Community Health Needs Assessment and Implementation Strategy
June 2016
COMMUNITY HEALTH NEEDS ASSESSMENT
TABLE OF CONTENTS I. EXECUTIVE SUMMARY ................................................................................................................................... 2 II. COMMUNITY PROFILE .................................................................................................................................. 3 III. ASSESSMENT PROCESS AND COMMUNITY INPUT ............................................................................................ 4 A. CRAVEN COUNTY ................................................................................................................................... 4 B. JONES COUNTY ...................................................................................................................................... 5 C. PAMLICO COUNTY .................................................................................................................................. 5 IV. COMMUNITY HEALTH NEEDS IDENTIFIED IN ASSESSMENT ............................................................................... 6 A. IDENTIFIED NEEDS ................................................................................................................................... 6 B. PRIORITIZATION OF NEEDS ....................................................................................................................... 6 C. MEDICAL CENTER’S HEALTH PRIORITIES ....................................................................................................... 7 V. ANALYSIS OF PRIORITIZED NEEDS .................................................................................................................. 8 A. SUBSTANCE ABUSE .................................................................................................................................. 8 B. OBESITY ................................................................................................................................................. 8 C. BEHAVIORAL AND MENTAL HEALTH .......................................................................................................... 9 D. CANCER ................................................................................................................................................. 9 E. HEART DISEASE ..................................................................................................................................... 10 V. COMMUNITY HEALTH RESOURCES .............................................................................................................. 11 A. SUBSTANCE ABUSE .................................................................................................................................. 11 B. OBESITY ................................................................................................................................................ 11 C. BEHAVIORAL AND MENTAL HEALTH ........................................................................................................... 12 D. CANCER ................................................................................................................................................ 12 E. HEART DISEASE ....................................................................................................................................... 13 VI. IMPLEMENTATION STRATEGY ........................................................................................................................ 14
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COMMUNITY HEALTH NEEDS ASSESSMENT I. EXECUTIVE SUMMARY
CarolinaEast Medical Center (Medical Center) conducted a community health needs assessment (CHNA) and developed an implementation strategy to address the health needs identified in the CHNA. The Medical Center helmed the assessment process with assistance provided by the health departments from Craven, Jones, and Pamlico Counties. Data was collected from residents through surveys administered throughout the three counties. This primary data was strengthened with secondary data from the North Carolina State Center for Health Statistics, Division of Public Health to provide a clear picture of the health issues affecting the Medical Center’s community. The Medical Center chose three health issues (obesity, substance abuse, and behavioral health) to address based upon ability to make an impact and the significance of the health issue as identified by the community. Afterwards, the Medical Center developed an implementation strategy to take action and establish realizable goals in order to measure the Medical Center’s progress on addressing these health issues. The CHNA consists of five steps pictured below:
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COMMUNITY HEALTH NEEDS ASSESSMENT II. COMMUNITY PROFILE 1
CarolinaEast Medical Center (Medical Center) serves a population of approximately 127,500 people in eastern North Carolina. A majority of the Medical Center’s service area is rural and includes Craven, Jones, and Pamlico Counties. About 82% of the population lives in Craven County which is home to the cities of New Bern and Havelock as well as the Marine Corps Air Station Cherry Point.
The community’s demographic population is approximately 68% white, 24% African American, 5% Hispanic, 2% Asian, 1% American Indian and Alaskan Natives. The age distribution consists of 19% of the population under the age of 18, 61% between the ages of 18‐65, and 20% above the age of 65. Both ethnicity and age statistics are similar when compared to North Carolina’s statewide percentages. The most notable difference is that the age group above the age of 65 is 6% higher than the state average. CarolinaEast Medical Center’s service area mean household income for the years 2009 to 2013 is $42,402 which is $4,000 lower than the state average. Five decades ago Jones and Pamlico counties joined together with Craven County to form a regional hospital and work together to become partners in health care. Geography and demographics are two primary reasons for combining the three counties into a single community. The Craven County borders surrounding the Medical Center’s location in New Bern are narrow in width. This slim taper in county border lines decreases the traveling distance for patients in neighboring counties and allows all three areas to benefit from the Medical Center’s central location. The populations of Pamlico and Jones Counties are significantly smaller than Craven County but have a similarly sized county area. Small populations widely dispersed across large areas would benefit from a large centrally located hospital. These factors lead all three counties to create the community served by CarolinaEast Medical Center. Data source is U.S. Census Bureau: State and County Quickfacts powered by Healthy Communities Institute found
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at www.carolinaeasthealth.com. The service area statistics were obtained by weighting each county’s statistic by the percentage of the individual county’s population compared to the service area’s total population.
