1. Statewide LHIC Leadership Meeting October 10, 2012 Columbia, MD
Welcome!
Statewide LHIC Leadership Meeting
October 10, 2012
Columbia, MD

2. President and CEO, Howard County General Hospital
Victor A. Broccolino
President and CEO,
Howard County General Hospital

3. Director Office of Population Health Improvement, DHMH
Madeleine Shea
Director
Office of Population Health Improvement, DHMH

4. Hospital Perspective
Lisa Hillman Senior Vice President, Legislative Affairs, President, AAMC Foundation
Kathleen McCollum Senior Vice President, Business Development and Ambulatory Services

5. We have one foot in the boat and one on the dock.

6. Healthy Anne Arundel Coalition
Coalition Network
Steering
Committee
Community Outreach Subcommittee
Co-Occurring Disorders Subcommittee
Community Health Needs Assessment Subcommittee
Promotion and Publicity Subcommittee
Obesity Prevention Subcommittee
Academia
Existing Boards, Committees & Coalitions
Government Agencies
Faith-Based Organizations
Community-Based Organizations
Health Care Providers
Philanthropy
Businesses
Leadership & Finance Subcommittee

7. Department of Health Steering Committee Member Organizations:
Anne Arundel County Office of the County Executive
Anne Arundel Co. Dept. of Aging and Disabilities
Anne Arundel County Department of Detentions
Anne Arundel Co. Dept. of Health
Anne Arundel Co. Dept. of Recreation & Parks
Anne Arundel Co. Dept. of Social Services
Anne Arundel Co. Public Schools
Anne Arundel Co. Mental Health Agency, Inc.
Anne Arundel Co. Chapter of the NAACP
Anne Arundel Community College
Anne Arundel Community Development Services
Anne Arundel Economic Development Corporation
Care First Blue Cross Blue Shield
City of Annapolis Mayor’s Office
City of Annapolis Dept. of Recreation and Parks
Community Foundation of Anne Arundel County
Housing Authority of the City of Annapolis
MEDSTAR Harbor Hospital
Northrop Grumman
People’s Community Health Centers, Inc.
Rite Aid Corporation
School of Public Heath, University of Maryland
Walmart

8. Opportunities
Working more collaboratively with the Department of Health and key players who play a role in the prevention, care and management of patients we commonly serve.
To develop consensus on primary health improvement targets and address allocation of resources.
Examining how the system of care - both prevention and public health - can work seamlessly together.
Sharing information on high utilizers of care together in order to examine prevention efforts that can minimize their utilization for better health outcomes.
Joint Community Health Needs Assessment.
Provides local health data and community input into the community benefit planning process.

9. Challenges Assuring representation from key stakeholders and partners.
Transition in hospital focus to population health and community benefit.
Hospitals have different primary service areas that may or may not overlap and each with their own unique needs.
Developing an implementation structure (5 sub-committees) that works and is manageable without being burdensome.
The Coalition's focus areas of obesity prevention and co- occurring disorders are complex health issues that will take substantial amounts of resources and time to improve.

11.
Laurie Fetterman, MSW
Phone:
Brandon J. Johnson, MHS
Phone:

12. Health Officer Howard County Health Department
Peter Beilenson
Health Officer
Howard County Health Department

13. Q & A and Discussion

14. Community Transformation
Don Shell
Director, Center for Tobacco Prevention & Control, DHMH

16. Executive Director Institute for Healthiest Maryland
Renee Fox
Executive Director
Institute for Healthiest Maryland

17. Institute for a Healthiest Maryland
Presentation to Statewide LHIC Leadership Meeting
October 10, 2012
Renee Ellen Fox, M.D.
Executive Director
Institute for Healthiest Maryland

18. Mission: To measurably improve the health of Maryland citizens, the Institute will support community transformation efforts, translate public health research into practice, and provide technical assistance to local health departments and community organizations.
Vision: Be a guiding resource for transforming Maryland communities into healthy environments for all.

