mount carmel west · in 2012, mount carmel health system joined area hospitals and community...

MOUNT CARMEL WEST 793 WEST STATE STREET COLUMBUS, OHIO 43222

mountcarmelhealth.com

COMMUNITY HEALTH ASSESSMENT AND IMPLEMENTATION PLAN 2013-2016

MOUNT CARMEL WEST

http:mountcarmelhealth.com

COMMUNITY HEALTH 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

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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

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http://www.countyhealthrankings.org/app/


THE COMMUNITY WE SERVE; AREA DEMOGRAPHICS

Franklin County County Health Rankings and Roadmaps http://www.countyhealthrankings.org/app/

Rank (of 88)

Franklin County Error Margin Ohio

National 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.

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http://www.countyhealthrankings.org/app


Area Demographics, continued

Columbus, Ohio Mount Carmel West is situated in Columbus’ Franklinton area which has a population of 5,232 with a forecasted decrease in population of 5.2% by 2016. The 2011 demographic distribution is as followed:

Race/Ethnicity White - 75 % Black - 14.4 % Hispanic - 4.3 % Asian and Pacific Islander - 1.7 % Other - 4.5%

Age Group 18 to 64 years – 60.2% Under 18 years – 30.1% 65 and over – 9.6%

This high need area has an average household income of $27,825, 59% below the national average.

14 $49,500

12 $49,000

10 $48,500

$48,000

Mill

ions 8

6 $47,500

4 $47,000

$46,500 2

$46,000 Median Household Income

0 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

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HealthMap 2013 Community Need Index for Zip Code 43222

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 43222, location of MCW is in bold.

Income (5) – 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 (4) – 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 (5) – 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 (5) – 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.

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Community need index (map showing color coded severity)

The final CNI (4.8) - 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 lack of use of primary care or assistance needed 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 1990. Six key factors are used to determine the Intercity Hardship Index score from zero to 100.The higher the score, the greater the hardship. The key factors are:

Unemployment – percent of civilians 16 years and older who are unemployed Dependency – percent of population under 18 years and over 64 year Education – percent of population 25 years and older who have less than a high school

education Income – per capita income Crowded housing – percent of occupied housing units with more than one person per

room Poverty – percent of people living below the federal poverty level, adjusted for local

cost of living Although the study reflected that cities in the Midwest had a high index score, since the inception of the Intercity Hardship Index, Columbus has always been one of the cities with the least hardship.3

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*Dignity Health Community Needs Index http://cni.chw-interactive.org/

1970 1980 1990 2000 Index Score 34.8 24.2 22.5 18.6 Rank 46 42 78 79 Total # Cities 55 55 86 86

Assessment, Methodology and Findings

In 2012, Mount Carmel Health System joined area hospitals and community agencies in performing a community health needs assessment that met the requirement of the Patient Care Protection Affordable Care Act.This assessment was completed and made public January 2013. The document form this assessment is the Franklin County HealthMap 2013: Navigating Our Way to a Healthier Community Together (HealthMap 2013).The collaborative effort was headed by the Central Ohio Hospital Council. The team included representatives from the four hospital systems in Franklin County, public health departments and community stakeholders to identify the health needs of the community.After months of collaboration, eight health indicators emerged:

Access to care

Chronic Disease

Infectious Disease

Behavioral HealthHigh

Incidence of Cancer

InterpersonalViolence

Unintentional Injuries

High-RiskPregnancy

CommunityHealth

*HealthMap 2013

Link to the HealthMap2013 (Franklin County Health Needs Assessment)

The community health needs assessment identified and prioritized health needs consisting of 8 priorities and 140 indicators. Specific information about these indicators can be found in Franklin County HealthMap 2013: Navigating Our Way to a Healthier Community Together.The HealthMap 2013 can be found at http://www.mountcarmelhealth.com/community-benefit

Understanding the prevalence of chronic health conditions, barriers in access to care, and other health issues, all of the central Ohio hospitals involved in this process aligned resources to determine which indicator they could adopt and develop programs, if not already in place, to address any of the eight indicators. MCHS has programs in place to address all eight of these health indicators. MCHS has also chosen to begin a new initiative to address infant mortality.

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http://www.mountcarmelhealth.com/community-benefithttp:http://cni.chw-interactive.org


Community Benefit Advisory Board

The decision to focus resources on infant mortality was decided by Mount Carmel Health System and the Community Benefit Advisory Board with statistics from the Franklin County Health Needs Assessment, HeallthMap2013 supporting this decision.The Mount Carmel Community Benefit Advisory Board members consist of individuals from the community, as well as Mount Carmel Health associates.Together, we work to ensure that community benefit programs are addressing the needs of the community.We have developed a Mount Carmel Health System Community Benefit Ministry Implementation Plan in response to the eight needs identified as priority by the Community Health Needs Assessment HealthMap2013*

Mount Carmel Health Community Benefit System-wide Strategies Goals

Achieve health equity Ensure equitable provision of care Improve access to health care services Invest in access solutions for those most vulnerable Embrace, celebrate and learn from diversity

Enhance the health of the community Expand chronic disease management programs Enhance the health of the community Educate and inform community on healthy behaviors Promote evidence based programs and activities that create health improvement Focus on health needs identified in local community health assessment Promote physical, social and policy activities that create health improvement Advance medical/healthcare knowledge

Demonstrate value of community benefit Document metrics and outcomes of all programs Partner with community organizations Give community voice in decisions regarding community benefit strategy and activities Demonstrate a return on investment Maintain and improve knowledge of community health Demonstrate transparency Relieve/reduce the burden of government/other community efforts

Although we are looking at identified needs system wide, each facility is focusing on the area surrounding the hospitals with the highest need and or disparities.We are including the determinates of health and reviewing needs from a life course prospective. Determinates of health are factors that contribute to a person's current state of health.“These factors may be biological, socioeconomic, psychosocial, behavioral or social in nature. Scientists generally recognize five determinants of health of a population:

Biology and genetics. Examples: sex and age Individual behavior. Examples: alcohol use, injection drug use (needles), unprotected sex, and

smoking Social environment. Examples: discrimination, income and gender Physical environment. Examples: where a person lives and crowding conditions Health services. Examples:Access to quality health care and having or not having health

insurance.” http://www.cdc.gov/socialdeterminants/Definitions.html

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Life course prospective looks how an individual’s lifestyle choices and health outcomes are affected by their family history. It connects past family social, economic and health history to individual behavior and outcomes in the present. (Bengtson and Allen 1993).We believe this is very important when planning preventative health measures.

Equity in care is also a priority at Mount Carmel Health System. Mount Carmel sponsored leaders to complete an executive disparities leadership program. The Disparities Leadership Program is the first program of its kind in the nation, and is designed for leaders from hospitals, health insurance plans, and other health care organizations who are seeking to develop practical strategies to eliminate racial and ethnic disparities in health care.The program is led by the Disparities Solutions Center at Massachusetts General Hospital (MGH) in Boston, Massachusetts.As a result of our commitment to equity in care Mount Carmel Health has launched a Health Equity committee to develop objectives that are patient-centered and population specific, connecting equity with ongoing hospital initiatives.