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COMMUNITY HEALTH NEEDS ASSESSMENT
III. ASSESSMENT PROCESS AND COMMUNITY INPUT The assessment process consisted of collaborating with health departments in Craven, Jones, and Pamlico Counties during each community health assessment (CHA). Each county slightly differed in how they collect and compile data. However, each county utilized the same survey questionnaire to obtain direct input from residents within the community. This survey allowed all three counties to identify common issues and leverage existing resources to coordinate initiatives and avoid duplicate efforts. An advisory team was created that included representatives from all three County Health Departments and the Medical Center. The team’s responsibilities were to provide feedback on assessment processes, review statistics, and survey data. The Community Health Assessment Steering Committee was created to develop the actual contents of the survey questionnaire. The Steering Committee consisted of representatives from various backgrounds including the county and city governments, educational institutes, faith‐based organizations including refugee ministry, health care providers, public service providers, oral health, substance abuse prevention and mental health. The steering committee developed the survey using Healthy North Carolina 2020 guidance from the North Carolina Division of Public Health. A detailed description of each county’s individual assessment process is provided to demonstrate the approaches taken by each county to assess the community’s health.
A. CRAVEN COUNTY 2 Three methods were used to collect the surveys in Craven County: 1. The survey was placed on the Craven County Website using SurveyMonkey and promoted throughout the county for voluntary completion. 191 participants completed the survey between July and December 2014. Results were analyzed using the SurveyMonkey software. 2. A door to door survey was administered using the CASPER (Community Assessment for Public Health Emergency Response) method June 11, 2014 through June 13, 2014. This method consists of GIS (Geographic Information Systems) Specialists selecting households for a statistically‐significant rapid needs assessment. 210 surveys were administered by staff and volunteers on hand‐held computers. Only 108 surveys were completed on the first attempt. As a result, additional surveys were conducted in the CarolinaEast Surgery waiting room. 65 surveys were completed in the waiting rooms for a combined total of 173 surveys. 3. Only 7% of the surveys completed by website and door to door attempts were by done by individuals over the age of 65. A focus group survey was implemented to represent the Craven County elderly population. East Carolina University (ECU) Nursing students surveyed 22 individuals over the age of 65 at the Craven County Senior Center. This increased the percentage of surveys completed by the elderly folk to 13%. Twelve additional surveys were Excerpt taken from “Craven County’s 2015 Community Health Assessment.”
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COMMUNITY HEALTH NEEDS ASSESSMENT
conducted by the ECU nursing students at the MERCI Clinic, a free health care clinic in New Bern, NC.
B. JONES COUNTY 3 Two methods were used to collect surveys in Jones County: 1. The survey was placed on the Jones County website using SurveyMonkey and promoted through the county for voluntary completion. Between July and December of 2014, 101 surveys were completed online. 2. Direct mail surveys were sent to randomly selected households using GIS mapping. Many surveys were not completed and returned to the Health Department. As a result, randomly selected residents were surveyed during jury selections at the Jones County courthouse and the Jones County Heritage day festival.