19. Initial Funding for IHM
Funding from DHMH via CDC Community Transformation Grant (CTG) from the Public Health Trust Fund of the ACA.
address obesity, tobacco use, hypertension and health disparities
Partially funds Executive Director and Assistant
Office of the President UMB to partially fund Executive Director and Assistant for 5 years
Long Term Goal: Self-sustaining through external funding.

20. MOU from DHMH to UMB
Provide Technical Assistance to Local Health Departments
through Academic Partners
UMB Law, Pharmacy, Medicine and Nursing
UMBC Tobacco Quit Program
UMCP SPH
JHU Bloomberg School of Public Health
Dr. Shell will present the specific goals of the CTG in a few minutes.

21. IHM Structure

22. IHM Role in CTG Conduct Local Health Departments’ needs assessment
Compile, develop, disseminate resources and best practices
Communication strategies
Training and technical assistance
Use the existing evidence based interventions
Contribute to the knowledge base.
I want to frame how the CTG works with IHM and after the next few presentations, will come back to discuss the goals of the Institute and get your feed back and suggestions on these goals and their implementation.

23. Contact Info
Renee Ellen Fox, MD, Executive Director
Phone
Greer Huffman

24. Asst. VP, Quality Policy & Advocacy Maryland Hospital Association
Nicole Stallings
Asst. VP, Quality Policy & Advocacy
Maryland Hospital Association

25. Supporting Policy Innovation to Improve Population Health Statewide LHIC Leadership Meeting October 10, Nicole Stallings, MPP Assistant Vice President, Quality Policy & Advocacy Maryland Hospital Association

26. Quality & Patient Safety
Population Health
Prevention
Care Coordination
Quality & Patient Safety

27. Population Health Management in the ACA
Community Health Needs Assessment requirements
Expansion of prevention and wellness services
Hospital Readmissions Reduction Program
Community-based Care Transitions Program
Accountable Care Organizations
Patient Centered Medical Homes
Increased funding for health centers

28. Opportunities for Hospitals to Explore
Quality of Care
Efficiency
Access
Physician Training
Health Information Technology
Physician Employment
Care Integration and Coordination
Behavioral Health Access
Disparities
Cultural and Linguistic Access
Disease Management
Provider Supply

29. Example: Total Patient Revenue Hospitals
Sources: HSCRC 2012

30. Source: HFMA. Value in Health Care: Current State and Future Directions. June 2011.

31. Hospitals’ State of Readiness
Focus on population health is already occurring; variation in level of investment
Partnerships are essential for success
Physicians and other clinicians
Post-acute care providers
Employers
Government and commercial payers
Social and community services
Public Health agencies
Local, State and Federal Policy

32. QUESTIONS? Contact: nstallings@mhaonline.org 410-379-6200
Thank You!
QUESTIONS?
Contact:

33. Reducing Readmissions and Medicare Opportunities
Fredia Wadley
CEO, Delmarva Foundation

34. Chief Medical Officer DHMH
Laura Herrera
Chief Medical Officer
DHMH

35. Overview of “State Innovation Models” Grant Proposal
Laura Herrera, MD, MPH
Chief Medical Officer
Maryland Department of Health and Mental Hygiene

36. State Innovation Models (SIM) Grant Solicitation
Released by Center for Medicare & Medicaid Innovation (CMMI) at CMS
Purpose: Develop, implement, and test new health care payment and service delivery models at the state-level
2 tracks:
Model Design: Planning grant to fund the development of a comprehensive state innovation plan; $1-3 million over 6 months
Model Testing: Funds implementation and testing of an existing state innovation plan; $20-60 million over 3.5 years
Maryland applied for Model Design
Funding period: December 2012 – June 2013
Opportunity to apply for Model Testing in 2013

37. Proposed Model: Community-Integrated Medical Home
Integration of a multi-payer medical home model with community health resources
4 pillars:
Primary care
Community health
Strategic use of new data
Workforce development
Two parallel stakeholder engagement processes
Payers and Providers
Local Health Improvement Coalitions
All-stakeholder summit to form policy recommendations and develop plan for Model Testing application

