Work Session_Community Health Needs Assessment and Health Improvement Plan
TO:
The Honorable Mayor and City Council Members
FROM:
Michael C. Van Milligen, City Manager
SUBJECT:
Work Session -Community Health Needs Assessment and Health
Improvement Plan
DATE:
June 8, 2017
Public Health Specialist Mary Rose Corrigan is transmitting information for the work
session regarding the Community Health Needs Assessment and Health Improvement
Plan.
_____________________________________
Michael C. Van Milligen
MCVM:jh
Attachment
cc:Crenna Brumwell, City Attorney
Teri Goodmann, Assistant City Manager
Mary Rose Corrigan, Public Health Specialist
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TO:
Mike Van Milligen, City Manager
FROM:
Mary Rose Corrigan, Public Health Specialist
SUBJECT:
Community Health Needs Assessment and Health Improvement Plan
DATE:
June 8, 2017
INTRODUCTION
This memorandum transmitsinformation related to the City Council Work Session on
the Community Health Needs Assessment and Health Plan on June 12, 2017.
BACKGROUND
The Community Health Needs Assessment and Health ImprovementPlan (CHNA HIP)
has been a requirement of the Iowa Department of Public Health for many years and
has been done in Dubuque County since the late 1980s. The most recent Community
Health Needs Assessment was completed in 2015.
DISCUSSION
The work session will discuss the most recent Community Health Needs Assessment
along with the history, process, progress and plan for a future needs assessment.
Members of the CHNA HIP steering committee will assist with the presentation.
Since the process is for Dubuque County, the City and County Health Departments,
along with other community partners including Mercy Medical Center, Finley Unity Point
Hospital, Dubuque Visiting Nurse Association, and Crescent Community Health Center
make up the steering committee. The CHNA HIPis approved by the Dubuque County
Board of Health, as required by IDPH.
Attached is a copy of the annual report which was submitted to IDPH on June 1, 2017.
REQUESTED ACTION
No action is required. The work session is for informational purposes.
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of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other
countries.
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Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark
of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other
countries.
The Community Health Needs
Assessment
and
Health Improvement Plan
(CHNA & HIP)
CHNA &HIP
June 12, 2017 Dubuque City Council Work session
Mary Rose Corrigan, Public Health Specialist
Agenda
•CHNA –HIP requirements
•History of CHNA HIP
•Current CHNA –HIP
(2015)
•Future (2018) next round
CHNA &HIP
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Why do a CHNA HIP?
▪Iowa Dept of Public Health Requirement
➢Iowa Code chapter 77
➢Eligibility for grant & other funds
▪Health Resources & Services Administration(HRSA)
Requirement for Community Health Centers
▪Federal 990 reporting for Hospitals
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Looking Back
How it all began
•Planning Department
•City and County Health Departments
•Mercy Medical Center
•VNA-Dubuque Visiting Nurse Association
•Mercy Hospital’s role in data collection and reporting
•Data collection assisted planning activities as well as public
health reports
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Champions
oPlanning Department
oCity and County Health Departments
oMercy Medical Center
oVNA-
•Hospital’s role in data collection and reporting
oWhy do hospitals do this and why partner with them….
•Data collection assisted planning activities as well as
public health reports
Outreach
•Hospitals/Libraries assisted with
outreach
•Surveys done within the
community -$$$
•Stakeholder interest
•Quality outreach is largely
depended on direct marketing
budget
Collaboration-Partnerships-Funding
•Steering Committee
•Healthy Dubuque 2000 Process
funding
•Community stakeholders
Health Priorities
•Changes over time ~ changes in the community
o 1990s: Binge Drinking, Drug Abuse,
Domestic Violence
o Early 2000s: Diabetes,
Access to Healthcare
o 2011: Chronic Disease, Obesity,
Access to Fitness Opportunities,
Mental Health
o 2015: Air Quality, Obesity/
physical activity,
Medical home, Healthy Homes
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Utilizing the plans
Crescent Community Health Center
Dubuque Area Substance Abuse Coalition
Community Transformation Grant
Utilizing health goals to support outcomes in grant
applications and eligibility
Partnerships provide opportunities to pool small
resources over many organizations into larger
coordinated funds.