FACILITY SPECIFIC OVERVIEW Mount Carmel West Hospital

Located near downtown Columbus, Mount Carmel West is the original hospital in the Mount Carmel Health System. Serving nearly 18,000 patients each year, this Columbus hospital offers exceptional facilities, a host of medical specialties and a number of exclusive specialty centers.

At its heart, Mount Carmel West is a teaching hospital, with ACGME-accredited residency programs in family practice, orthopedics, general surgery, internal medicine, OB/GYN and transitional year.The Mount Carmel College of Nursing, which is located on our Columbus medical center’s West campus, is Ohio's fourth-largest baccalaureate nursing program.And our physicians, residents, nurses, staff, students and patients have access to a vast library of multimedia resources through a state-of-the-art Center for Learning and Education.

Continual updates and enhancements have made our Columbus, Ohio hospital a truly outstanding facility. It is a Level II Trauma Center with 14 operating rooms, a urology suite, a state-of-the-art endoscopy lab and multiple intensive care units (Surgical ICU, Medical-Cardiac ICU, Open Heart Recovery Unit and Neuro ICU).The hospital also features a number of specialty centers dedicated exclusively to epilepsy monitoring, inpatient rehabilitation, bariatric treatment, long-term acute care and palliative care. As a tertiary hospital, MCW has access to some of the area’s top medical and surgical specialists in Emergency Medicine, Neurology, Physical Medicine and Rehabilitation, and Women’s Health among many other specialties.

The MCW facility experiences a high utilization of the emergency department for non-emergency care.This may be because the population in the surrounding area does not use primary care nor needs assistance in managing chronic diseases or conditions. MCW has responded to this need in two ways by creating a Nursing Center and a community health resource center both located on the MCW campus. It also sponsors the Health Station for primary care located off campus on Parsons Avenue.

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Nursing Center for Family Health

Through a partnership of Mount Carmel College of Nursing and Lower Lights Christian Health Center (FQHC) the growing need and patient demand are able to be met by suing the expertise of MCCN Advanced Practice Nurses (APN).The nursing center provides primary care, such as preventative health services, patient education and disease management, as well as, routine physicals, health screenings, immunizations, management of chronic disease conditions, and acute care of non-emergency conditions.The center is an excellent platform for qualified faculty member, graduate students and undergraduates to participate in the care and in the development of health education programs for patients in the community.

Community Health Resource Center

The Mount Carmel West Community Education and Support Center provides support for women’s health initiatives in the specific areas of diabetes management for pregnant women and outpatient lactation consultation.This center will house a variety of health care services available to the local Franklinton community. One of the goals is to increase breastfeeding rates and breastfeeding duration with monthly classes, telephone follow up, and weekly breastfeeding support groups. Lactation consultants will support new Mothers in their efforts to breastfeed babies and Certified Diabetes Educators will assist Mothers in compliance with controlling and monitoring their blood sugar levels, attainment of normal test levels and appropriate gestational infant size.

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Health Stations

Health Stations are facilities anchored at two local churches and a public high school. Health care is conveniently available in the neighborhood and everyone is able to receive primary medical care and health education at these locations. The underserved, uninsured, and poor populations are included in the targeted population. In alliance with our mission and values, MCHS vows to provide professional medical, administrative and management services to families, individuals, seniors and children who are in need. Mount Carmel Health is able to provide affordable health care to many because of the collaboration with First Church of God, United Methodist Church For All People, and Reynoldsburg High School.

United Methodist Church for All People 946 Parsons Avenue Columbus, Ohio 43206

Community Benefit Reporting (Link to Community Benefit Report)

Many of our other programs are highlighted in the Community Benefits Report at this link http://www.mountcarmelhealth.com/community-benefit

Specific Facility Response Plan to Findings

The following implementation plan lists each of the eight needs identified by HealthMap 2013. Each need was reviewed for lack of access, awareness or education and then plans were made to meet these needs.

MOUNT CARMEL WEST

http://www.mountcarmelhealth.com/community-benefit


Mount Carmel West implementation plan:

2013 – 2015 CHNA IMPLEMENTATION STRATEGY HEALTH ISSUE PLANNING PROFILE

Mount Carmel Campus: Mount Carmel West

CHNA HEALTH ISSUE: Access to Care

CHNA REFERENCE PAGE: Pages 5 & 19 RANKING: 1 Brief Description of Issue: Emergency departments (EDs) in Franklin County experience higher utilization, when comparing rates per population, than do EDs across the state. Similarly, emergency departments in Franklin County are utilized more often for less severe cases, when comparing rates per population, than EDs across the state. In terms of specific conditions where access to care poses a problem, Franklin County adults have more difficulty in accessing dental care when compared to adults across Ohio. GOAL: To improve access to care in underserved populations. OBJECTIVE: Add resources to reduce emergency department (ED) utilization and improve access to dental care. STRATEGIES (BY OBJECTIVE):

1. Utilize mobile coach clinic for outreach 2. Aggressive outreach programs to reach underserved populations 3. Maintain pharmacy assistance program 4. Increase number of individuals who have health care coverage 5. Participate in a planning process to address adult dental care.

ANTICIPATED OUTCOME(S): 1. Measurable reduction of utilization of ED 2. Increase number of individuals who have coverage and/or access to financial assistance

KEY PARTNERS: Southeast, Inc, Christ the King Church, Friends of the Homeless, Hoge Memorial, Presbyterian Church, Clintonville Community Resource Center, Holy Family Soup Kitchen, Reynoldsburg Shepherd's Place, Salvation Army, Stowe Baptist Church, Southeast, Inc , the Coalition on Homelessness and Housing in Ohio, Lower Lights Christian Health Center, and Columbus Neighborhood Health Centers.

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CHNA HEALTH ISSUE: Chronic Disease

CHNA REFERENCE PAGE: 6 RANKING: 2 Brief Description of Issue: Chronic diseases – such as heart disease, stroke, cancer, diabetes – are the leading causes of death and disability at the local, state and national levels. According to the Centers for Disease Control and Prevention medical care costs of people with chronic diseases account for more than 75% of total medical care costs in the U.S. In Franklin County, over 60% of all deaths were due to chronic disease. Franklin County has a higher prevalence of both adults and youth diagnosed with asthma when compared to state and national data. Though the prevalence of adults in Franklin County diagnosed with diabetes is slightly less than for adults in the state of Ohio, it is higher than for adults in the U.S. There is also a higher prevalence of obesity in Franklin County adults which can lead to diabetes. GOAL: Improve management of chronic disease, specifically heart failure and diabetes OBJECTIVE: Improve self-management of asthma and diabetes by ensuring uninsured individuals have access to pharmaceuticals through continued pharmaceutical assistance programs. STRATEGIES (BY OBJECTIVE): 1. Increase awareness and education on self-management through speakers and disease specific and

prevention literature. 2. Continue the pharmaceutical programs for underinsured/uninsured individuals. 3. Participate in community collaborate to address obesity.

