MUW)

Sponsored Blood drives – at least 4 times Average of 15 per drive

Facility chef performed cooking demonstration at the local Food Market in the Fall

Held Relay for Life and other cancer fundraisers

Held annual Kid’s Fair in the Spring Around 600 children

Take A Swing at Cancer Golf Tournament

Columbus Air Force Base Community Partnership – Wings Over Columbus Trauma Outreach 50

Columbus Air Force Base Health Fair 50

Trauma ER nursing director attended an Career Expo at BancorpSouth Center

KaBoom playground – large community event – October 2017

Prairie Arts Festival volunteering 15 staff members

Represented the hospital in an 8 month Golden Triangle Leadership class

Health Fair held

Flu shots given 150

United Way Day of Caring – 10 volunteers and sponsored lunch

Entered float in the West Point Christmas parade 20 employees

Held live Disaster excise in the community 50 community & staff

Several sponsorships throughout the year

Diabetic Educator provided a healthy eating/diabetes presentation 2-3 times at the Community Counseling 20 – 30 people

The Progressive Foundation of Clay County – First Annual Sickle Cell Awareness Walk/Run Approx. 75 people

CARES trainers 10

CARES trainers

Spring Break Camp offered at Wellness Center 10

Provided speakers to various organizations upon request

Balance class offered in May 2018 20

Wellness Center Director did a presentation for Rotary Club – Summer 2018 50

Bone Density screenings offer at the Wellness Center – Sept 2018 20 people

9/11 Community Challenge – Sept 2018 50 people

Wellness Center Director offered CPR and First Aid classes in the community

Taught Yoga two times per week 100 – 125 students

6

ACTIONS TAKEN SINCE 2016 CHNA

Community Activity for FY 2019 Approximate Number of Participants

Several members of the leadership team serve on different boards and participate in events associated with organizations (i.e. Excel

by 5, Main Street Association, Sally Kate Winter’s Family Resources, EMCC, MUW)

PFAC 10 members

Sponsored Blood drives – at least 4 times

Relay for Life and other cancer fundraiser

Spring Kid’s Fair 550 students/25 volunteers

Annual Take A Swing at Cancer Golf Tournament

Columbus Air Force Base Community Partnership – Wings Over Columbus Trauma Outreach

Prairie Arts Festival volunteering 10

Helen Copeland represented the hospital in an 8 month Golden Triangle Leadership class

Health Fair held

Flu Shots given 150

Nursing education offered a presentation to nursing students at MUW – October 2018

Held live Disaster exercise with Community 50+

United Way Day of Caring 10 volunteers and sponsored lunch

Various sponsorships

Diabetic Educator provided a healthy eating/diabetes presentation 2-3 times at the Community Counseling

Spring Break Camp offered at Wellness Center

CARE trainers

Provided speakers to different organizations upon request

Wellness Center Director offered CPR and First Aid classes in the community

Certified 40 teaches at Oak Hill Academy in CPR/First Aid 40

Donated first aid kits to all teachers at Oak Hill Academy 40 – 50 kits

Sponsored Women’s Amateur Golf Tournament at Old Waverly Over 60 volunteers

Ribbon cutting for Aux. Gift Shop remodel 20

Best of West Point Contest 6 recognitions of staff, doctors and clinics

Award 2 scholarships to high school seniors 2

Offered free physicals to high school students at Oak Hill Academy 75

Community Activities for FY 2019 Continued Approximate Number of Participants

Took 20 auxiliary members to Tupelo community theater for National Volunteer Week 20

Masa Jewelry fundraisers twice this year Over 400 community and staff members

Kitty Bryan Dill mammography suite dedication 150

Annual sponsor of The Growth Alliance Banquet 250

Numerous retirement parties Average 200 attendees

Wake Up West Point (networking) 6 times a year 50

Auxiliary volunteers held recruitment tea 25 – 30

Taught Yoga to children at Southside twice a week 100 -125 students

April 4 - Kids Fair – promoted health, wellness and safety to Pre-K to 1st Grade students

April 12 - Taught CPR/First Aid to Mississippi Forestry Commission 30

April 23 – Eating for a Healthy Lifestyle – promoted healthy diet, good nutritional choices 15

