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Engagement and Accreditation Heather Fink and Shawn Hinz

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1 Engagement and Accreditation Heather Fink and Shawn Hinz
The Community Health Needs Assessment and Improvement Plan Process in Yellowstone County Engagement and Accreditation Montana Public Health Association Conference October 1, 2014 Heather Fink and Shawn Hinz Shawn

2 What is Community Engagement?
Diverse perspectives Willingness to participate Respect for ideas/interests Common goals What’s in it for me?

3 Community Health Improvement
The Alliance Shawn Community Health Improvement

4 Objectives To introduce a Community Health Needs Assessment approach including potential strategies for engaging key collaborators and community members in the process. To demonstrate alignment with required domains of Public Health Accreditation. Heather

5 ACHI Framework for the CHNA and CHIP
Suggested 7th step: revisit and refine plan and process. Heather

ACHI steps 1 & 2: Establish and Assess Infrastructure Survey Design CHNA Advisory Group PRC Contract Survey tools finalized (HBDL) ACHI step 3: Analyze Data Results Returned Alliance & HBDL review BC, RSH & SVH internal review CHNA Advisory Group review HBD Coalition review ACHI step 4: Select Priorities Prioritization Process Community process Institutional processes Alliance final adoption ACHI step 6: Plan for Action Author CHIP ACHI step 6: Monitor Progress CHIP begins July-Sept 14 Aug-Oct 13 Nov-Dec 13 Jan-Feb 14 Mar-June 14 Mar-July 13 ACHI step 5: Document and Communicate Results Results Released Publicly a) Press Conference (Jan) b) Internal, key groups, community, & media – results, priorities & engage ACHI step 3: Collect Data Survey Conducted Focus Groups (PRC) Telephone (PRC) ACHI step 6: Plan for Action CHIP Adopted (June 30) BC adopts facility plan SVH adopts facility plan step 7: Revisit and Refine plan and process Heather CHNA= Community Health Needs Assessment PRC= Professional Research Consultants – vendor CHIP= Community Health Improvement Plan HBDL=Healthy By Design Leadership ACHI=Association of Community Health Improvement (framework for CHNA-steps referenced)

7 Assess DOMAIN 1: Conduct and disseminate assessments focused on population health status and public health issues facing the community Standard 1.1: Participate in or Conduct a Collaborative Process Resulting in a Comprehensive Community Health Assessment Standard 1.2: Collect and Maintain Reliable, Comparable, and Valid Data That Provide Information on Conditions of Public Health Importance and On the Health Status of the Population Standard 1.3: Analyze Public Health Data to Identify Trends in Health Problems, Environmental Public Health Hazards, and Social and Economic Factors That Affect the Public’s Health Standard 1.4: Provide and Use the Results of Health Data Analysis to Develop Recommendations Regarding Public Health Policy, Processes, Programs, or Interventions S

8 Community Engagement DOMAIN 4: Engage with the community to identify and address health problems Standard 4.1: Engage with the Public Health System and the Community in Identifying and Addressing Health Problems Through Collaborative Processes Standard 4.2: Promote the Community’s Understanding of and Support for Policies and Strategies That will Improve the Public’s Health S

9 Community Health Needs Assessment
Completed every 5 years, now every 3 Sponsored by the Alliance Randomized telephone survey of 404 Yellowstone County adults Secondary Data Public health data & vital records statistics Focus Groups Physicians & other Health Professionals Legislators Social Service Providers Educators Employers South side neighborhood residents H

10 Action Plan S Measure Opportunity for Improvement History/Current
Status Action Documentation Responsible Staff Date 4.1.2 Example 2 Required Documentation Source of Evidence-based practices RiverStone Health may want to consider how the work they currently do or could do provides their many community coalition partners with technical assistance, tools and resources to provide information about community engagement principles, processes, and/or models. RiverStone Health is using the Association of Community Health Improvement (ACHI) model for Community Engagement. This process was also used in 2010. Present to community members who have selected priority areas and stakeholders on how the ACHI model of community engagement is used in the development of a CHIP and other types of community engagement. The community members will participate in setting priority activities. Invitation Agendas of meetings Meeting Minutes PowerPoint Presentation ACHI model Documentation of Priority Planning Attendance Sheets Shawn Hinz, Director and Heather Fink, Coordinator for On 5/2/2014 S