C. PAMLICO COUNTY 4 Three methods were used to collect surveys in Pamlico County: 1. The survey was placed on the Health Department’s website using SurveyMonkey and promoted through the county for voluntary completion. 2. Surveys were made available in the waiting rooms at the county Health Department, CarolinaEast Health System, and Pamlico Community Health Center. In addition, surveys were available at Pamlico County Public Library and Pamlico Community College’s library. The survey was administered to residents at churches, community events, and community meetings. Each CHA report for all three counties were based on primary and secondary data sources. Members of the community from various backgrounds were included in every phase as an effort to identify the needs of the county. Focus groups were established to concentrate on data changes, trends and emerging issues. Data was compared to prior years and peer counties with similar population sizes. After carefully analyzing the data, the focus groups chose the top three health priorities for their county. It is with great interest that the three counties' top three identified needs were identical. 1. Substance Abuse 2. Obesity 3. Behavioral Health
3 Excerpt taken from “Jones County’s 2015 Community Health Assessment.” 4 Excerpt taken from “Pamlico County’s 2014 Community Health Assessment.”
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COMMUNITY HEALTH NEEDS ASSESSMENT IV. COMMUNITY HEALTH NEEDS IDENTIFIED IN ASSESSMENT A. IDENTIFIED NEEDS
The survey results of each county were compiled to make an extensive list of the health needs identified in that county. Primary data generated from the surveys was presented independently to the Community Health Assessment Task Force and Health Boards of each county. Based on the data gathered from the surveys, fifteen health needs were identified among the three counties. Secondary statistical data supported the identification of these fifteen health needs. The following table shows the fifteen most significant health needs identified across the community.
COMMUNITY HEALTH NEEDS IDENTIFIED AMONG ALL COUNTIES ADOLESCENT SEXUAL HEALTH & PREGNANCY PREVENTION
ADULT AND PEDIATRIC ASTHMA
BEHAVIORAL/MENTAL HEALTH
CANCER
CHRONIC & LIFESTYLE DISEASE
COMMUNICABLE DISEASE PREVENTION
DIABETES
HEART DISEASE
HIV & STD’S
OBESITY
SUBSTANCE ABUSE
SUICIDE
TOBACCO USE PREVENTION
WEIGHT MANAGEMENT, EXERCISE, FITNESS AND NUTRITION
UNINTENTIONAL INJURIES
B. PRIORITIZATION OF NEEDS After careful consideration each county selected their three most significant health needs to be addressed over the next three years. Both primary and secondary sources were assessed in prioritizing these needs. Each county’s prioritization method is described on the following page. All three counties top three health needs were identical. Craven County 5 Primary data from survey results and secondary data from Healthy North Carolina 2020: A Better State of Health was presented to the Community Health Assessment Task Force and the Craven County Board
Excerpt taken from “Craven County’s 2015 Community Health Assessment.”
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COMMUNITY HEALTH NEEDS ASSESSMENT
of Health. This group worked together to select the top three priorities for Craven County which are listed below.
Substance Abuse Obesity Behavioral/Mental Health
Jones County 6 All health needs identified were presented to the Community Health Assessment Task Force, and the Jones County System of Care Collaborative. Once all of the data was carefully analyzed, the following three health issues were selected as targets for improvement over the next three years.
Substance Abuse Weight Management/Exercise/Fitness/Nutrition Behavioral/Mental Health
Pamlico County 7 The survey data collected during 2014 was presented to the Community Health Assessment Task Force and the Pamlico County Board of Health. Based on the information presented they were asked to choose the top three health concerns to be addressed for the next three to four years by both the Health Department and Pamlico County community partners. The following areas were identified as priorities.
Substance Abuse Obesity Behavioral/Mental Health
D. Medical Center’s Health Priorities After each county identified their health priorities, the Medical Center’s CHNA group reviewed their choices and decided to choose the following health needs as priorities: 1. Substance Abuse 2. Obesity 3. Behavior/Mental Health
6 Excerpt taken from “Jones County’s 2014 Community Health Assessment.” 7 Excerpt taken from “Pamlico County’s 2015 Community Health Assessment.”
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COMMUNITY HEALTH NEEDS ASSESSMENT
The choices were based on two factors: the ability of the Medical Center to impact the health need, and the significance of the health need to the community. These priorities are the same as chosen by all three counties as identified by the community.
V. ANALYSIS OF PRIORITIZED NEEDS Detailed analysis of the three prioritized needs that CarolinaEast Medical Center has chosen to address are described below.