April 26 – Taught CPR/First Aid to Oak Hill Academy seniors 25

May 24 – Taught CPR/First Aid to Mississippi Forestry Commission 30

May 31 – provided education on nutrition to promote healthy eating behaviors 15

June 7 – Taught CPR/First Aide to Mississippi Forestry Commission 30

August 5 – Taught CPR/First Aid to Oak Hill Academy teachers 40

August 8 – Taught CPR/First Aid to East Mississippi Community College students

ACTIONS TAKEN SINCE 2016 CHNA

7

NORTH MISSISSIPPI HEALTH SERVICES AT A GLANCE

North Mississippi Health Services (NMHS) is a nonprofit, integrated health care delivery system serving 24 counties in north Mississippi and northwest Alabama (twenty Mississippi counties and four Alabama counties).

NMHS’ headquarters is located in Tupelo, MS (North Mississippi Medical Center-Tupelo and the system has five community hospitals with locations in Mississippi (Amory, Eupora, Iuka, Pontotoc and West Point and one community hospital located in Alabama (Hamilton).

In addition to seven hospitals, NMHS has a regional network of more than 50 primary and specialty clinics, four nursing homes, managed care plans and offers telehealth services. NMHS’ physicians and staff are committed to providing quality patient care.

NMMC-Tupelo was honored with the Baldrige Award in 2006 and North Mississippi Health Services in 2012.

Source: https://www.nist.gov/baldrige/north-mississippi-health-services 8

According to the American Heart Association, overweight, obesity and lack of exercise are common causes of heart disease

American Cancer Society states making healthy choices like eating right, staying active and not smoking reduces the risk of cancer

OBESITY

ADULT SMOKING

PHYSICAL INACTIVITY

10%

15%

20%

25%

Current Performance Target/Goal

20%

25%

30%

35%

40%

45%

Current Performance Target/Goal

15%

25%

35%

45%

Current Performance Target/Goal

Source: County Health Rankings (2019). Current performance shows rate for each 24 service area county in alphabetical order (Alcorn, Benton, Calhoun, Chickasaw, Choctaw, Clay, Colbert, Franklin, Itawamba, Lafayette, Lamar, Lee, Lowndes, Marion, Marshall, Monroe, Oktibbeha, Pontotoc, Prentiss, Tippah, Tishomingo, Union, Webster, and Yalobusha). The target goal is the US top performers, i.e., adult smoking (14%), obesity (26%) and physical inactivity (19%).

HEALTH BEHAVIORS IN THE NMHS SERVICE AREA

9

Health behaviors, clinical care, social/economic factors, and

physical environment

County Ranking

Alcorn 9

Benton 21

Calhoun 19

Chickasaw 24

Choctaw 18

Clay 23

Colbert 3

Franklin 17

Itawamba 5

Lafayette 1

Lamar 7

Lee 2

Lowndes 16

Marion 15

Marshall 20

Monroe 14

Oktibbeha 6

Pontotoc 8

Prentiss 10

Tippah 12

Tishomingo 11

Union 4

Webster 13

Yalobusha 22

Source: Adapted from the University of Wisconsin Population Health Institute. County Health Rankings & Roadmaps 2019. www.countyhealthrankings.org

RANKING OF HEALTH OUTCOMES FOR THE 24 COUNTIES IN THE NMHS SERVICE AREA

NMMC-WEST POINT AT A GLANCE

Clay County Medical Corporation dba North Mississippi Medical Center- West Point is located in Clay County. NMMC-West Point enjoys tremendous support from the community, dedicated physicians and staff, and an affiliation with North Mississippi Health Services.

NMMC-West Point is a full-service, 60-bed medical facility. This private, not-for-profit hospital opened its doors in 1985 and continues to grow.

Rooms are "nested," which means four to six rooms are clustered around each nursing unit. This design reduces walking distance, allows nurses to view several patients from a central point, and provides closer access to medical equipment.

Surgeons utilize four operating suites for a wide array of cases, including general, orthopedic and obstetrics-gynecology. The Same Day Surgery Unit features six rooms for outpatient surgery patients to rest before and after their procedure, as well as two endoscopy suites.

The six-bed Intensive Care Unit offers invasive and non-invasive monitoring for medical and surgical patients. The hospital also has 10 licensed swing beds for patients who need extended care.