…”
“Your zip code is as important as your genetic code in
determining your health and life expectancy…”
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
The Social Determinants of Health
Public
Health
Employment
Income
Poverty Status
Education
Age
Disability Status
Race
Ethnicity
Neighborhood Crime
Recreation
Opportunities
Transportation Options Overcrowded Housing
Healthy Foods
Clean Water
Culture & Beliefs
Family Relationships
Social Support
Networks
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Spatial Determinants of Health
National
Regional
State
County
City
Neighborhood
Data-it’s all about the Data
•IDPH Database
•Hospitals data from IHA
•Collection of primary data from
surveys
•County Health Rankings
•Federal HRSA and census data-
FactFinder
Indicators Measured
•Critical Ages
–Under 5
–5-17
–65+
•Minority Population
•Hispanic/Latino Population
•Education Attainment
–No High School
–No Diploma
•Local Unemployment
•Health Insurance Coverage
•Overcrowded Housing
•Median Income
•Poverty Status
•SNAP/Food Stamps
•Disability Status
•No Vehicles
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Health Equity
Health disparities between neighborhoods
Are neighborhoods with higher health risk also at a high
risk for environmental health determinants and hazards?
Lead Poisoning
Lack of Open Space/Recreation
Natural Hazards
Elevated Lead
Levels
Higher concentrations of lead in homes within
neighborhoods with the most health risk levels
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Health Equity
Health disparities between neighborhoods
Are neighborhoods with higher health risk also at a
high risk for environmental health determinants and
hazards?
Lead Poisoning
Lack of Open Space
Natural Hazards
CHNA HIP 2015
Task Forces
•Healthy Behaviors
•Transitions of Care
•Preventing the Spread of
Disease
•Environmental Health
Steering Committee
•City of Dubuque
•Dubuque County
•Mercy Medical Center
•Finley Hospital
•VNA
•Crescent CHC
Engagement & Outreach
Community Survey
•> 1000 responses
Community Cafes
Participants
•DCSD/Holy Family Schools
•Medical Associates Clinics
•IDNR
•ISU extension
•United Clinical Lab
•Hillcrest
•Hy-Vee
•UD
•Dubuque Comm Y
Healthy Behaviors
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Transitions of Care
Formerly Access to Health Care
Mental Health
Access to Care
Care Coordination
Preventing Spread of Disease
•Reportable Communicable
Disease increases
•Consistent information for
managing communicable
diseases
•Emerging Infectious diseases
•Provider Communication
Environmental Health
•Water Quality
•Air Quality
•Healthy Homes
Principles
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
How Can Community Design
Affect Public Health?
Water Quality
Traffic-related Crashes
Physical Activity Levels
Access to Healthy Foods,
Education & Healthcare
Climate Change & Extreme Weather
Social Connections
Social Equity
Air Quality
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Utilizing the plans: Results
Crescent Community Health Center: Health care access
Dubuque Area Substance Abuse Coalition
Community Transformation Grant
Utilizing health and human services goals for grant
applications
Partnerships provide opportunities to pool small
resources over many organizations into larger
coordinated funds.
Air Quality Focus-EPA PM Advance Program
Healthy Behaviors
•Dubuque Eats Well
•Dubuque on the Move
•Community Gardens
•Trail Expansion
•Pesticide Free Parks
Transitions of Care
•ER referral system
•Expanded urgent care
locations
•Marshall Island Health
Project
•ACA outreach
•Case mangagment &
Medical Home
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Environmental Health
EPA PM Advance Program
Lead & Healthy Homes
Bee Branch Healthy Homes Program
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Prevent the Spread of Disease
Education of health care providers
Redundant, timely communication with health care
providers
Community messages and Education
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Planning and Public Health in the
Comprehensive Plan Update
2012 Comprehensive Plan Update–expands
with improvements
Incorporating Sustainable Dubuque into the
Comp Plan
Health a primary focus of comprehensive
planning.
Iowa Dept. of Public Health
http://www.idph.state.ia.us/chnahip/default.asp
Next CHNA-HIP Cycle
Begin: late summer/fall 2017
Stake Holder task forces: Oct-Dec, 2017
Community Engagement/Input: Jan-April, 2018
Review of Draft Assessment: May, 2018
Final CHNA-HIP Adoption: Summer 2018
Questions? Discussion
CHNA &HIP