ANTICIPATED OUTCOME(S): 1. Better chronic disease management through the utilization of pharmaceuticals. 2. Access to primary care and preventative information 3. Decreased avoidable hospital admissions as a result of unmanaged diabetes or heart failure

KEY PARTNERS: Pharmaceutical programs, local churches and Church Partnerships, Community Health Collaborative Project .

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CHNA HEALTH ISSUE: Infectious Disease

CHNA REFERENCE PAGE: 7 RANKING: 3 Brief Description of Issue: Incidences of infectious diseases, especially those that are sexually transmitted, more prevalent in Franklin County than in Ohio. Franklin County rates for pertussis and tuberculosis are higher than Ohio rates. The incidence rates for two hospital-acquired infections --methicillin-sensitive Staphylococcus Aureus (MSSA) and methicillin-resistant Staphylococcus Aureus (MRSA) -- are slightly higher in Franklin County than in Ohio. GOAL: Reduce instances of infectious diseases. OBJECTIVE: Increase community awareness and prevent the spread of infectious diseases.

STRATEGIES (BY OBJECTIVE): 1. Collaboration with the Columbus Public Health Department to educate community regarding flu and

pandemics. 2. Promote prevention education and access to vaccinations 3. Look to leadership from the Health Department for prevention of other infectious diseases.

ANTICIPATED OUTCOME(S): Decrease the cases of infectious diseases KEY PARTNERS: Columbus Public Health Department , local churches, and Church Partnerships

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CHNA HEALTH ISSUE: Behavioral Health

CHNA REFERENCE PAGE: 7 RANKING: 4 Brief Description of Issue: A wide spectrum of psychiatric disorders is prevalent in Franklin County, including depression, chronic mental health conditions, substance abuse and post-traumatic stress. In 2006-2008, suicide was the tenth leading cause of death in Franklin County. The overall rate in Franklin County was 12.4 suicide deaths per 100,000 people. This was higher than the 2006-2008 rate for the state of Ohio which was 11.3 per 100,000. According to the National Institutes of Mental Health, in 2007, suicide was also the tenth leading cause of death in the U.S., accounting for 34,598 deaths which was an overall rate of 11.3 suicide deaths per 100,000 people. An estimated 11 attempted suicides occur per every suicide death. GOAL: Reduce cancer incidence and increase cancer screenings. OBJECTIVE: Navigate underserved individuals to behavioral health services within the community

STRATEGIES (BY OBJECTIVE): 1. Utilize the mobile coach to identify and navigate individuals to behavioral health services within the

community. 2. Participate in community planning process to address behavioral health and access to services. 3. Provide support for pharmaceutical services ANTICIPATED OUTCOME(S): Improved behavioral health management through improved education and use of resources. KEY PARTNERS: Southeast, Inc., Pharmaceutical programs

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CHNA HEALTH ISSUE: High Incidence of cancer

CHNA REFERENCE PAGE: 8 RANKING: 5 Brief Description of Issue: Cancer places a tremendous emotional and financial burden on patients, families and society. The number of new cancer cases can be reduced, and many cancer deaths can be prevented through early detection, vaccination, and maintaining healthy behaviors, such as being physically active and maintaining a healthy weight. In Franklin County, cancer is the second leading cause of death. The top five cancer mortality rates in Franklin County are lung, colon, breast, pancreatic and prostate. Franklin County has a higher mortality rate than Ohio for lung, breast, and pancreatic cancer, but a lower mortality rate for colon and prostate cancer. Franklin County fairs well with cancer screenings, with percentages of adults receiving tests for cervical, breast and colorectal cancers higher than state and national percentages; however testing for prostate cancer was lower than state and national percentages. GOAL: Reduce cancer incidence and increase cancer screenings. OBJECTIVE: Reach populations at risk for cancer

STRATEGIES (BY OBJECTIVE): 1. Continue colon health program outreach and targeting of African American males. 2. Continue breast cancer screening with financial assistance available for poor and underserved 3. Maintain support programs to help patients recover ANTICIPATED OUTCOME(S): Reduce cancer prevalence in high risk populations. KEY PARTNERS: Taylor Station Ambulatory Surgery Center, Mount Carmel Medical Group, Local and national cancer organizations & foundations, American Cancer Society, Other Mount Carmel Health System facilities.

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CHNA HEALTH ISSUE: High-Risk Pregnancy

CHNA REFERENCE PAGE: 9 RANKING: 7 Brief Description of Issue: Infant mortality rate, preterm birth rate and infant birth weights are all important measures of the care pregnant women and their newborns receive during pregnancy. In 2009, the March of Dimes gave Ohio an “F” for its efforts to reduce preterm births. Ohio is ranked 34th among the 50 states, Puerto Rico and the District of Columbia. Unfortunately, Franklin County fares even worse than the state in several areas of these. In Franklin County, the infant mortality rate and the percentage of low birth weight babies is higher than statewide data. GOAL: Reduce infant mortality rate and low birth weight babies. OBJECTIVE: Increase community awareness of infant mortality, preterm birth rate and low birth weight babies. STRATEGIES (BY OBJECTIVE): 1. Convene process to identify three potential programs/methods to increase public awareness. 2. Continue programs directed at infant vitality. 3. Participate in community collaborative focused on infant mortality. ANTICIPATED OUTCOME(S): Measurable decrease in infant mortality rates. KEY PARTNERS: Ohio Better Birth Outcomes, Ohio Hospital Association, Women, Infant and Children (WIC), Action for Children, Franklin County Jobs and Family Services, Local Churches, Childcare Facilities, Moms 2B, Nationwide Children's Hospital

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Unaddressed Identified Needs

All priority needs identified by HealthMap 2013 have been addressed by at least one of Mount Carmel Health System facilities.These needs may not have been addressed by all facilities due to limited resources.

Identified Need: MCW or Addressed by:

1. Access to Care x 2. Chronic Disease x 3. Infectious Disease x 4. Behavioral Health x 5. High Incidence of Cancer x 6. Interpersonal Violence x MCNA and resources on pg. 9 of HealthMap 2013 7. High Risk Pregnancy x 8. Untentional Injuries x MCE, MCSA and resources on pg. 10 of the

HealthMap 2013.

X= not addressed by this facility

MCE = Mount Carmel East

MCW = Mount Carmel West

MCSA = Mount Carmel St.Ann’s

MCNA = Mount Carmel New Albany

DR = Diley Ridge

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Attachments

Appendix A- Data Sources 1. Health Map 2013 2. Reference: 2 – U.S. Census Bureau, 2010 Census.Accessed:

http://quickfacts.census.gov/qfd/states/30/3018000.html 3. CNI (web site) http://cni.chw-interactive.org/printout.asp 4. Research Health Partners (web site) 5. Demographics Expert 2.7: 2011 Demographic Snapshot of Zip code 43222, 2011

Nielson Company, 2012 Thomson Reuters. Accessed 6/13/12.