A. SUBSTANCE ABUSE There are over 100 drug overdose deaths per day in the United States which makes drug overdoses the leading cause of injury death. Deaths involving pain medications like methadone, oxycodone, and hydrocodone have increased over 400% in the state of North Carolina.8 There are limited number of health care providers with substance abuse outpatient treatment in the community, however, support groups are available in some areas. The unintentional poisoning related to medication more than doubled from 2011 to 2013. These statistics are increasing throughout the U.S. Drug related deaths at the age adjusted rate per 100,000 for the period 2004‐2010 were 11 for Pamlico County and for period 2012‐2014 were 15 for Craven County. 9
B. OBESITY Obesity is an indicator of the overall health of a community. Obesity can lead to heart disease, type 2 diabetes, cancer, hypertension, stroke, liver and gallbladder disease, respiratory problems and osteoarthrosis. Living a healthy lifestyle through proper nutrition and exercise can limit one’s risk to these diseases. North Carolina ranks number 25 in the nation of highest adult obesity rates.10 The percentage of adults who are over the age of 20 and are obese are as follows for 2012: Craven County 29.5%, Jones County 34.4%, and Pamlico County 31.9%. High rates of obesity make public health efforts and surveillance important in a community.11
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Jones County’s 2015 Community Health Assessment "Death Rate Due to Drug Poisoning." Community Health Needs Assessment Dashboard. Healthy Communities Institute, 2016. Web. . 10 Obesity: Better Policies for a Healthier America 11 "Adults Who Are Obese." Community Health Needs Assessment Dashboard. Healthy Communities Institute, 2016. Web. . 9
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COMMUNITY HEALTH NEEDS ASSESSMENT Percentage of Obese Adults Over the Age of 20 by County Craven
Jones
Pamlico
34% 32% 30%
2012
C. BEHAVIORAL AND MENTAL HEALTH Psychological distress can have negative impacts on a person’s behaviors and outlooks. The number of days that adults reported their mental health as “not good” in the past 30 days for the measured period of 2014 are as follows: Craven County 3.6 days, Jones County 3.9 days and Pamlico County 3.7 days.12 Persistent mental health problems should be evaluated and treated by a qualified professional. Recognizing physiological issues before they become critical is key to ensuring a healthy lifestyle. Patients who do not have insurance have difficulty finding practitioners willing to provide services and some providers choose not to serve Medicaid clients.
D. CANCER The second leading cause of death in the United States is cancer according the Centers for Disease Control and Prevention. Cancer is expected to surpass Heart Disease as the leading cause of death by the year 2015.13 One hundred different types of cancer exist and among those lung, colon, breast, pancreatic and prostate generate the greatest number of deaths annually. The age‐adjusted incidence rate for all cancers for the period 2009‐2013 are as follows: Craven County 485.7, Jones County 497.5, and Pamlico County 475.7.14 A majority of cancers are related to personal lifestyle or environmental factors. Such factors include diet and smoking. Prevention and early detection are critical components in reducing the number of cancer deaths.
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"Poor Mental Health Days." Community Health Needs Assessment Dashboard. Healthy Communities Institute, 2016. Web. . 13 Jones County’s 2015 Community Health Assessment 14 "Cancer Incidence Rates." NC Health and Human Services, 2016. Web. .
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COMMUNITY HEALTH NEEDS ASSESSMENT Cancer Age Adjusted Deaths Number of Deaths
300 250
Craven Jones
200
Pamlico 150
NC
100 2009
2010
2011
2012
2013
E. HEART DISEASE Heart disease is the number one cause of death in the United States accounting for 25% of total deaths. The most common form of heart disease in the US is coronary artery disease which causes heart attacks and heart failure. Modifiable risks include smoking, obesity, sedentary lifestyle, and high levels of lipoproteins. The age‐adjusted death rates per 100,000 population due to heart disease in 2013 are as follows: Craven County 164.8, Jones County 203.9, and Pamlico County 164.8.15 Each of these three counties have seen improvements over the past five years related to deaths caused by heart disease, but further work is needed to ensure continued progress.
