lake sunapee region strategic planning initiative meeting four: presenting the data (06.23.13) 1

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Meeting Agenda 1:00-1:15 - Agenda, Role Assign, Overview 1:15-2:00- Presenting the Data: Social Determinants of Health & Service Area Health Data 2:00-2:30 -New London Hospital Programs & Successes 2:30-2:50-Keene Summit Summary 2:50-3:00-Next steps and next meeting date (6/29 from 3 – 5pm at Lake Sunapee Bank) 3

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Lake Sunapee Region Strategic Planning Initiative Meeting Four: Presenting the Data ( ) 1 Lake Sunapee Region Community Wellness Task Force Current Members 2 NAMEBUSINESSTITLE Stephen TherouxLake Sunapee BankPresident/CEO Thomas C. Galligan, JrColby-Sawyer CollegePresident Snyder, DanCommunity MemberN/A Nancy FrieseNew London Council on AgingExecutive Director Jerome FrewKearsarge Regional School DistrictSuperintendant Irwin SussmanNewport School DistrictSuperintendant Kris Eschbach, MDNew London HospitalPhysician PJ LovelyNewport Recreation DepartmentRec Director Travis DezotellNewbury Recreation DepartmentRec Director Kim HallquistTown of New LondonAdministrator Ella CaseyNewport Area Chamber of CommerceDirector James Murphy, MDNew London HospitalChief Medical Officer Catherine BardierNew London HospitalVice President, HR Kristin Hampers, PANew London HospitalPhysicians Asst Lauren ConkeyNew London HospitalWellness Outreach Coordinator Sukriti RautColby-Sawyer CollegeIntern Meeting Agenda 1:00-1:15 - Agenda, Role Assign, Overview 1:15-2:00- Presenting the Data: Social Determinants of Health & Service Area Health Data 2:00-2:30 -New London Hospital Programs & Successes 2:30-2:50-Keene Summit Summary 2:50-3:00-Next steps and next meeting date (6/29 from 3 5pm at Lake Sunapee Bank) 3 Role Assignments Leader Catherine Bardier Recorder Lauren Conkey Timekeeper Facilitator 4 OVERVIEW 5 Process and Outcomes Forming a strong team Defining decision making process Clarifying our service area Studying landscape who, what, where Drafting Mission, Vision, Values, Goal One Developing action steps Employers as a vehicle for promoting community health and wellness Collaborating with Healthy Monadnock and D-H 6 Strategic Questions to Think About What is our formal name? Is anyone missing at this table? Who needs to be giving input to our first drafts? How will we make decisions now and in the future? What will our infrastructure look like? What are the limits of collaborative planning? How will we make our work sustainable? How will we fund this community work? Priorities short term and long term? What are our outcome and process (economic, health, funding) measures? What data do we need? How to build public involvement and buy-in (on-going)? Communication strategy? How to continuously refresh our plan? What are our measures of success? 7 Timeline Meeting ObjectivesJanFebAprilMay*JuneJuly*AugSeptOct* Pre WorkX SWOT (Key Leader Interviews, Reports, Data)X KickoffX Mission, Vision Values X Community Health Improvement Models X How do other communities do and fund this work? X Review Community Data X Technical expert X Draft Goals, Objectives, Timeline X Finalize first draft of Strategic Plan X Community Forum- Input on Plan X Finalize Plan X Implement Plan X * Months with two meetings 8 SERVICE AREA DATA 9 Towns Serviced by NLH, Kearsarge and Newport School Districts: Andover Bradford Croydon Danbury Goshen Grantham Lempster Newbury New London Newport Springfield Sunapee Sutton Warner Washington Wilmot Anything missing? New London Hospital Patient Visits* FY2008/2009 * Includes inpatient and selected outpatient procedures Source: Uniform Hospital Data Discharge Set (UHDDS) Service Area Data: Demographics Highlighted towns have oldest median age Service Area Data: Demographics Determinants of Health Models Help Frame Data and Information Service Area Data: Disease & Injury Highlighted outcomes indicate statistically significant difference Service Area Data: Disease & Injury Merrimack & Sullivan counties have statistically significant higher rates of premature death & substance abuse-related emergency hospital discharges than the state of NH Sullivan county has a statistically significant higher rate of unintentional injury-related emergency hospital discharges than the state of NH Health & Function Physical FunctioningMental Functioning Role FunctioningSocial Functioning Service Area Data: Health & Function Health OutcomesMerrimack CountySullivan CountyNH Activities limited due to health in at least 14 of previous 30 days (percent of adults), %8.1%5.4% Service Area Data: Health Care Individual Response - Behaviors Intermediate determinant Behaviors e.g., diet, exercise, drinking, smoking, drug use, coping, are seen as responses to other factors Not voluntary acts amenable to direct intervention Shaped by multiple forces: social and physical environments and genetics Behavior change remains a goal Health Eating Active Living Service Area Data: Individual Behavior 62.6%63.6%63.0% Service Area Data: Individual Behavior Social Environment Service Area Data: Social Environment Lowest