Appendix B – Anticipated Partners MCHS Constituents The MCHS Foundation Mission Services Service Line Administration Outreach Neighborhood Services Finance Administration Emergency Department Services Communication and Public Affairs The College of Nursing

� Community Constituents American Cancer Society Columbus City Schools Columbus Health Department Columbus State Community College Heart of Ohio Family Health Centers Mid-Ohio Food Bank Westerville South High School Avondale School Gladden Community House Franklin County Red Cross Columbus Police Department United Way of Central Ohio Westerville Area Resource Ministry (WARM) YMCA of Central Ohio Coalition on Homelessness and Housing in Ohio Christ The King, Bishop Griffin Center Clintonville Community Resource Center Holy Family Soup Kitchen Second Servings Reynoldsburg Shepherd’s Place Salvation Army Stowe Baptist Church Church For All People First Church of God Reynoldsburg High School

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http://cni.chw-interactive.org/printout.asphttp://quickfacts.census.gov/qfd/states/30/3018000.html


Stelzer Road Trailer Park Faith Mission Lower Lights Christian Health Center Southeast Inc. Heart of Ohio Family Health Centers

� – Capital Family Health Center � – Whitehall Family Health Center

*** The community health needs and the implementation strategy are based on data supporting the health needs and resources available for a certain period of time.These needs and resources may change and therefore the implementation strategy must also change to remain relevant to the community and hospital system.

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Structure Bookmarks793 WEST STATE STREET COLUMBUS, OHIO 43222 793 WEST STATE STREET COLUMBUS, OHIO 43222 mountcarmelhealth.com mountcarmelhealth.com

Figure

COMMUNITY HEALTH ASSESSMENT AND IMPLEMENTATION PLAN 2013-2016 COMMUNITY HEALTH ASSESSMENT AND IMPLEMENTATION PLAN 2013-2016 FigureMount Carmel Health System Community Health Needs Assessment Implementation Plans 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 Contents 1. Mount Carmel Health System a. a. a. Our Purpose and Overview

b. b. The Community We Serve;Area Demographics

2. Assessment, Methodology and Findings a. a. a. Link to the HealthMap 2013 (Franklin County Health Needs Assessment)

b. b. Community Benefit Advisory Board

c. c. Mount Carmel Health Community Benefit System-wide Strategies Goals

3. 3. 3. Facility Specific Overview

4. 4. Community Benefit Reporting (Link to Community Benefit Report)

5. 5. Specific Facility Response to Finding

6. 6. Unaddressed Identified Needs

7. 7. 7. Attachments

a. a. a. Data Sources

b. b. Anticipated Partners

Mount Carmel Health System OUR PURPOSE AND OVERVIEW 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 Mission 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 Vision 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 Values Values

Respect Social Justice Compassion Care of the Poor and Underserved Excellence

THE COMMUNITY WE SERVE; AREA DEMOGRAPHICS THE COMMUNITY WE SERVE; AREA DEMOGRAPHICS County Health Rankings and Roadmaps / Franklin County http://www.countyhealthrankings.org/app

TableTRRank (of 88) Franklin County Error Margin Ohio National Benchmark*

Health Outcomes Health Outcomes 58

MortalityMortality 56

Premature death Premature death 7,870 7,694-8,046 7,457 5,317

MorbidityMorbidity 64

Poor or fair health Poor or fair health 14% 13% - 16% 15% 10%

Poor physical health days Poor physical health days 3 - 7 3.3 - 4.0 3.6 2.6

Poor mental health days Poor mental health days 4 3.6 - 4.3 3.8 2.3

Low birth weight Low birth weight 9.4% 9.2 - 9.5% 8.6% 6.0%

Health Factors Health Factors 41

Health Behaviors Health Behaviors 47

Adult Smoking Adult Smoking 21% 19 - 23% 22% 13%

Adult Obesity Adult Obesity 31% 29 - 33% 30% 25%

Physical inactivity Physical inactivity 25% 23 - 27% 27% 21%

Excessive drinking Excessive drinking 19% 17 - 21% 18% 7%

Motor vehicle crash death rate Motor vehicle crash death rate 9 8 - 9 11 10

Sexually transmitted infections Sexually transmitted infections 703 422 92

Teen birth rate Teen birth rate 45 44 - 46 38 21

Clinical Care Clinical Care 11

Uninsured Uninsured 15% 14 - 16% 14% 11%

Primary care physicians** Primary care physicians** 1,065:1 1,348:1 1,067:1

Dentists** Dentists** 1,317:1 1,928:1 1,516:1

Preventable hospital stays Preventable hospital stays 70 68 - 73 79 47

Diabetic screening Diabetic screening 85% 83 - 87% 83% 90%

Mammography screening Mammography screening 60% 58 - 62% 63% 73%

Social & Economic Factors Social & Economic Factors 52

High school graduation** High school graduation** 83% 78%

Some college Some college 69% 61% 70%

Unemployment Unemployment 7.6% 8.6% 5.0%

Children in poverty Children in poverty 27% 24 - 29% 24% 14%

Inadequate social support Inadequate social support 19% 17 - 21% 20% 14%

Children in single-parent households Children in single-parent households 39% 37 - 40% 34% 20%

Violent crime rate Violent crime rate 537 332 66

Physical environment Physical environment 46

Daily fine particulate matter Daily fine particulate matter 13.5 13.3 - 13.7 13.4 8.8

Drinking water safety Drinking water safety 0% 2% 0%

Access to recreational facilities Access to recreational facilities 10 10 16

Limited access to healthy foods** Limited access to healthy foods** 6% 6% 1%

Fast food restaurants 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.

Area Demographics, continued Area Demographics, continued Columbus, Ohio Columbus, Ohio

Mount Carmel West is situated in Columbus’ Franklinton area which has a population of 5,232 with a forecasted decrease in population of 5.2% by 2016. The 2011 demographic distribution is as followed: White - 75 % Black - 14.4 % Hispanic - 4.3 % Asian and Pacific Islander - 1.7 % Other - 4.5% Race/Ethnicity

18 to 64 years – 60.2% Under 18 years – 30.1% 65 and over – 9.6% Age Group

This high need area has an average household income of $27,825, 59% below the national average. 14 $49,500 12 $49,000 10 $48,500 $48,000 Millions8 6 $47,500 $47,500 $47,500

4 4

$47,000 $47,000

$46,500 $46,500 2

$46,000 $46,000 Median Household Income 0 Total Population

100% 100%

90% 90%

80% 80%

70% 70%

60% 60%

50% 50%

40% 40%

30% 30%

20% 20%

10% 10%

Ohio Ohio 0%

TRIndividuals Living Individuals < 18 High School

Franklin County Franklin County Below Poverty years Living Graduate

TRLevel Below Poverty

TRLevel

HealthMap 2013 Community Need Index for Zip Code 43222 HealthMap 2013 Community Need Index for Zip Code 43222 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 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 socioeconomic barriers (high need).The scores are averaged to obtain the final CNI score. The description of how each category was calculated has been itali-