Heart Disease
Number of Deaths
Age Adjusted Deaths 260 240 220 200 180 160 140 120 100
Craven Jones Pamlico NC
2009
2010
2011
2012
2013
15
Craven, Jones and Pamlico County’s 2014 and 2015 Community Health Needs Assessments
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COMMUNITY HEALTH NEEDS ASSESSMENT
V. COMMUNITY HEALTH RESOURCES CarolinaEast Medical Center’s service area has numerous resources available to meet the identified health needs. The Medical Center plays a large role in the community by offering volunteer services, sponsoring support groups and facilitating health fairs and screenings. Volunteers of the Medical Center operate the Lifeline Personal Emergency Response System for 300 individuals consisting of senior citizens who live alone, children alone at home after school, and chronically ill individuals. The Health System sponsors and participates in special events such as American Cancer Society Relay for Life, YMCA Triathlon and the Multiple Sclerosis Bike Tour and Training Rides. The Medical Center participates in organizing health fairs such as The MumFest which offers free blood pressure checks and blood sugar screenings. Cancer screenings are offered to aid in early detection of skin cancer and prostate cancer. Various support groups such as the Diabetes Support Group, Caregivers Support Group, Cancer Support Group, and Mended Hearts are also sponsored by CarolinaEast. A detailed list has been compiled that shows many of the health and health‐related resources available to the community whether provided internally at the hospital or through other community resources. Please review each county’s community health assessment for a more comprehensive list. We have provided a sample of the extensive health resources available to address the health needs identified by the community.
A. SUBSTANCE ABUSE
PORT HUMAN SERVICES is a private, nonprofit Critical Access Behavioral Agency (CABHA). Their mission is to help individuals and families navigate through life’s challenges by providing effective and efficient substance abuse, mental health and intellectual/developmentally disabled services and supports. The organization was founded in 2003 and accepts private insurance, Medicaid, Medicare and self‐payments. RECOVERY INNOVATIONS/WELLNESS CITY OF NEW BERN support areas include mental health, substance use, or intellectual/development disabilities. Recovery Innovations is dedicated to making sure Medicaid recipients receive the help they need. Those who have no insurance or who are unable to pay may also receive assistance through Recovery Innovations. RHA HEALTH SERVICES, LLC is a multi‐state company providing a comprehensive network of support services for people with intellectual, physical and developmental disabilities and individuals with health needs or substance use challenges. Both children and adults are supported at every level of need. The guiding principle of RHA is that every individual is unique and, therefore, every path to recovery and wellness is unique.
B. OBESITY
CRAVEN COUNTY SENIOR SERVICES provides services to enhance the quality of life for older adults in Craven County, allowing them to remain active and independent in their own homes. Education seminars, exercise classes, yoga, arts and crafts and special programs for the visually impaired
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COMMUNITY HEALTH NEEDS ASSESSMENT
and hard of hearing are available free of charge to individuals 60 years or older. Balanced and nutritious meals are served each weekday to people who are sixty years or older. TWIN RIVERS YMCA focuses on three main areas; youth development, healthy living, and social responsibility. The organization strives to improve the nation’s health and well‐being while giving back and providing support to the community. JONES COUNTY SENIOR CENTER offers a variety of senior activities including equipment for physical activity, senior health fairs, regular blood pressure checks, nutrition programming, and information on diabetes. Nutritious meals are also offered each weekday that meet the daily nutritional requirements of senior adults. PARKS AND RECREATION ‐ CITY AND COUNTY, provides outdoor areas to facilitate a wide variety of activities. The vast majority of these areas are free to public use throughout the entire year. The organization also offers programs for children of all ages to participate in sports such as volleyball, golf, basketball, etc.