IncomeHighest Income Physical Environment Prosperity ConstructHealth Impact Socioeconomic Status (Income and Education, Class) Better health associated with increasing income, education, social class UnemploymentUnemployment associated with financial instability leading to poorer health. Access to good nutrition/foodShortage or lack of food leads to malnutrition. Community EconomyHealthy economy provides jobs, products, services. Service Area Data: Prosperity Least Affluent: Croydon, Danbury, Goshen, Lempster, Newport, Washington More affluent: Andover, Bradford, Grantham, New London, Newbury, Springfield, Sunapee, Sutton, Wilmot Service Area Data: Prosperity Lower Income: Croydon, Danbury, Goshen, Lempster, Newport, Washington Higher Income: Andover, Bradford, Grantham, New London, Newbury, Springfield, Sunapee, Sutton, Wilmot Service Area Data: Prosperity Well-Being/Perceived Quality of Life Satisfaction with Community Able to do what you want to do Satisfaction/sense of peace with your life and health Needs Prioritization from Needs Assessment Availability of affordable healthcare, prescriptions, and related services Communication between healthcare providers and other community service providers regarding the breadth of services available (i.e., so that providers can effectively refer clients/patients to other services in the community) Primary care physician availability Drug and alcohol abuse early detection and treatment* Insurance coverage rates Chronic disease screenings - hypertension, cancer, heart disease* Coordination of care among provider organizations Dementia spectrum issues / Elder care services* Obesity / Nutrition / Exercise education and services* NEW LONDON HOSPITAL PROGRAMS 55 NLH Wellness Committee Mission The mission of the New London Hospital Wellness Committee is to promote a healthy lifestyle among Employees, Volunteers, Board of Trustees, and the Community. Past Accomplishments Establishment of Committee and Branding Tobacco Free Campus 97.8% Employees, Volunteers, and Board of Trustees received the Flu Immunization Healthy food options and snack cooler at Breezes caf (no fried foods) Nutritional labeling in Breezes Caf $0.25 fruit initiative in Breezes Caf 6 week-Wellness 101 Series with Dr. Lori Richer On-site Yoga classes Hiking / Walking Group & Challenges On-site Weight Loss Program (TOPS) Fit Stop Fitness Center & NHC Equipment Monthly Wellness Lunch n Learns NLH Cigna 5k Team Community Outreach (KRSD Wellness Committee) 2013 Initiatives CSA program with Spring Ledge Farm Stair Well to Health Murals.25 cent Fruit Initiative in Breezes 6-week Fly Casting Series Draft Community Wellness Strategic Plan Hire a Part-time Wellness Outreach Coordinator Grow the Walking Challenge Participation Development of dedicated Nurturing Room NLH Prouty Team Expand Lunch n Learns to Volunteer Base Expand NLH Wellness Web Page Recruit Provider Champions for Committee(s) KEY OBSERVATIONS - MEASUREMENTS 2010 Plan Design changes and Focus on Wellness/Preventative Care CY 2010 CY 2011CY 2012 $4,230,987 $2,211,959$2,545, 164 Overall key cost drivers in 2011: EndocrinologyPMPM decreased 14.7% OrthopedicsPMPM decreased 52.8% CardiologyPMPM decreased 31.9% GastroenterologyPMPM decreased 17.0% PreventativePMPM increased 19.3% KEENE SUMMIT June 6, Vision 2020/Healthy Monadnock Healthiest Community is when Cheshire county is doing better than the US average on 27 core indicators. Examples of indicators: Percentage of 9th graders that graduate w/in 4 years Adults with good or better health Adults at healthy weight Children in poverty Healthy Monadnock 2020 Vision 2020/Healthy Monadnock Action Plan 21 action strategies organized by three themes: Active living Healthy eating Social Determinants of Health Currently undergoing a 2nd round of action planning to address mental well-being indicators Vision 2020/Healthy Monadnock Aha! Moments Great data & statistics support action strategies Example: Between 2000 and 2004 there was a 20% drop in sales of bikes to kids Branding From Vision 2020 to Healthy Monadnock 2020 Health messaging and brand awareness Vision 2020/Healthy Monadnock Aha! Moments Champions Program Currently have 1,900+ champions, 74 organizational champions and 18 school champions Goal: 15,000 (25% of community; i.e. the tipping point) 2020 Partners in Action: Coalition Partners working on one or more action strategy Advocates for Healthy Youth (AFHY) Monadnock Region Transportation Management Association (MRTMA) Monadnock Farm & Community Coalition Cheshire County Healthy Eating Active Living (HEAL) City of Keene Question to Ponder Can we form a partnership with Healthy Monadnock 2020? We have been invited to attend leadership meetings Healthy Monadnock team has offered to provide us with technical assistance (TA), as needed Goal: New Hampshire-wide healthy eating, active living initiative NEXT STEPS 67 Next Steps Next meeting July 29 th from 3 5 pm at Lake Sunapee Bank (9 Main Street, Newport, NH) Agenda/Speakers HEAL presentation (Terry Johnson, Director, HEAL NH) Determine Leadership Team structure Brainstorm/map local agencies Review first draft of Strategic Plan