Income (5) – 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 (4) – 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 (5) – 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 (5) – 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. Figure

Community need index (map showing color coded severity) Community need index (map showing color coded severity) Community need index (map showing color coded severity)

The final CNI (4.8) - 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 lack of use of primary care or assistance needed in managing chronic diseases or conditions. Intercity hardship index 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 1990. Six key factors are used to determine the Intercity Hardship Index score from zero to 100.The higher the score, the greater the hardship. The key factors are: • Unemployment – percent of civilians 16 years and older who are unemployed • Dependency – percent of population under 18 years and over 64 year • Education – percent of population 25 years and older who have less than a high school education • Income – per capita income • Crowded housing – percent of occupied housing units with more than one person per room • Poverty – percent of people living below the federal poverty level, adjusted for local cost of living Although the study reflected that cities in the Midwest had a high index score, since the inception of the Intercity Hardship Index, Columbus has always been one of the cities with the least hardship.3

*Dignity Health Community Needs Index / http://cni.chw-interactive.org

TableTR1970 1980 1990 2000

Index Score Index Score 34.8 24.2 22.5 18.6

Rank Rank 46 42 78 79

Total # Cities Total # Cities 55 55 86 86

Assessment, Methodology and Findings Assessment, Methodology and Findings Assessment, Methodology and Findings

In 2012, Mount Carmel Health System joined area hospitals and community agencies in performing a community health needs assessment that met the requirement of the Patient Care Protection Affordable Care Act.This assessment was completed and made public January 2013. The document form this assessment is the Franklin County HealthMap 2013: Navigating Our Way to a Healthier Community Together (HealthMap 2013).The collaborative effort was headed by the Central Ohio Hospital Council. The team included representaAccess to care Chronic Disease Infectious Disease Behavioral HealthHighIncidence of Cancer InterpersonalViolence Unintentional Injuries High-RiskPregnancy CommunityHealth *HealthMap 2013

Link to the HealthMap2013 (Franklin County Health Needs Assessment) Link to the HealthMap2013 (Franklin County Health Needs Assessment) Link to the HealthMap2013 (Franklin County Health Needs Assessment)

The community health needs assessment identified and prioritized health needs consisting of 8 priorities and 140 indicators. Specific information about these indicators can be found in Franklin County HealthMap 2013: Navigating Our Way to a Healthier Community Together.The HealthMap 2013 can be found at http://www.mountcarmelhealth.com/community-benefit

Understanding the prevalence of chronic health conditions, barriers in access to care, and other health issues, all of the central Ohio hospitals involved in this process aligned resources to determine which indicator they could adopt and develop programs, if not already in place, to address any of the eight indicators. MCHS has programs in place to address all eight of these health indicators. MCHS has also chosen to begin a new initiative to address infant mortality.

Community Benefit Advisory Board Community Benefit Advisory Board Community Benefit Advisory Board

The decision to focus resources on infant mortality was decided by Mount Carmel Health System and the Community Benefit Advisory Board with statistics from the Franklin County Health Needs Assessment, HeallthMap2013 supporting this decision.The Mount Carmel Community Benefit Advisory Board members consist of individuals from the community, as well as Mount Carmel Health associates.Together, we work to ensure that community benefit programs are addressing the needs of the Health System Community Benefit Minicommunity.We have developed a Mount Carmel

Mount Carmel Health Community Benefit System-wide Strategies Goals Mount Carmel Health Community Benefit System-wide Strategies Goals

Ensure equitable provision of care Improve access to health care services Invest in access solutions for those most vulnerable Embrace, celebrate and learn from diversity Achieve health equity

Expand chronic disease management programs Enhance the health of the community Educate and inform community on healthy behaviors Promote evidence based programs and activities that create health improvement Focus on health needs identified in local community health assessment Promote physical, social and policy activities that create health improvement Advance medical/healthcare knowledge Enhance the health of the community

Document metrics and outcomes of all programs Partner with community organizations Give community voice in decisions regarding community benefit strategy and activities Demonstrate a return on investment Maintain and improve knowledge of community health Demonstrate transparency Relieve/reduce the burden of government/other community efforts Demonstrate value of community benefit

Although we are looking at identified needs system wide, each facility is focusing on the area surrounding the hospitals with the highest need and or determinates of health and reviewing needs from a life course prospective. Determinates of health are factors that contribute to a person's current state of health.“These factors may be biological, socioeconomic, psychosocial, behavioral or social in nature. Scientists generally recognize five determinants of health of a population: disparities.We are including the

• Biology and genetics. Examples: sex and age • Individual behavior. Examples: alcohol use, injection drug use (needles), unprotected sex, and smoking • Social environment. Examples: discrimination, income and gender • Physical environment. Examples: where a person lives and crowding conditions • Health services. Examples:Access to quality health care and having or not having health insurance.” http://www.cdc.gov/socialdeterminants/Definitions.html

Life course prospective looks how an individual’s lifestyle choices and health outcomes are affected by their family history. It connects past family social, economic and health history to very important when planning preventative health measures. individual behavior and outcomes in the present. (Bengtson and Allen 1993).We believe this is

Equity in care is also a priority at Mount Carmel Health System. Mount Carmel sponsored leaders to complete an executive disparities leadership program. The Disparities Leadership Program is the first program of its kind in the nation, and is designed for leaders from hospitals, health insurance plans, and other health care organizations who are seeking to develop practical strategies to eliminate racial and ethnic disparities in health care.The program is led by the Disparities Solutions Center at MassachuMassachusetts.As

FACILITY SPECIFIC OVERVIEW FACILITY SPECIFIC OVERVIEW Mount Carmel West Hospital

Located near downtown Columbus, Mount Carmel West is the original hospital in the Mount Carmel Health System. Serving nearly 18,000 patients each year, this Columbus hospital offers exceptional facilities, a host of medical specialties and a number of exclusive specialty centers. At its heart, Mount Carmel West is a teaching hospital, with ACGME-accredited residency programs in family practice, orthopedics, general surgery, internal medicine, OB/GYN and transitional year.The Mount Carmel College of Nursing, which is located on our Columbus medical center’s West campus, is Ohio's fourth-largest baccalaureate nursing program.And our physicians, residents, nurses, staff, students and patients have access to a vast library of multimedia resources through a state-of-the-art Center for LeContinual updates and enhancements have made our Columbus, Ohio hospital a truly outstanding facility. It is a Level II Trauma Center with 14 operating rooms, a urology suite, a state-of-the-art endoscopy lab and multiple intensive care units (Surgical ICU, Medical-Cardiac ICU, Open Heart Recovery Unit and Neuro ICU).The hospital also features a number of specialty centers dedicated exclusively to epilepsy monitoring, inpatient rehabilitation, bariatric treatment, long-term acute care and palliative care. AThe MCW facility experiences a high utilization of the emergency department for nonemergency care.This may be because the population in the surrounding area does not use primary care nor needs assistance in managing chronic diseases or conditions. MCW has responded to this need in two ways by creating a Nursing Center and a community health resource center both located on the MCW campus. It also sponsors the Health Station for primary care located off campus on Parsons Avenue. -