11 Community Resources The Alliance
Community Health Improvement Leadership CHNA Advisory Group Healthy By Design Coalition CHIP workgroup Points of engagement Press Conference and Preview Meetings CHNA Advisory Group Check-Ins Community Forum Content Expert Meetings CHIP Strategy Discussions H

12 Areas of Opportunity Access to Health Services* Cancer*
Chronic Kidney Disease Dementias, Including Alzheimer’s Disease Heart Disease & Stroke* Injury & Violence* Infant Health & Family Planning Mental Health & Mental Disorders* Nutrition, Physical Activity & Weight* Respiratory Diseases* Substance Abuse* Tobacco Use H Here is the listing of opportunities in its entirety. You will note the top concerns of the focus groups bolded. Opportunities denoted in previous assessment have an asterisk. The Community Forum held February 4th was a successful gathering of 85 community representatives. (Top 6 priorities underlined here) Bold items were identified as a top concern in focus groups. * Denotes issues identified as Areas of Opportunity in 2010 as well. Underlined-identified in 2014 Community Forum

13 Identified Community Priorities
Access to Health Services Mental Health & Mental Disorders, Substance Abuse Nutrition, Physical Activity & Weight H

14 Policies and Plans DOMAIN 5: Develop public health policies and plans
Standard 5.1: Serve As a Primary and Expert Resource for Establishing and Maintaining Public Health Policies, Practices, and Capacity Standard 5.2: Conduct a Comprehensive Planning Process Resulting in a Tribal/State/Community Health Improvement Plan Standard 5.3: Develop and Implement a Health Department Organizational Strategic Plan Standard 5.4: Maintain an All Hazards Emergency Operations Plan S

15 Opportunity for Improvement History/Current Status
Action Plan Measure Opportunity for Improvement History/Current Status Action Documentation Responsible Staff Accomplish by Date 5.2.4 The required documentation includes monitoring progress in meeting performance measures and a description of the progress made on health indicators as defined in the plan. The primary constraint for meeting this measure is related to the newness of the plan. That said, the plan and the updates could be improved if the objectives and strategies/interventions were written as SMART, and rather than simply aiming to decrease or increase a particular activity, the plan could set specific targets; for example, increase by x% from x to y, etc. RiverStone Health conducted Community Health Needs Assessments in 2005, 2010, and 2014 in partnership with the local hospitals (The Alliance). Following each needs assessment, a plan to improve the health of the community was written using community engagement. The 2014 CHIP is currently being written and the strategies will be written as SMART objectives. Reports of progress for the 2010 CHIP will be provided. In December 2013, a presentation to the Alliance on the health priorities and outcomes occurred comparing the results of the 2005, 2010, and 2014 Community Health Needs Assessment. Work groups were formed following the development of the 2010 CHIP and developed work plans which were updated in March 2014 Report of CHIP progress Meeting Minutes Attendance PowerPoint 2014 CHIP update which includes; work plans, progress, updates and revisions March 2014. Shawn Hinz, Director and Heather Fink, Coordinator for Community Health Improvement 7-8-13 March 2014 S

16 Mental Health and Substance Abuse Access to Health Services
The Alliance Community Health Improvement CHNA and Implementation Plan Healthy Weight Healthy By Design Mental Health and Substance Abuse Access to Health Services Community Health Improvement Plan Priorities S

17 Healthy Weight Priority
Healthy By Design’s Current Initiatives Making the healthy choice the easy choice Focused on Policy, Systems and Environmental Change! H

18 Healthy By Design Coalition
Better Billings Foundation Big Sky EDA Big Sky State Games Billings Clinic Billings Family YMCA Cancer Control Coalition Chamber of Commerce/CVB City-County Planning Dept. community health advocates League of Women Voters MET Transit McCall Development MSU Billings MSU Extension Service Northern Plains Resource Council Nutrition for the Future Parks and Rec Peaks to Plains Design RiverStone Health Safe Routes to School Salvation Army St. Vincent Healthcare School Health Advisory Council United Way H

19 Priority: Healthy Weight (Brand: Healthy By Design)
Focus Areas Wellness Health Equity Built Environment Workgroups Children/ Families (partners: BAFHK, SHAC) Worksite Projects: BSED Recognition Active Living Every Day Gardeners’ Market Food Access Alternative Transportation H Community Message:

20 Evidence Based Practice
DOMAIN 10: Contribute to and apply the evidence base of public health Standard 10.1: Identify and Use the Best Available Evidence for Making Informed Public Health Practice Decisions Standard 10.2: Promote Understanding and Use of Research Results, Evaluations, and Evidence-based Practices With Appropriate Audiences S

21 Healthy By Design Workgroup Workplan Example


23 Zimmerman Trail near Poly Drive
“Complete Streets” passed unanimously by City Council. Adopted by Billings August 22, 2011 Complete streets are designed and operated to enable safe access for all users. Pedestrians, bicyclists, motorists, and public transportation users of all ages and abilities are able to safely move along and across a complete street.* H Zimmerman Trail near Poly Drive * Source: National Complete Streets Coalition

24 Gardeners’ Market Report on 2014…
Average of customers each week Average of 12 sellers weekly Moved to South Park SNAP, Debit, Credit H

25 Active Living Every Day Classes
Address identified physical activity barriers and opportunities.

26 Opportunity for Improvement History/Current Status
Action Plan Measure Opportunity for Improvement History/Current Status Action Documentation Responsible Staff Accomplish by Date 10.1.1 Example 2 Required Documentation Source of Evidence-based practices To seek out and utilize evidence-based or promising practices that are aligned with the 10 Essential Public Health Services The Healthy By Design Coalition is led by RiverStone Health, and Alliance partners Billings Clinic and St. Vincent Healthcare. There are 5 active workgroups: Healthy Weight, Worksite Wellness, Health Equity, Built Environment, and Recognition Program that all embrace 5210 messaging. 5 fruits/vegetables, 2 hours or less of screen time, 1 hour of physical activity per day, and 0 sugary beverages. This 5210 messaging is centered around our work to decrease obesity and chronic disease (a priority of our current CHIP) and evidenced by the success of the “Let’s Go Maine” program and referenced in many CDC resource lists. See below To assure consistent messaging of the 5210 model a train the trainer program will be developed and implemented to include sanitarians, and immunization staff. Identify target audiences for future 5210 trainings Invitation PowerPoints Attendance Training Materials s/minutes Melissa and Dasheema 5/15/2014 S

27 S Part of a national campaign to promote healthy weight, the message was created by Let’s Go! Maine, but has been shared across the nation, and many communities have personalized the logo. A fun example includes the Let’s Go Hawaii version above. Here in Billings, the message has been adopted locally as a community-wide message and call to action. RiverStone Health played a large part in the adoption and branding, along with other members of the Healthy By Design Coalition. Let’s Go Maine, Hawaii Initiative for Childhood Obesity Research and Education, Healthy By Design.

28 Healthy Weight Collaborative Project

29 Community Message H

30 Healthy By Design H

31 Alliance and Community Health Improvement Leadership
Community Health Improvement Staff Community Health Needs Assessment Community Health Improvement Plan Community Priorities S Mental Health/ Substance Abuse Access to Care Healthy Weight

32 Priority: Mental Health/ Substance
Strategy team meeting 8/27/14: Heather Fink, Nathan Stahley, Kristin Lundgren, TommiLee Harper, Libby Carter Proposed co-chairs: Libby Carter, DPHHS and Barbara Mettler, Mental Health Center (to be approached by Kristin) Common strategies of focus: Increase capacity for trauma informed care Support advocacy efforts for co-occurring treatment and family treatment Identify mental health and substance abuse related resources (integrate trauma informed certification) Actions: Outline strategy plan, aligned with DESTRESS grant Finalize chairs Hiring for grant coordinator Identify opportunity to connect/collaborate with Tobacco and Substance Abuse Coalitions Pursue potential interns to support H

33 Priority: Clinical/Access
Finalizing Alliance organizations strategy team representatives Determine meeting time and date Review CHNA, CHIP, strategies Recognize current efforts underway Determine priority strategies and potential opportunities Meeting scheduled in October Determine where Healthy Weight Plans fit H

34 Alliance and Community Health Improvement Leadership
Community Health Improvement Staff WHO? Community Health Needs Assessment Community Health Improvement Plan Community Priorities S Mental Health/ Substance Abuse Access to Care Healthy Weight

35 Backbone Structures Who does the work? Collaborative
Nonprofit organization Dedicated staff

36 Collective Impact Making a difference

37 THANK YOU Shawn Hinz Vice President, Public Health Services
RiverStone Health Heather Fink Community Health Improvement Manager On behalf of the Alliance: Billings Clinic, RiverStone Health, St. Vincent Healthcare S

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