38. Proposed Model: Community-Integrated Medical Home

39. Payer and Provider Engagement Process
Develop a governance structure for medical homes
Establish a public utility to administer payment and quality analytics processes
Set programmatic standards, such as
Criteria for practice inclusion
Quality assessment
Analytics
Shared savings
Hilltop and its contractor will conduct actuarial modeling of health costs to demonstrate savings expected from CIMH

40. Local Health Improvement Coalition Engagement Process
Complement medical care by linking high-need patients with wrap-around community-based health services
Capacity of LHICs will be strengthened
Will be asked to help develop new models to carry out CIMH activities (e.g., 501(c)3, integration with LHD, etc.)
Community health workers may play role of coordinating with practices
LHICs will be asked to help define responsibilities and required skills/education for CHWs
Use new data and mapping resources to “hot-spot” high utilizers and bring them into CIMH
LHICs will review prototypes of these resources

41. New Data Resources and Workforce
Data for “hot-spotting:” Real-time hospital admissions data
Data for population health monitoring: Health status, claims, administrative, and survey data
Workforce development
Maryland Learning Collaborative will develop resources and help prepare practices for community integration
MLC will partner with AHECs for training, especially in southern Maryland
Example of hot-spotting with admission data

42. Senior Research Analyst Hilltop Institute
Michael Abrams
Senior Research Analyst
Hilltop Institute

43. Coordination of Care for Persons with Substance Use Disorders under the Affordable Care Act
Maryland State Local Health Improvement Coalition Leadership Meeting
Howard County General Hospital
October 10th, 2012
Michael T. Abrams, M.P.H.
Funding: Baltimore Substance Abuse Systems, Inc.

44. Even smart people are unclear about what’s in the ACA

45. The Report
Affordable Care Act (ACA) review (U.S. Public Laws and )
Literature review
Existing program review (Behavioral Health Integration)
Opportunities and barriers in the recently passed federal health care law (the ACA) regarding the development of overall health care coordination for persons with SUD?
Patient-centered medical home

46. Essential Health Benefits
(A) Ambulatory patient services
(B) Emergency services
(C) Hospitalization
(D) Maternity and newborn care
(E) Mental health and substance abuse services, including behavioral health treatment
(F) Prescription drugs
(G) Rehabilitative and habilitative services and devices
(H) Laboratory services
(I) Preventive and wellness services and chronic diseases management
(J) Pediatric services, including oral and vision
(ACA § 1302(b)(1)(E) – p. 59)

47. A health home provider is…
“a physician, clinical practice or clinical group practice, rural clinic, community health center, community mental health center, home health agency, or any other entity or provider (including pediatricians, gynecologists, and obstetricians) that is judged by the State and approved by the Secretary to be qualified to be a health home for eligible individuals with chronic conditions on the basis of documentation showing that the physician, practice, or clinic – (A) has the systems and infrastructure in place to provide health home services; and (B) satisfied the qualification standards established by the Secretary”
(ACA § 2703(a)(h)(5)(A and B) – p. 232)

48. Medicaid Subgroups: Health Home Targets
Latent Class Grouping
Variable
Adult - High Somatic Morbidity
Adult - High Psychological Morbidity N
3,732
3,258
Mean Age (stdev)
46 (11)
38 (12)
Alcohol Dependence
30%
38%
Opioid Dependence
44%
47%
Cocaine Dependence
12%
28%
Anxiety disorders
10%
63%
Tobacco use 9%
71%
Schizophrenia spectrum 1%
67%
Depression 3%
85%
Cardiovascular
97%
61%
Gastrointestinal/Hepatic
96%
53%
Hematologic
72%
15%
Musculoskeletal
93%
74%
Neurologic
90%
65%
Renal
80%
29%
Respiratory
94%
51%
Source: Abrams et al., 2012,

49. Barriers
Payment reform (Finkelstein et al., 2011; Lindly et al., 2011; Croze et al., )
Burden of new data monitoring and collection (Medical Directors Council, 2005)
Avoid “double-billing” for the same service (Integrated Care Resource Center, 2012)
Essential benefits too vague (Buck, 2011; Garfield et al., 2010; Takach, 2011)
Inertia (Croze et al., 2011)