Nursing Center for Family Health Nursing Center for Family Health Nursing Center for Family Health

Through a partnership of Mount Carmel College of Nursing and Lower Lights Christian Health Center (FQHC) the growing need and patient demand are able to be met by suing the expertise of MCCN Advanced Practice Nurses (APN).The nursing center provides primary care, such as preventative health services, patient education and disease management, as well as, routine physicals, health screenings, immunizations, management of chronic disease conditions, and acute care of non-emergency conditions.The center is an e

Community Health Resource Center Community Health Resource Center Community Health Resource Center

The Mount Carmel West Community Education and Support Center provides support for women’s health initiatives in the specific areas of diabetes management for pregnant women and outpatient lactation consultation.This center will house a variety of health care services available to the local Franklinton community. One of the goals is to increase breastfeeding rates and breastfeeding duration with monthly classes, telephone follow up, and weekly breastfeeding support groups. Lactation consultants will support

Health Stations Health Stations Health Stations

Health Stations are facilities anchored at two local churches and a public high school. Health care is conveniently available in the neighborhood and everyone is able to receive primary medical care and health education at these locations. The underserved, uninsured, and poor populations are included in the targeted population. In alliance with our mission and values, MCHS vows to provide professional medical, administrative and management services to families, individuals, seniors and children who are in n

United Methodist Church for All People United Methodist Church for All People 946 Parsons Avenue Columbus, Ohio 43206 Figure

Community Benefit Reporting (Link to Community Benefit Report) Community Benefit Reporting (Link to Community Benefit Report) Community Benefit Reporting (Link to Community Benefit Report)

Many of our other programs are highlighted in the Community Benefits Report at this link http://www.mountcarmelhealth.com/community-benefit

Specific Facility Response Plan to Findings Specific Facility Response Plan to Findings Specific Facility Response Plan to Findings

The following implementation plan lists each of the eight needs identified by HealthMap 2013. Each need was reviewed for lack of access, awareness or education and then plans were made to meet these needs. Mount Carmel West implementation plan: 2013 – 2015 CHNA IMPLEMENTATION STRATEGY HEALTH ISSUE PLANNING PROFILE 2013 – 2015 CHNA IMPLEMENTATION STRATEGY HEALTH ISSUE PLANNING PROFILE 2013 – 2015 CHNA IMPLEMENTATION STRATEGY HEALTH ISSUE PLANNING PROFILE

Mount Carmel Campus: Mount Carmel Campus: Mount Carmel West

CHNA HEALTH ISSUE: CHNA HEALTH ISSUE: Access to Care

CHNA REFERENCE PAGE: Pages 5 & 19 RANKING: 1 Brief Description of Issue: Emergency departments (EDs) in Franklin County experience higher utilization, when comparing rates per population, than do EDs across the state. Similarly, emergency departments in Franklin County are utilized more often for less severe cases, when comparing rates per population, than EDs across the state. In terms of specific conditions where access to care poses a problem, Franklin County adults have more difficulty in accessiCHNA REFERENCE PAGE: Pages 5 & 19 RANKING: 1 Brief Description of Issue: Emergency departments (EDs) in Franklin County experience higher utilization, when comparing rates per population, than do EDs across the state. Similarly, emergency departments in Franklin County are utilized more often for less severe cases, when comparing rates per population, than EDs across the state. In terms of specific conditions where access to care poses a problem, Franklin County adults have more difficulty in accessi

GOAL: To improve access to care in underserved populations. GOAL: To improve access to care in underserved populations.

OBJECTIVE: Add resources to reduce emergency department (ED) utilization and improve access to dental care. OBJECTIVE: Add resources to reduce emergency department (ED) utilization and improve access to dental care.

STRATEGIES (BY OBJECTIVE): 1. Utilize mobile coach clinic for outreach 2. Aggressive outreach programs to reach underserved populations 3. Maintain pharmacy assistance program 4. Increase number of individuals who have health care coverage 5. Participate in a planning process to address adult dental care. STRATEGIES (BY OBJECTIVE): 1. Utilize mobile coach clinic for outreach 2. Aggressive outreach programs to reach underserved populations 3. Maintain pharmacy assistance program 4. Increase number of individuals who have health care coverage 5. Participate in a planning process to address adult dental care.

ANTICIPATED OUTCOME(S): 1. Measurable reduction of utilization of ED 2. Increase number of individuals who have coverage and/or access to financial assistance ANTICIPATED OUTCOME(S): 1. Measurable reduction of utilization of ED 2. Increase number of individuals who have coverage and/or access to financial assistance

KEY PARTNERS: Southeast, Inc, Christ the King Church, Friends of the Homeless, Hoge Memorial, Presbyterian Church, Clintonville Community Resource Center, Holy Family Soup Kitchen, Reynoldsburg Shepherd's Place, Salvation Army, Stowe Baptist Church, Southeast, Inc , the Coalition on Homelessness and Housing in Ohio, Lower Lights Christian Health Center, and Columbus Neighborhood Health Centers. KEY PARTNERS: Southeast, Inc, Christ the King Church, Friends of the Homeless, Hoge Memorial, Presbyterian Church, Clintonville Community Resource Center, Holy Family Soup Kitchen, Reynoldsburg Shepherd's Place, Salvation Army, Stowe Baptist Church, Southeast, Inc , the Coalition on Homelessness and Housing in Ohio, Lower Lights Christian Health Center, and Columbus Neighborhood Health Centers.

2013 – 2015 CHNA IMPLEMENTATION STRATEGY HEALTH ISSUE PLANNING PROFILE 2013 – 2015 CHNA IMPLEMENTATION STRATEGY HEALTH ISSUE PLANNING PROFILE 2013 – 2015 CHNA IMPLEMENTATION STRATEGY HEALTH ISSUE PLANNING PROFILE


CHNA HEALTH ISSUE: CHNA HEALTH ISSUE: Chronic Disease

CHNA REFERENCE PAGE: 6 RANKING: 2 Brief Description of Issue: Chronic diseases – such as heart disease, stroke, cancer, diabetes – are the leading causes of death and disability at the local, state and national levels. According to the Centers for Disease Control and Prevention medical care costs of people with chronic diseases account for more than 75% of total medical care costs in the U.S. In Franklin County, over 60% of all deaths were due to chronic disease. Franklin County has a higher prevalence of bCHNA REFERENCE PAGE: 6 RANKING: 2 Brief Description of Issue: Chronic diseases – such as heart disease, stroke, cancer, diabetes – are the leading causes of death and disability at the local, state and national levels. According to the Centers for Disease Control and Prevention medical care costs of people with chronic diseases account for more than 75% of total medical care costs in the U.S. In Franklin County, over 60% of all deaths were due to chronic disease. Franklin County has a higher prevalence of b

GOAL: Improve management of chronic disease, specifically heart failure and diabetes GOAL: Improve management of chronic disease, specifically heart failure and diabetes

OBJECTIVE: Improve self-management of asthma and diabetes by ensuring uninsured individuals have access to pharmaceuticals through continued pharmaceutical assistance programs. OBJECTIVE: Improve self-management of asthma and diabetes by ensuring uninsured individuals have access to pharmaceuticals through continued pharmaceutical assistance programs.