C. BEHAVIORAL AND MENTAL HEALTH
CROSSROADS ADULT MENTAL HEALTH focuses on behavioral health needs and teaches new ways to cope with the illness. Patients are assisted in determining appropriate levels of medication and teaching patients how to use their medication appropriately. Treatment services include 24‐ hour behavioral health monitoring, behavioral health diagnostic evaluations, medication stabilization, individual and group therapy, and recreational therapies. These therapies are designed to help the patient return home and resume their lives as quickly as possible. TRILLIUM HEALTH RESOURCES is the regional Local Mental Health Managing Entity/Managed Care organization for twenty‐four counties. They are responsible for referral and coordination of behavioral health services and have contracts with many local mental health practitioners to provide services to Medicaid recipients and care for those without insurance or inability to pay. HEARTWORKS is a nonprofit community service agency that addresses the underserved mental and physical health needs of youth and their families. Programs include academic lessons, life skills development, promotion of positive physical and mental health, and family advocacy. HeartWorks provides the guidance and resources necessary to stop poverty, abuse and violence.
D. CANCER
CAROLINAEAST CANCER CARE provides the most advanced treatment regimens in the coastal Carolina region. The program is accredited by the American College of Surgeons Commission on Cancer and was the first to offer life‐saving radiation therapy to the region. Radiation therapy is provided to over 600 patients annually, each undergoing numerous treatments. The Health System sponsors a number of community initiatives to diagnose cancer in its earliest stages and to increase awareness of cancer prevention, treatment and cure. BREAST AND CERVICAL CANCER CONTROL PROGRAM – this program is offered in Craven, Jones and Pamlico counties. Each county’s’ individual program facilitates early detection of breast and cervical cancer. The program provides services to women including physical assessments, pap
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COMMUNITY HEALTH NEEDS ASSESSMENT
smears, clinical breast exams and mammography referrals. Free examinations are offered for women between the ages of 40 and 64 who have little or no insurance and meet financial requirements.
E. HEART DISEASE
CAROLINAEAST CARDIOVASCULAR CENTER OF EXCELLENCE is a leader in heart care and provides the latest in diagnostic and interventional technologies and preventative care. The Cardiovascular Center of Excellence offers access to educational opportunities and wellness initiatives aimed at prevention and early detection of potential cardiovascular health issues. Opportunities include free health screenings, educational sessions, support groups and much more. COASTAL CAROLINA HEALTH CARE, P.A. has specialists who deal with the diagnosis and treatment of congenital heart defects, coronary artery disease, electrophysiology, heart failure and valvular heart disease. GIVE YOUR HEART A HEALTHY BEAT is a program that provides research‐based information helping individuals make healthful changes in eating and exercise habits designed to prevent cardiovascular disease. LOCAL FARMERS' MARKETS provide an opportunity for citizens to purchase local, whole foods from farms that are unprocessed and generally a healthy alternative to food choices present in our society.
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COMMUNITY HEALTH NEEDS ASSESSMENT
VI. IMPLEMENTATION STRATEGY CarolinaEast Medical Center has developed an implementation strategy for each health priority identified above. This Implementation Plan will be rolled out over the next three years. The Medical Center will work with community partners and health issue experts on the following for each of the approaches to addressing the health needs listed:
Identify what other local organizations are doing to address the health priority Develop support and participation for these approaches to address health needs Develop specific and measurable goals so that effectiveness of these approaches can be measured. Develop detailed work plans Communicate with others involved to ensure appropriate coordination with other efforts to address the issue.
CarolinaEast Medical Center is committed to conducting another health needs assessment in three years. In addition, the Medical Center will continue to play a leading role in addressing the health needs of those within the community, with a special focus on the underserved. As such, community benefit planning will be integrated into the Hospital’s annual planning and budgeting process to ensure the community benefits are supported effectively. Please see next page for implementation strategies developed for each prioritized health need.
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COMMUNITY HEALTH NEEDS ASSESSMENT Community Health Need:
Substance Abuse Prevention
Specific Needs Identified in the CHNA:
Percentage of adults who reported heavy drinking in past 30 days. Deaths due to drug poisoning (per 100,000 people)
Healthy People 2020 Target is 25.4% for Alcohol Abuse and 11.3 deaths for Drug Poisoning
Alcohol Abuse: Craven County 16.8%; Jones County 13.2%; Pamlico County 13.6% Drug Poisoning: Craven County 15.0 deaths; Pamlico County 11.0 deaths
Goals: Collaborate to reduce the substance abuse in the tri-county. Strategy: Align with community partners to establish a task force to address substance abuse/mental health in the tri-county area. Action Step
Accountability
Timeline
Desired Outcome
Hospital
Complete and ongoing
Collaboration and Cooperation
Hospital in Cooperation with the Community Strategy: Support and promote location of drop boxes in the tri-county area.