NMMC-West Point offers 24-hour emergency services at the Level IV Trauma Center, as well as a paramedic-level ambulance service.

Outpatient services include cardiac and pulmonary rehabilitation programs, as well as physical, occupational and speech-language rehabilitation services. Cardiac stress tests and holter monitoring are also offered.

Source: http://www.nmhs.net/westpoint/ 11

NMMC-WEST POINT AT A GLANCE CONTINUED

ANCILLARY SERVICES

Radiology services include general diagnostic, fluoroscopic, CT scans, nuclear medicine scans, ultrasound, bone density and mammography.

A wide array of chemistry, bacteriology, blood bank and drug testing is available 24 hours daily in the hospital's Laboratory. Pharmacy services are provided to hospital inpatients and outpatients.

The Respiratory Therapy Department is staffed by licensed respiratory therapists who perform all respiratory support services, including ventilator procedures, arterial blood gases, BIPAP/CPAP, pulmonary function testing, smoking cessation education and asthma consults. The department also offers spirometry and pulmonary testing for area industries.

The Sleep Disorders Center is fully accredited by the American Academy of Sleep Medicine with a board-certified sleep specialist and registered sleep technologists help individuals overcome sleep apnea, narcolepsy, chronic insomnia and other conditions.

NMMC-West Point’s 14,000-square-foot Wellness Center boasts around 1,300 members and offers numerous classes for exercisers of all ages and fitness levels.

In addition to the hospital and Wellness Center, the NMMC-West Point campus is also home to several medical practices.

Source: http://www.nmhs.net/westpoint/

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13

NMMC-WEST POINT

150 MEDICAL CENTER DRIVE

WEST POINT MS

NMMC-West Point's remarkable design was inspired by the history and culture of this charming Southern community. The entire structure is built around a central atrium filled with greenery. Interestingly, this configuration was inspired by a similar architectural idea used to build the antebellum Waverly Plantation House located nearby.

Source: http://www.nmhs.net/westpoint/

CLAY COUNTY14

CLAY COUNTY DEMOGRAPHICS

20,383

19,640

19,200

19,400

19,600

19,800

20,000

20,200

20,400

20,600

as of July 2012 as of July 2013 as of July 2014 as of July 2015 as of July 2016 as of July 2017

Population Trend

Clay County population is 10.26% of the NMMC- West Point service area. The median age is 38.6 compared to median age of 37.7 for US.

53.6% of the residents of Clay County are female and 46.4% are male. Clay County is 410.1 square miles with 49.1 people per square mile.

Per Capita income is $19,097, about two thirds of the amount for the US ($29,829). Median household income in Clay County is $33,142, about three-fifths of the national amount at $55,322.

Source: U.S. Census Bureau (2016). American Community Survey 5-year estimates. Retrieved from Census Reporter Profile page for Clay County, MS https://censusreporter.org/profiles/05000US2-clay-county-ms/, retrieved August 2019

Age Group Both sexes Male Female

Under 5 years 1,125 573 552

5 to 13 years 2,336 1,151 1,185

14 to 17 years 1,067 542 525

18 to 24 years 1,685 831 854

25 to 44 years 4,778 2,245 2,533

45 to 64 years 5,118 2,332 2,786

65 years and over 3,531 1,512 2,019

12.3%14.0% 13.0%

11.7% 11.6%13.7%

12.1%

8.0%

3.5%

-2%

3%

8%

13%

18%

0 - 9 10 - 19 20 - 29 39 - 39 40 - 49 50 - 59 50 - 59 70 - 79 80 +

63.7%

24.1%

11.2%

1.0%

0% 10% 20% 30% 40% 50% 60% 70%

Under $50K

$50K - $100K

$100K - $200K

Over $200K

Source: U.S. Census Bureau, Population Division, Release Date: June 2018, Annual Estimates of the Resident Population for Selected Age Groups by Sex July 1, 2017, retrieved August 19, 2019

Source: U.S. Census Bureau, Population Division, Annual Estimates of the Resident Population: April 1, 2012 to July 1, 2017, retrieved July 12, 2018

15

CLAY COUNTY DEMOGRAPHICS CONTINUED

Ethnicity

Geographical mobility: 9.5% of population moved since the prior year, about two-thirds the rate for US (14.8%).