STRATEGIES (BY OBJECTIVE): 1. Increase awareness and education on self-management through speakers and disease specific and prevention literature. 2. Continue the pharmaceutical programs for underinsured/uninsured individuals. 3. Participate in community collaborate to address obesity. STRATEGIES (BY OBJECTIVE): 1. Increase awareness and education on self-management through speakers and disease specific and prevention literature. 2. Continue the pharmaceutical programs for underinsured/uninsured individuals. 3. Participate in community collaborate to address obesity.

ANTICIPATED OUTCOME(S): 1. Better chronic disease management through the utilization of pharmaceuticals. 2. Access to primary care and preventative information 3. Decreased avoidable hospital admissions as a result of unmanaged diabetes or heart failure ANTICIPATED OUTCOME(S): 1. Better chronic disease management through the utilization of pharmaceuticals. 2. Access to primary care and preventative information 3. Decreased avoidable hospital admissions as a result of unmanaged diabetes or heart failure

KEY PARTNERS: Pharmaceutical programs, local churches and Church Partnerships, Community Health Collaborative Project . KEY PARTNERS: Pharmaceutical programs, local churches and Church Partnerships, Community Health Collaborative Project .



CHNA HEALTH ISSUE: CHNA HEALTH ISSUE: Infectious Disease

CHNA REFERENCE PAGE: 7 RANKING: 3 Brief Description of Issue: Incidences of infectious diseases, especially those that are sexually transmitted, more prevalent in Franklin County than in Ohio. Franklin County rates for pertussis and tuberculosis are higher than Ohio rates. The incidence rates for two hospital-acquired infections -methicillin-sensitive Staphylococcus Aureus (MSSA) and methicillin-resistant Staphylococcus Aureus (MRSA) -- are slightly higher in Franklin County than in Ohio. CHNA REFERENCE PAGE: 7 RANKING: 3 Brief Description of Issue: Incidences of infectious diseases, especially those that are sexually transmitted, more prevalent in Franklin County than in Ohio. Franklin County rates for pertussis and tuberculosis are higher than Ohio rates. The incidence rates for two hospital-acquired infections -methicillin-sensitive Staphylococcus Aureus (MSSA) and methicillin-resistant Staphylococcus Aureus (MRSA) -- are slightly higher in Franklin County than in Ohio. -

GOAL: Reduce instances of infectious diseases. GOAL: Reduce instances of infectious diseases.

OBJECTIVE: Increase community awareness and prevent the spread of infectious diseases. OBJECTIVE: Increase community awareness and prevent the spread of infectious diseases.

STRATEGIES (BY OBJECTIVE): 1. Collaboration with the Columbus Public Health Department to educate community regarding flu and pandemics. 2. Promote prevention education and access to vaccinations 3. Look to leadership from the Health Department for prevention of other infectious diseases. STRATEGIES (BY OBJECTIVE): 1. Collaboration with the Columbus Public Health Department to educate community regarding flu and pandemics. 2. Promote prevention education and access to vaccinations 3. Look to leadership from the Health Department for prevention of other infectious diseases.

ANTICIPATED OUTCOME(S): Decrease the cases of infectious diseases ANTICIPATED OUTCOME(S): Decrease the cases of infectious diseases

KEY PARTNERS: Columbus Public Health Department , local churches, and Church Partnerships KEY PARTNERS: Columbus Public Health Department , local churches, and Church Partnerships



CHNA HEALTH ISSUE: CHNA HEALTH ISSUE: Behavioral Health

CHNA REFERENCE PAGE: 7 RANKING: 4 Brief Description of Issue: A wide spectrum of psychiatric disorders is prevalent in Franklin County, including depression, chronic mental health conditions, substance abuse and post-traumatic stress. In 2006-2008, suicide was the tenth leading cause of death in Franklin County. The overall rate in Franklin County was 12.4 suicide deaths per 100,000 people. This was higher than the 2006-2008 rate for the state of Ohio which was 11.3 per 100,000. According to the National ICHNA REFERENCE PAGE: 7 RANKING: 4 Brief Description of Issue: A wide spectrum of psychiatric disorders is prevalent in Franklin County, including depression, chronic mental health conditions, substance abuse and post-traumatic stress. In 2006-2008, suicide was the tenth leading cause of death in Franklin County. The overall rate in Franklin County was 12.4 suicide deaths per 100,000 people. This was higher than the 2006-2008 rate for the state of Ohio which was 11.3 per 100,000. According to the National I

GOAL: Reduce cancer incidence and increase cancer screenings. GOAL: Reduce cancer incidence and increase cancer screenings.

OBJECTIVE: Navigate underserved individuals to behavioral health services within the community OBJECTIVE: Navigate underserved individuals to behavioral health services within the community

STRATEGIES (BY OBJECTIVE): 1. Utilize the mobile coach to identify and navigate individuals to behavioral health services within the community. 2. Participate in community planning process to address behavioral health and access to services. 3. Provide support for pharmaceutical services STRATEGIES (BY OBJECTIVE): 1. Utilize the mobile coach to identify and navigate individuals to behavioral health services within the community. 2. Participate in community planning process to address behavioral health and access to services. 3. Provide support for pharmaceutical services

ANTICIPATED OUTCOME(S): Improved behavioral health management through improved education and use of resources. ANTICIPATED OUTCOME(S): Improved behavioral health management through improved education and use of resources.

KEY PARTNERS: Southeast, Inc., Pharmaceutical programs KEY PARTNERS: Southeast, Inc., Pharmaceutical programs



CHNA HEALTH ISSUE: CHNA HEALTH ISSUE: High Incidence of cancer

CHNA REFERENCE PAGE: 8 RANKING: 5 Brief Description of Issue: Cancer places a tremendous emotional and financial burden on patients, families and society. The number of new cancer cases can be reduced, and many cancer deaths can be prevented through early detection, vaccination, and maintaining healthy behaviors, such as being physically active and maintaining a healthy weight. In Franklin County, cancer is the second leading cause of death. The top five cancer mortality rates in Franklin County are lung, cCHNA REFERENCE PAGE: 8 RANKING: 5 Brief Description of Issue: Cancer places a tremendous emotional and financial burden on patients, families and society. The number of new cancer cases can be reduced, and many cancer deaths can be prevented through early detection, vaccination, and maintaining healthy behaviors, such as being physically active and maintaining a healthy weight. In Franklin County, cancer is the second leading cause of death. The top five cancer mortality rates in Franklin County are lung, c

GOAL: Reduce cancer incidence and increase cancer screenings. GOAL: Reduce cancer incidence and increase cancer screenings.