Complete and ongoing
Best Practice sharing
Action Step
Accountability
Timeline
Desired Outcome
1. Push locations on a regular basis through social media.
Hospital
Ongoing
Awareness
2. Re-visit possibility of establishing a drop box on site that meets all regulatory requirements.
Hospital
Proper disposal of prescription medications.
3. Assist with take-back events.
Hospital and community
2017 (after first floor of tower completed Ongoing )
1. Invite local law enforcement, counselors, judicial officials, healthcare providers, non-profits, etc. to group discussion to identify extent of the substance abuse issue, share current initiatives and explore possible new initiatives going forward. 2. Invite organizations and or entities from across the state to a forum to share successes.
Proper disposal of prescription medications.
Strategy: Heighten public awareness of the critically of substance abuse in our area. Action Step
Accountability
Timeline
Desired Outcome
Hospital, community, local di Hospital
Complete and ongoing
Awareness
Ongoing
Awareness
Hospital
Ongoing
Education and Awareness
Accountability
Timeline
Desired Outcome
1. Continue to support the Coastal Coalition for Substance Abuse Prevention (CCSAP) in their efforts to eliminate or significantly decrease accessibility of alcohol and prescription medications.
Hospital, CCSAP, community
Ongoing
Limited access to alcohol and prescription medications to underage and adults.
2. Assist local community stakeholders (pharmacies, law enforcement) with take-back events.
Hospital and community
Ongoing
Removal of prescription medications to avoid inappropriate use and diversion.
1. Work with local media (Sun Journal) on series examining the problem in eastern North Carolina. 2. Utilize social media to keep communication going. 3. Distribute information regarding substance abuse in our area and resources for prevention and recovery at all our community outreach events (i.e. MumFest.)
Strategy: Decrease underage drinking and misuse of prescription medications. Action Step
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COMMUNITY HEALTH NEEDS ASSESSMENT Community Health Need:
Obesity
Specific Needs Identified in the CHNA:
High percentage of obesity among adults aged 20 and older with the tri-county primary service area.
Healthy People 2020 Target is 30.5%
Craven County 29.5%; Jones County 34.4%; Pamlico County 31.9%
Goals: Promote and encourage nutrition and exercise as the best ways to impact regional level of obesity. Strategy: Continue to offer healthy menu options to our 2,200 employees and thousands of guests annually. Action Step 1. Clearly define nutritional content of cafeteria meals and make information available to patients ordering their meals.
Accountability
Timeline
Desired Outcome
Hospital
Ongoing
Awareness
2. Continue to promote use of the CarolinaEast employee Hospital Ongoing Wellness for covered lives. wellness center, expanding availability of classes focusing on nutrition. Strategy: Partner with local government to promote existing options for fitness opportunities available at minimal to no cost to community such as nature trails, parks and recreation. Action Step Accountability Timeline Desired Outcome 1. Secure promotional literature about local fitness opportunities Hospital and make them available to employees through the wellness and fitness center.
Ongoing
Awareness and increased physical activity
2. Use Health System's popular social media channels to promote availability to followers on Facebook/Twitter and subscribers to e-newsletter.
Hospital
Ongoing
Awareness and increased physical activity
3. Explore possibility of offering healthy eating cooking classes as part of the Comprehensive Cancer Center prevention initiatives.
Cancer Center
2018 (completion of Prevention cancer center)
Strategy: Support community partners to promote their initiatives that focus on healthy eating and physical activity. Action Step 1. Maintain Presenting Sponsorship of Neuse River Bridge Run.
Accountability
Timeline
Desired Outcome
Hospital
Annually in October Community Wellness and support of partner non-profits.
2. Support Bike MS - encourage CarolinaEast team participation Hospital
Annually in September
3. Support various runs, walks, awareness events (Coastal Women's Shelter, Twin Rivers YMCA Triathlon, Creekside/ACS Run the Yellow Brick Road, etc.)