Population migration since previous year

39.2%59.0%

0.3% 0.6% 0.7% 0.2%0%

25%50%75%

100%

White AfricanAmerican

Native Hispanic Asian Two +

90.2%

5.9%

2.3%

1.6%

0% 20% 40% 60% 80% 100%

Same house year ago

from same county

from different county

from different state

There are 2.6 persons per household, same as the US figure. Eighty five percent of the housing units are occupied and only fifteen percent are vacant. Sixty nine percent of the housing units are owner occupied with the remaining 31% occupied by renters. The median value of owner occupied housing units in Clay County is $81,600, about two-fifths of the US value ($184,700).

45.6%

54.4%

Marital Status

Married

Single

Source: U.S. Census Bureau (2016). American Community Survey 5-year estimates. Retrieved from Census Reporter Profile page for Clay County, MS https:/censusreporter.org/profiles/05000US28025-clay-county-ms/, retrieved August 19, 2019 16

CLAY COUNTY OVERALL HEALTH COMPOSITE

Clay County is worse than the national rate in 17 of 18 measures and better in only one measure.

Clay County has the highest food insecurity in the NMHS service area.

Measure Clay County National Rate Better/Worse

Cancer incidence rate 446.4 441.2 Worse

Opioid prescription rate 113.4 per 100 persons 66.5 per 100 persons Worse

Premature deaths 12,500 per 100,000 6,700 per 100,000 Worse

Adult smoking 20% 17% Worse

Physical inactivity 37% 23% Worse

Adult obesity 34% 28% Worse

Diabetes monitoring 82% 85% Worse

Mammography screening 60% 63% Worse

Uninsured 16% 11% Worse

Preventable hospital stays52 per 1,000 Medicare

enrollees

49 per 1,000 Medicare

enrolleesWorse

Children in poverty 38% 20% Worse

Food insecurity 24.4%* 12.9% Worse

Air pollution – particulate matter 9.9 8.7 Worse

Severe housing problems 21% 19% Worse

Long commute – driving alone 27% 35% Better

% of adults with less than high school diploma 21.2% 13.1% Worse

% or adults completing some college or assoc. degree 27.8% 29.1% Worse

% of adults with bachelor’s degree or higher 18.9% 30.3% Worse

Source: http://www.countyhealthrankings.org/ 17

CLAY COUNTY HEALTH OUTCOMES, HEALTH FACTORS AND CLINICAL CARE

Measure Clay County US

Premature deaths1 - 2015 12,500 per 100,000 population 6,700 per 100,000 population

Adult smoking - 2016 20% 17%

Physical inactivity2 - 2014 37% 23%

Adult obesity - 2014 34% 28%1Years of potential life lost before age 752Percent of adults aged 20 and over reporting no leisure-time physical activity

Measure Clay County US

Uninsured - 2015 16% 11%

Primary care physicians - 2015 2,000:1 1,320:1

Dentists - 2016 6,620:1 1,480:1

Mental health providers - 2017 660:1 470:1

Preventable hospital stays3 - 2015 52 per 1,000 Medicare Enrollees 49 per 1,000 Medicare Enrollees3Number of hospital stays for ambulatory-care sensitive conditions per 1,000 Medicare enrollees

0 500 1,000 1,500 2,000 2,500 3,000 3,500

Lowndes

Clay

Monroe

Oktibbeha

Chickasaw

Webster

RATIO OF POPULATION (CONTIGUOUS COUNTIES/CLAY) TO PRIMARY CARE PHYSICIANS

3,300:1

2,890:1

2,370:1

2,110:1

2,000:1

1,930:1

Source: County Health Rankings - 2018, http://www.countyhealthrankings.org/ 18

CLAY COUNTY HEALTH OUTCOMES, HEALTH FACTORS AND CLINICAL CARE

Fertility:

7.4%

10.3%

9.1%

0.0%

1.5%1.9%

0%

2%

4%

6%

8%

10%

12%

15 - 19 20 - 24 25 - 29 30 - 35 35 - 39 40 - 44

Women who gave birth during the past year by age group

Source: U.S. Census Bureau (2016). American Community Survey 5-year estimates. Retrieved from Census Reporter Profile page for Clay County, MS https://censusreporter.org/profiles/05000US28025-clay-county-ms/, retrieved August 19, 2019 19