50. Barriers continued
Medical culture (Kunins, Sohler, Roose, & Cunningham, 2009; Davidson & White, 2007)
Stigma (Davidson & White, 2007; Edlin et al., 2005)
For substance use disorders especially
Confidentiality (Lindly et al., 2011)

51. Opportunities
Social justice argument (Boyer & Indyk, 2006; Edlin et al., 2005; Secker et al., 2006)
Technology
FQHC expansion/leveraging (Abrams et al., 2011)
ACA language and grant support
Includes many types of efforts, venues, provider types
Strong leadership (Lindly et al., 2011)

52. Contact Information
Michael T. Abrams, MPH
Senior Research Analyst
The Hilltop Institute
University of Maryland, Baltimore County (UMBC)

53. Q & A and Discussion

54. Break!

55. Director, Community Wellness Calvert Memorial Hospital
Margaret Fowler
Director, Community Wellness
Calvert Memorial Hospital

56. Community Health Improvement Roundtable
Calvert County’s Local Health Improvement Coalition
LHIC Leadership Meeting
October 10, 2012

57. Background
CMH has coordinated the Community Health Improvement Roundtable since 1995.
Membership: Calvert Memorial Hospital, Calvert County Health Department, Calvert County Government, Calvert County Public Schools, Hospice, Department of Social Services, Clergy, Health Impact Council, Oral Health Task Force, Tobacco/Cancer Coalition, Health Ministry Network, IPOP
Integrated SHIP objectives into Community Health Needs 2011.

58. Transforming Calvert County to A Culture of Wellness
LOCAL HEALTH IMPROVEMENT COALITION (LHIC)
Transforming Calvert County to A Culture of Wellness
Goals, Objectives & Action Plan
Community Health Needs Assessment (CHNA)
State Health Improvement Process (SHIP)
Local Health Improvement Coalition (LHIC)

59. SHIP Target Area Priority Area #1 Smoking Priority Area #2 Obesity
Objective #32
Objective #33
Priority Area #2 Obesity
Objective #30: Increase health weight of adults
Priority Areas #3 & #4 Death Rates
Objective #25: Reduce Heart Related Deaths
Objective #26: Reduce Cancer Related Deaths
Priority Area #5 Disparities
Objective #27 Reduce ER Utilization for Diabetes
Objective #28 Reduce ER Utilization for Hypertension
Objective #39 Access to Care
2 Forms
New activity form for more details about new services or programs
Update activity form for ongoing programs and serivces

60. Disparity Addressed ER Utilizations for Diabetes Related Visits
4.5 times the rate of Caucasians
Why?
ER Utilization for Hypertension Related Visits
4.75 times the rate of Caucasians

61. New Initiatives Data Analysis Creation of education tools
Diabetes Boot Camp
Diabetes Survival Guide
A1c Screening
Health Literacy
Community Coordination Care Team

62. Previous Care Coordination
PATIENT
Emergency Room Visit
Care Transition Coach
PCP Care Coordinator
Access To Primary Care Physician (PCP)
Health Ministry Team Network
Living Well Program
Diabetes Self Management
Mental Health Services
Substance Abuse Services

63. Community Coordination Care Team
PATIENT
Emergency Room Visit
Care Transition Coach
PCP Care Coordinator
Access To Primary Care Physician (PCP)
Health Ministry Team Network
Living Well Program
Diabetes Self Management
Diabetes Boot Camp
Mental Health Services
Substance Abuse Services
Diabetes Care Coordinator

64. Health Officer, Worcester County & Lower Shore Coalition Lead
Debbie Goeller
Health Officer, Worcester County & Lower Shore Coalition Lead

65. Prevention Program Model for Lower Shore Tri-County
National Diabetes
Prevention Program Model for
Lower Shore Tri-County
Health Improvement
Deborah Goeller, R.N., M.S.N.,
Health Officer
Worcester County
10/10/12
[Start speaking on next slide]