OBJECTIVE: Reach populations at risk for cancer OBJECTIVE: Reach populations at risk for cancer

STRATEGIES (BY OBJECTIVE): 1. Continue colon health program outreach and targeting of African American males. 2. Continue breast cancer screening with financial assistance available for poor and underserved 3. Maintain support programs to help patients recover STRATEGIES (BY OBJECTIVE): 1. Continue colon health program outreach and targeting of African American males. 2. Continue breast cancer screening with financial assistance available for poor and underserved 3. Maintain support programs to help patients recover

ANTICIPATED OUTCOME(S): Reduce cancer prevalence in high risk populations. ANTICIPATED OUTCOME(S): Reduce cancer prevalence in high risk populations.

KEY PARTNERS: Taylor Station Ambulatory Surgery Center, Mount Carmel Medical Group, Local and national cancer organizations & foundations, American Cancer Society, Other Mount Carmel Health System facilities. KEY PARTNERS: Taylor Station Ambulatory Surgery Center, Mount Carmel Medical Group, Local and national cancer organizations & foundations, American Cancer Society, Other Mount Carmel Health System facilities.



CHNA HEALTH ISSUE: CHNA HEALTH ISSUE: High-Risk Pregnancy

CHNA REFERENCE PAGE: 9 RANKING: 7 Brief Description of Issue: Infant mortality rate, preterm birth rate and infant birth weights are all important measures of the care pregnant women and their newborns receive during pregnancy. In 2009, the March of Dimes gave Ohio an “F” for its efforts to reduce preterm births. Ohio is ranked 34th among the 50 states, Puerto Rico and the District of Columbia. Unfortunately, Franklin County fares even worse than the state in several areas of these. In Franklin County, the CHNA REFERENCE PAGE: 9 RANKING: 7 Brief Description of Issue: Infant mortality rate, preterm birth rate and infant birth weights are all important measures of the care pregnant women and their newborns receive during pregnancy. In 2009, the March of Dimes gave Ohio an “F” for its efforts to reduce preterm births. Ohio is ranked 34th among the 50 states, Puerto Rico and the District of Columbia. Unfortunately, Franklin County fares even worse than the state in several areas of these. In Franklin County, the

GOAL: Reduce infant mortality rate and low birth weight babies. GOAL: Reduce infant mortality rate and low birth weight babies.

OBJECTIVE: Increase community awareness of infant mortality, preterm birth rate and low birth weight babies. OBJECTIVE: Increase community awareness of infant mortality, preterm birth rate and low birth weight babies.

STRATEGIES (BY OBJECTIVE): 1. Convene process to identify three potential programs/methods to increase public awareness. 2. Continue programs directed at infant vitality. 3. Participate in community collaborative focused on infant mortality. STRATEGIES (BY OBJECTIVE): 1. Convene process to identify three potential programs/methods to increase public awareness. 2. Continue programs directed at infant vitality. 3. Participate in community collaborative focused on infant mortality.

ANTICIPATED OUTCOME(S): Measurable decrease in infant mortality rates. ANTICIPATED OUTCOME(S): Measurable decrease in infant mortality rates.

KEY PARTNERS: Ohio Better Birth Outcomes, Ohio Hospital Association, Women, Infant and Children (WIC), Action for Children, Franklin County Jobs and Family Services, Local Churches, Childcare Facilities, Moms 2B, Nationwide Children's Hospital KEY PARTNERS: Ohio Better Birth Outcomes, Ohio Hospital Association, Women, Infant and Children (WIC), Action for Children, Franklin County Jobs and Family Services, Local Churches, Childcare Facilities, Moms 2B, Nationwide Children's Hospital

Unaddressed Identified Needs Unaddressed Identified Needs Unaddressed Identified Needs

All priority needs identified by HealthMap 2013 have been addressed by at least one of Mount Carmel Health System facilities.These needs may not have been addressed by all facilities due to limited resources. Identified Need: MCW or Addressed by: 1. 1. 1. Access to Care x

2.2. Chronic Disease x

3.3. Infectious Disease x

4.4. Behavioral Health x

5. 5. High Incidence of Cancer x

6. 6. Interpersonal Violence x MCNA and resources on pg. 9 of HealthMap 2013

7. 7. High Risk Pregnancy x

8.8. Untentional Injuries x MCE, MCSA and resources on pg. 10 of the HealthMap 2013.

X= not addressed by this facility MCE = Mount Carmel East MCW = Mount Carmel West MCSA = Mount Carmel St.Ann’s MCNA = Mount Carmel New Albany DR = Diley Ridge

Attachments Attachments Attachments

Appendix A- Data Sources Appendix A- Data Sources

1. 1. 1. Health Map 2013

2. 2. Reference: 2 – U.S. Census Bureau, 2010 Census.Accessed: http://quickfacts.census.gov/qfd/states/30/3018000.html

3. 3. CNI (web site) http://cni.chw-interactive.org/printout.asp

4. 4. Research Health Partners (web site)

5. 5. Demographics Expert 2.7: 2011 Demographic Snapshot of Zip code 43222, 2011 Nielson Company, 2012 Thomson Reuters. Accessed 6/13/12.

Appendix B – Anticipated Partners Appendix B – Anticipated Partners

MCHS Constituents MCHS Constituents

• The MCHS Foundation • Mission Services • Service Line Administration • Outreach • Neighborhood Services • Finance • Administration • Emergency Department Services • Communication and Public Affairs • The College of Nursing . Community Constituents

• American Cancer Society • Columbus City Schools • Columbus Health Department • Columbus State Community College • Heart of Ohio Family Health Centers • Mid-Ohio Food Bank • Westerville South High School • Avondale School • Gladden Community House • Franklin County Red Cross • Columbus Police Department • United Way of Central Ohio • Westerville Area Resource Ministry (WARM) • YMCA of Central Ohio • Coalition on Homelessness and Housing in Ohio • Christ The King, Bishop Griffin Center • Clintonville Community Resource Center • Holy Family Soup Kitchen • Second Servings • Reynoldsburg Shepherd’s Place • Salvation Army • Stowe Baptist Church • Church For All People • First Church of God • Reynoldsburg High School • Stelzer Road Trailer Park • Faith Mission • Lower Lights Christian Health Center • Southeast Inc. • Heart of Ohio Family Health Centers . – Capital Family Health Center . – Whitehall Family Health Center *** The community health needs and the implementation strategy are based on data supporting the health needs and resources available for a certain period of time.These needs and resources may change and therefore the implementation strategy must also change to remain relevant to the community and hospital system.

mount carmel west · in 2012, mount carmel health system joined area hospitals and community...

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