CLAY COUNTY SOCIAL AND ECONOMIC FACTORSSource: USDA, Bureau of Labor Statistics and US Census

Measure Clay County US

Unemployment – 2017 8.1 4.4

Median household income - 2016 $33,142 55,322

High school graduate or higher, 2012-2016 78.8% 87%

Bachelor’s degree or higher, 2012-2016 18.9% 30.3%

% with less than high school diploma, 2012-2016 21.2% 13.0%

Children in Poverty4 - 2015 38% 20%

Food insecurity Rate, 2016 24.4% 12.3%4Children under the age of 18 in poverty

21.2%

32.1%

27.8%

12.0%

6.9%

0%

5%

10%

15%

20%

25%

30%

35%

No degree High school Some college Bachelor's Post-grad

POPULATION BY MINIMUM LEVEL OF EDUCATION

78.8% of the Clay County population is a high school graduate or higher compared to the national rate of 87%. Residents of Clay County with a bachelor’s degree or higher is 18.9%, about three-fifths of the US rate (30.3%).

Measure Clay County

Language at home, children 5-17 98% English only

Language at home, adults 18+ 98% English only

Sources: http://www.countyhealthrankings.org and U.S. Census Bureau (2016). American Community Survey 5-year estimates. Retrieved from Census

Reporter Profile page for Clay County, MS https://censusreporter.org/profiles/05000US28025-clay-county-ms/, retrieved August 2019

20

CLAY COUNTY PHYSICAL ENVIRONMENt

Measure Clay County National Rate

Air pollution – particulate matter - 2012 9.9 8.7

Severe housing problems – 2010 - 2014 21% 19%

Driving alone to work – 2012 – 2016 89% 76%

Long commute – driving alone – 2012 - 2016 27% 35%

86.90%

7.2%1.8% 3.5% 0.5%

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

Drove alone Carpooled Walked Worked at home Other

MEANS OF TRANSPORTATION TO WORK

Source: U.S. Census Bureau (2016). American Community Survey 5-year estimates. Retrieved from Census Reporter Profile page for Clay County, MS, https://censusreporter.org/profiles/05000US28015-clay-county-ms and : http://www.countyhealthrankings.org/, retrieved August 19, 2019

The mean travel time to work in Clay County is 22.4 minutes compared to 24.2 minutes in Mississippi and 26.2 minutes in the US.

21

Source: County Health Rankings - 2018, http://www.countyhealthrankings.org/

CLAY COUNTY CAUSES OF DEATH

CAUSE RATE

HEART DISEASE 342.6

MALIGNANT NEOPLASMS (CANCER) 216.6

OTHER DISEASES AND CONDITIONS 206.5

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)/EMPHYSEMA 80.6

CEREBROVASCULAR DISEASES (STROKE) 55.4

UNINTENTIONAL INJURY 55.4

ALZHEIMER’S DISEASE 50.4

DIABETES MELLITUS 35.3

NEPHRITIS, NEPHROTIC SYNDROME AND NEPHROSIS (KIDNEY DISEASE) 35.3

SEPTICEMIA 30.2

PNEUMONIA & INFLUENZA 20.2

SUICIDE 20.2

CHRONIC LIVER DISEASE & CIRRHOSIS 15.1

HYPERTENSION 10.1

HIV/AIDS 5.0

HOMICIDE AND LEGAL INTERVENSION 5.0

OTHER EXTERNAL CAUSES 5.0

Source: http://mstahrs.msdh.ms.gov/forms/morttable.html 22

CLAY COUNTY CANCER INCIDENCE RATES

Clay US

INCIDENCE RATE - ALL Sites 446.4 441.2 Worse

Uterus Suppressed 20.5 n/a

Non-Hodgkin Lymphoma Suppressed 18.9 Worse

Pancreas Suppressed 12.6 n/a

Breast-female 117.5 124.7 Better

Lung/Bronchus 71.7 60.2 Worse

Kidney & Renal Pelvis 19.1 16.4 Worse

Bladder 16.5 20.3 Better

Leukemia 15.9 13.6 Worse

Melanoma of Skin 14.9 21.3 Better

CLAY COUNTY OPIOID PRESCRIBING RATES

County 113.4 prescriptions per 100 persons

US 66.5 prescriptions per 100 persons

74.1

86.8

102.3

113.4

124.2

155.0

0 40 80 120 160

Oktibbeha

Chickasaw

Monroe

Clay

Lowndes

Webster

2016 PRESCRIBING RATES PER 100 PERSONS

WEST POINT AND CONTIGUOUS COUNTIES

Sources: CDC’s National Program of Cancer Registries, Incident Rate Report by County, 5 year trend (2011-2015) and CDC and CDC’s US County Prescribing Rates (2016)