66. Lower Shore Maryland
14.3% of Lower Shore residents have been diagnosed with diabetes , almost double the State of Maryland at 8.3%. (2009 Community Health Assessment)
2010 HSCRC data revealed Lower Shore rate for emergency department visits due to primary diabetes diagnosis exceeded the State of Maryland (565.5 vs )
2009 Community Health Assessment by Professional Research Consultants found Lower Shore citizens being diagnosed with diabetes at an alarming rate of 14.3% vs. Maryland’s 8.3%.
The high prevalence poses a burden on both patients and the health care system, especially emergency department use.
2010 HSCRC data, lower shore rate for emergency department visits was per 100,000 which was higher than the state rate (347.2)

67. History of Worcester County Health Department Experience with NDPP
Preventive Health and Health Services (PHHS) Block Grant funding to focus on Diabetes
“ Lifestyle Balance”
Utilized NDPP curriculum and evaluation tools
Group Intervention- Education + Exercise
Team Taught- Registered Dietitian, American College of Sports Medicine Certified Clinical Exercise Specialist, Health Educator
[Don’t read the slide out loud]
Our pilot used the full curriculum and most of the evaluation tools required by the NDPP for certification.

68. Implemention in Worcester
16 Week Program
“ Coaching”
Food/Activity Journals
Locations- Workplaces, Recreation Centers, Community Sites, YMCA
Notice the intensive staff time involved over a full year of training, coaching, and tracking

69. Outcomes
July May 2012, 344 individuals have participated in the program
219 (64%) individuals have completed the program (attended at least 75% of classes)
17 sixteen-week programs have been completed
Offered at 13 different locations
I’ll just flash thru these slides: by multiple measures NDPP is successful

70. Fruit and Vegetable Intake
Improvement in food choices

71. Physical Activity
Physical activity

72. Body Mass Index
BMI reduction

73. COOP Quality of Life Assessment
Dartmouth COOP (Primary Care Cooperative ) Charts were used to evaluate health-related quality of life. Each chart consists of a simple title, one question, and five response choices. Each possible response is described in words and presented graphically , as a caricature, along a five-point ordinal scale. There are nine scales, each of which are used to measure a different aspect of patient functional status (physical activity, feelings, daily activities, social activities, pain, change in health, overall health, social support, and Quality of Life)

74. National Diabetes Prevention Program
Somerset, Wicomico, and Worcester Counties received CDC “partial recognition” for NDPP
Grant funding used to sponsor “Lifestyle Coach” training conducted by DTTAC , Emory University, in June 2012
10 Local Health Department Staff from 3 lower shore counties completed the training
We’ve completed training
One of the requirements for a program to become a CDC “Recognized” provider, is for coaches to complete “Lifestyle Coach” Training provided by Emory University DTTAC Staff.
Cost of the training was $13, The price to send a staff to Atlanta, Georgia for training is $1200/per person for training alone (does not include travel or lodging).

75. NDPP Implementation in Tri County
Grant Funding will support one full year (16 core sessions and 6 post-core monthly)of the NDPP in each of the 3 Counties.
20 individuals will complete the program which will be offered in each of the 3 counties (60 participants total)
Somerset, Wicomico, and Worcester County Health Departments collaborate to market the program through Local News Media, Tri County PIOs, Websites, Social Media, News Releases, and Local Public Television.
[Mimi note the #] The first cohort of 31 participants began 7 weeks ago and already have lost a combined total of 142 pounds.

76. Recognition Leads to Billing and Sustainability
All 3 LHDs will pursue “Full Recognition” from the CDC for the National Diabetes Prevention Program requiring data reports every six months for the next 24 months.
Full Recognition allows billing and program sustainability as fee for service.
The best part of the NDPP is the potential for sustainability as a fee for service prevention program.