Both sexes, all ages, all races – 2011 - 2015

Source: CDC – 2016 Rate

23

CLAY COUNTY CHRONIC DISEASES

24Source: Mississippi Hospital Association, Dimensions – April 2019

40

50

60

70

80

90

100

CY 2015 CY 2016 CY 2017

Stroke

30

32

34

36

38

40

42

44

46

CY 2015 CY 2016 CY 2017

COPD

10

15

20

25

30

35

CY 2015 CY 2016 CY 2017

Myocardial Infarction

64

66

68

70

72

74

CY 2015 CY 2016 CY 2017

Heart Failure

20

25

30

35

40

45

CY 2015 CY 2016 CY 2017

Diabetes

COMMUNITY HEALTH NEEDS SURVEY

In addition to collecting social and demographic data from secondary sources, additional input was solicited from community residents who represent broadly diverse interests of the service area ranging from nonprofit community volunteers to retired educators, bankers and private business leaders (Appendix). The Strategy Team of NMHS developed an electronic SWOT (strengths, weaknesses, opportunities, threats) survey format to collect the community feedback, manage the collection process specifically designed to gather the perspectives of various community leaders’ experiences and their knowledge of the service area. The hospital administrator recruited potential community stakeholders and electronic invitations were sent to residents who expressed an interest in participating in the SWOT. Of those who agreed to participate in the West Point Service Area SWOT, 84.6% completed the survey and a summary of their prioritized results are shown on the next five pages of this document:

Healthcare resources readily available to you Healthcare resources not available to you Unmet needs you would like to see addressed Imminent serious health threats to you/your family

25

26

Clinics including urgent care that meet various patient/family needs

Although limitations - some specialty offerings

Full service hospitals in Golden Triangle Area with emergency services – 24/7

Wellness centers

Local health department/service offerings

SURVEY RESULTS

HEALTHCARE RESOURCES READILY AVAILABLE

27

Medical needs related to abuse, addiction and treatment

Specialists, e.g., podiatry, urology, ophthalmology, orthopedics, oncology

Specialty clinics with full time providers

Education on healthy lifestyle choices, poor nutrition, etc.

Cancer related illnesses

SURVEY RESULTS

HEALTHCARE RESOURCES NOT AVAILABLE

28

Community-wide education on health risks

Cancer awareness and assistance for those w/limited means

Drug addiction and rehabilitative treatment

Mental health services

More providers in the community

SURVEY RESULTS

UNMET NEEDS THEY WOULD LIKE TO SEE ADDRESSED

29

Cancer diagnosis – education and treatment

Lifestyle and dietary education on life choices

Cardiovascular disease, diabetes and obesity related issues

Drug addition and treatment - both legal (opioids) and illegal drugs

Social issues, e.g., poor educational level, low paying jobs, unemployment, etc.

SURVEY RESULTS

IMMINENT SERIOUS HEALTH THREATS

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Chronic diseases including cardiovascular associated illnesses

Drug addiction and treatment

Cancer prevention education

Healthy lifestyle choices and behaviors, e.g., exercise, nutrition, obesity awareness etc.