77. Reducing Behavioral Health ED Visits
Amy Baker
Program Director, Care Coordination Unit
Carroll County Health Department

78. Deputy Director, Community Services Harford County
Sharon Lipford
Deputy Director, Community Services
Harford County

79. Harford County Local Health Improvement Plan
Behavioral Health:
Emergency Room Diversion
Susan Kelly, Harford Co. Health Dept.
Health Officer
Sharon Lipford, Harford Co. Dept. Community Services
Deputy Director/ LHIP Behavioral Health Chair

80. Demographic Indicators
Baseline Data (per 100,000):
Demographic Indicators
Harford County
Maryland
County 2014 Target
Behavioral health-related admissions to E.R.
1,243.7
1,206.3
1,183.4
Suicide rate
11.7
9.6
11.2
Drug-induced death rate
14.9
13.4
13.9
1,235.7
Harford County’s rate of ER visits for a behavioral health condition.
3rd HIGHEST
Harford County’s
death rate from intoxication was the
in Maryland
19.0%
12.8%
Anxiety
Disorder
Rates
HARFORD
MARYLAND
Source: Health Services Cost Review Commission; CDC Behavioral Risk Factor Surveillance System; Office of the State Medical Examiner

81. Behavioral Health Workgroup
Strategic Direction
Develop mechanisms to integrate mental health and substance abuse treatment
Improve the delivery of behavioral health services
Progress to Date
Youth Behavior Survey ~170 parents across Harford County
Parents believe substance abuse is a problem among youth, with alcohol being a primary concern, followed by drugs
Anxiety is also of concern among parents
Focus group with Emergency Room Staff from Upper Chesapeake Health and Harford Memorial Hospital
Bazelon Center for Mental Health Law Behavioral Health/Criminal Justice Review
Prescription Drug Take-Backs

82. Next Steps: Prevention, Intervention, Recovery Focused
Use Primary Care/Urgent Care Doctor as a first line of intervention - depression/suicide screening
Expand training for Law Enforcement- EP/ED Diversion
Multi-disciplinary ~information sharing and cross-training of addiction and mental health services
Promote recovery and support through peers, families and faith-based communities

83. Health Officer Allegany County Health Department
Sue V. Raver
Health Officer
Allegany County Health Department

84. Allegany County Health Planning Coalition
Partners:
Allegany County Health Department
Western Maryland Health System
Allegany County Board of Education
Tri-State Community Health Center
Western Maryland Area Health Education Center
County United Way
Allegany County Human Resources Development Commission

85. Local Health Improvement Plan: Priority 5: Substance Abuse – Alcohol & Drugs
Priority 5.B.4

86. Breathalyzer Project Purpose:
To reduce alcohol related crashes through educational awareness initiatives.
Funding:
Community Health Resources Commission (CHRC) Grant
Partners:
Western Maryland Health System
ACHD Prevention Program
Maryland State Police

87. Consultation Legal Issue:
The Network for Public Health Law – University of MD
“The education benefit (e.g. knowing what being over the limit ‘feels like’) seems to trump the legal risks.”
Maryland State Police in Garrett County

88. What We Do Personnel: DRE Maryland State Police Officers
Drug Resistance Education (DRE)
ACHD Prevention Staff
Location:
Large public events where alcohol is served/purchased
Provided Services:
Non-threatening education
Voluntary breathalyzer (Maryland State Police)
Alcohol consumption information
Dangers of driving under the influence
Facts and myths about alcohol

89. VOLUNTARY PARTICIPANTS
Events To-Date
EVENT
VOLUNTARY PARTICIPANTS
OVER LEGAL LIMIT (0.8)
Friday After Five 19 6
Frostburg Block Party 9 3
F-Bar in Frostburg* (10/2) 32 24
Frostburg Homecoming (10/12)
Not yet available
* Funded through Strategic Prevention Framework (SPF) Grant. Some initiatives undertaken by the F-Bar include the addition of food to their menu, Tuesday trivia night, and TIPS (Training for Intervention ProcedureS) training for employees (to recognize potential alcohol-related problems and intervene to prevent alcohol-related tragedies).

90. Comments
Interested to know how drinking affected BAC (blood alcohol content) level
Interested to know what factors are involved:
Sex
Weight
Food Consumption
Time Frame of Consumption
Prevalent Myth:
Drinking coffee can make one sober

91. Q & A and Discussion

92. Joshua M. Sharfstein
Secretary
DHMH

93. SHIP Data Development and Plans
Madeleine Shea

94. Maryland SHIP 2012 Update Statewide LHIC Leadership Meeting
October 10, 2012
Howard County General Hospital Wellness Center

95. Maryland SHIP 2012 Statewide Update Objectives 7-12

96. National Data Source: Healthy People 2020, National Child Abuse And Neglect Reporting System
Maryland Data Source: Maryland Department of Human Resources (DHR)

97. National Data Source: Healthy People 2020, National Center for Education Statistics
Maryland Data Source: Maryland State Department of Education (MSDE)

98. Data Source: Maryland Health Services Cost Review Commission (HSCRC)

99. Maryland SHIP 2012 Update County-level data
Data Source: Maryland Youth Tobacco Survey (MYTS)

100. Maryland SHIP 2012 Update County-level data
Data Source: Maryland DHMH Vital Statistics Administration

101. Maryland SHIP 2012 Update County-level data
Data Source: Maryland Health Services Cost Review Commission (HSCRC)
IMPORTANT: Only visits made by Maryland residents to Maryland hospitals were used for the analysis; emergency department visits made by Maryland residents to out-of-state hospitals were not included. Data are coded by patient’s county of residence.

102. Maryland SHIP 2012 Update County-level data
Data Source: Maryland Health Services Cost Review Commission (HSCRC)
IMPORTANT: Only visits made by Maryland residents to Maryland hospitals were used for the analysis; emergency department visits made by Maryland residents to out-of-state hospitals were not included. Data are coded by patient’s county of residence.

103. Maryland SHIP 2012 Update Disparities

104. Maryland SHIP 2012 Update Disparities

105. Maryland SHIP 2012 Update Disparities

106. Tricia Supik Executive Director & CEO
Partnership for a Healthier Carroll County, Inc.

107. Connecting people. Inspiring action. Strengthening community.

108. The Partnership Mission Connecting people, Inspiring action, Strengthening community
Track and interpret health data to “check the pulse” of our community/results.
Current structure includes eleven Core Health Improvement Areas (e.g., Prevention and Wellness, Elder Health, Access to Health Care etc.)
Established in 1999 by Carroll Hospital Center and CC Health Department.
Collaborate to build the capacity of individuals and organizations to improve the health and quality of life in our community.
Influence policies, form leadership teams (mini coalitions), drive change, promote engagement/ accountability , measure results and advance a healthy community vision.

109. Purposes driving the 2012 CHNA:
Provide information needed for development of a CHC Community Benefit Plan in compliance with their charitable organization Mission and elements of the 2010 Affordable Care Act
CHC Strategic planning
The Partnership's operational and organizational strategic planning
Inform the CHC Cancer Committee ongoing accreditation process
SHIP/LHIP compliance expectations

110. Components of the 2012 Community Health Needs Assessment
Common Themes
Prevalent Issues
High Impact Issues
Components of the 2012 Community Health Needs Assessment
1. Community Health Surveys and Key Informant Surveys
2. SHIP/LHIP and Secondary Data
Analysis
3: Focus Groups, Carroll County Health Rankings, CC Transit Development Plan

111. Targeted Populations Focus Groups
Five focus groups conducted:
African American (Completed with NAACP )
Hispanic (Completed with CCC ESOL Program at B.E.R.C.)
Low Income (Completed with CC Head Start of Taneytown and with Human Services Program of Carroll County)
Older Adult Providers (Completed with Elder Health Leadership Team)
Online profile collected, sessions recorded
For Hispanic program, Interpreters provided by CCHD

112. Information from Key Informant Survey
Obesity most frequently identified concern, but not listed as most urgent concern to be addressed.
Health care access was not listed as a primary concern.
Goal was a 70% return rate or about 95 Key Informant responses.
136 persons, ranging from private practice doctors to law enforcement to private business owners.
Geographies were considered.

113. Integrating the SHIP - LHIP with other Carroll County Specific Secondary Data

114. Q & A and Discussion

115. SHIP Next Steps
Madeleine Shea

116. Thank You!