Social and economic issues including food insecurity

Source: NMHS Community Health Needs Assessment (2019)

SURVEY RESULTS

SIGNIFICANT NEEDS IDENTIFIED FOR THE WEST POINT SERVICE AREA

Implementation Strategies

NMMC – WEST POINT

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LISTENING AND LEARNING TO IMPROVE

NMHS as the parent corporation of NMMC-West Point routinely uses diverse methods to capture the voice of those they serve in the 24 rural counties in northeast Mississippi and northwest Alabama. A SWOT analysis was designed to identify the service area’s perceived strengths, weaknesses, opportunities and threats. The Strategy Team of NMHS developed the survey questions (methodology referenced in Section VI). The elicited responses helped NMHS validate health-related needs and community opportunities. The SWOT along with data from various publicly available sources, e.g., regional/local organizations and agencies assisted NMHS in systematically identifying its strategic priorities. The below methods were also used to glean needs and preferences of service area residents:

Satisfaction surveys

Discharge phone calls

Face time with community leaders

Social media

Community outlets/organizations

Board and employee participation

Research32

TOP CAUSES OF DEATH IN WEST POINT AND THE NMHS SERVICE AREA

OKTIBBEHA

CANCER

LOWNDES

CANCERCHOCTAW

HEART DISEASE

WEBSTER

HEART DISEASE

CLAY

HEART DISEASE

MONROE

HEART DISEASE

CHICKASAW

HEART DISEASE

CALHOUN

HEART DISEASE

YALOBUSHA

HEART DISEASE

LAFAYETTE

HEART DISEASE

LAMAR

HEART DISEASE

MARION

HEART DISEASE

ITAWAMBA

HEART DISEASE

LEE

CANCERPONTOTOC

CANCER

UNION

HEART DISEASE

PRENTISS

HEART DISEASE

TIPPAH

CANCER

MARSHALL

CANCER

BENTON

HEART

DISEASE

ALCORN

HEART DISEASE

FRANKLIN

HEART DISEASE

COLBERT

HEART DISEASETIS

HO

MIN

go

HE

AR

TD

ISE

AS

E

For MS Counties: MS State Department of Health – 2016For AL Counties: AL Public Health Center for Health Statistics - 2015

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34Source: Adapted from the University of Wisconsin Population Health Institute. County Health Rankings & Roadmaps 2019 www.countyhealthrankings.orgShows the ranking of Clay County relative to the 24 counties in the North Mississippi Health Services Service Area

STRATEGIC PRIORITIES FOR 2019

Our mission is to continuously improve the health of the people of our region. Therefore, we continually utilize data gathered from our diverse listening and learning approaches to prioritize our strategic opportunities. NMMC-West Point is dedicated to being the provider of the best patient-and family-centered care and health services in America.

In 2012, the NMHS system was a recipient of the prestigious Malcolm Baldrige National Quality Award. Every business entity has strategically aligned goals based on the identified needs of those we serve. Improve access and obesity/chronic disease management continues to be a significant strategic priority.

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Mission and VisionWhy We ExistTo continuously improve the health of the people of our region.

What We Want To BeThe provider of the best patient- and family-centered care and health services in America.

STRATEGIC PRIORITY - MISSION-CENTRIC FOCUS

ALIGN INTERNAL AND EXTERNAL STAKEHOLDERS

INTERNAL GOAL

• Identify social and behavioral influences relative to chronic disease management and implement initiatives that will improve the health of the people of our region

EXTERNAL GOAL

• Increase beneficiary awareness of available community services and facilitate alignment of regional partners to influence health outcomes

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Implementation Activities NMMC-West Point

• Continue primary care and specialty provider succession planning and growth strategy to better serve the needs of the community

• Continue expansion and promotion of telehealth capabilities

913.13% increase in telehealth procedures

Overall travel miles saved by community residents due to ambulatory telehealth offerings – 101,192

• Enhance Patient and Family Advisory Council

• Partner with population health to improve overall care transition

• Evaluate mutually beneficial partnerships with other service area providers and clinicians

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Appendix

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APPENDIX – COMMUNITY SURVEY PARTICIPANTS

Participant Industry/Affiliation Description Broad Interest of Community

Finance professional/community volunteer Diverse community/patient and family advocate/financial

Private business – comptroller/community volunteer Diverse population/patient and family advocate/financial

Private business – human resources professional/community volunteer General and diverse community/patient and family advocate

Private business – banking industry/community volunteer General population/financial/patient and family advocate

Private business – technology/community volunteer Diverse community financial perspective/patient and family advocate

Retired banker/community volunteer x 2 General/diverse community/geographic economics/patient/family advocate

Retired health care professional x 2 Diverse knowledge of patient/family needs – general population

Fitness instructor/community volunteer General population and knowledge of health

Community development leader Diverse population

Retired teacher/community volunteer General/diverse population – familiar with education stats