Annually throughout Community Wellness and support the year of partner non-profits.
Hospital
Community Wellness and support of partner non-profits.
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COMMUNITY HEALTH NEEDS ASSESSMENT Community Health Need:
Behavioral and Mental Health
Specific Needs Identified in the CHNA:
Deaths due to suicide (per 100,000 people)
Healthy People 2020 Target is 10.2 deaths due to suicide
Craven County 12.3 deaths; Jones County 8.9 deaths; Pamlico County 22.4 deaths
Goals: Collaborate to reduce the number of suicides in the tri-county. Strategy: Increase accessibility to mental health services in our community. Action Step
Accountability
Timeline
Desired Outcome
Ongoing
Service Utilization
Current and ongoing
Mental Health Support
to include intensive outpatient (IOP) therapy services. 3. Expand Crossroads Partial Hospitalization Program (PHP) to Hospital accommodate additional military personnel suffering from PTSD.
Current and ongoing
Mental Health Support
1. Collaborate with community partners to increase availability of Hospital and and accessibility to appropriate resources. Community 2. Expand services of Crossroads Adult Mental Health Services P Hospital
4. Partner with Trillium to support additional Medicaid inpatient adult mental health beds.
Hospital and Trillium
Complete
Mental Health Support
5. Support the Trillium initiative to build a regional facility to provide intensive/acute services and support to individuals in crisis.
Hospital and Trillium
2017 and beyond
Mental Health Support
Strategy: Eliminate/reduce the misuse of prescription medications (substance abuse and mental/behavioral health are closely linked.) Accountability Timeline Desired Outcome Action Step 1. Continue to support the Coastal Coalition for Substance Abuse Prevention (CCSAP) in their efforts to eliminate or significantly decrease accessibility of alcohol and prescription medications.
Hospital, CCSAP and Community
Ongoing
Limited access to alcohol and prescription medications to underage and adults
2. Assist local community stakeholders (pharmacies, law enforcement) with take-back events.
Hospital, community
Ongoing
Removal of prescription medications to avoid inappropriate use and diversion.
3. Re-visit possibility of establishing a drop box on site that meets all regulatory requirements.
Hospital
4. Assist with public take-back events.
Hospital
2017 (after Proper disposal of prescription completion on new medications. tower) Ongoing Proper disposal of prescription medications.
Strategy: Increase awareness of services available locally to consumers. Timeline
Desired Outcome
1. Host second annual Consumer and Provider Behavioral Health Hospital Fair.
3/1/2014 and 7/8/16
Education and Awareness.
2. Provide service information at CarolinaEast's many community Hospital outreach events
Ongoing
Education and Awareness.
Hospital
Ongoing
Education and Awareness.
Action Step
3. Make resource availability information readily available to our employees for their personal use, family members and/or to share with our patients when a need is recognized.
Accountability
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COMMUNITY HEALTH NEEDS ASSESSMENT
The following is a list of health needs not addressed after considering the levels to which the needs are already addressed in the service area. Additionally, some community needs fall out of the scope of expertise and resources of the Medical Center. The following chart outlines why some of the needs identified in the health needs assessment are not addressed.
Community Needs Not Addressed Community Need
Reasons Needs Not Addressed
Adolescent Sexual Health and Pregnancy Prevention Adult and Pediatric Asthma
Craven, Jones and Pamlico County Health Departments provide these services and have programs to address prevelance.
Communicable Disease Prevention Diabetes
Craven, Jones and Pamlico County Health Departments provide these services and have programs to address prevalence.
HIV and STD's
Craven, Jones and Pamlico County Health Departments provide these services and have programs to address prevalence.
Unintentional Injuries
Several local agencies (police departments, fire departments, health departments) have educational programs aimed at preventing injuries.
Craven County Health Department monitors the prevelance and causes of Asthma in our community. Pediatric and adult clinics within CCHD support and treat. Local
CarolinaEast has a robust diabetes education program for patient education, sponsors a diabetes support group through our Foundation and provides free blood glucose
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AMY L. BIBBY Partner Tax
[email protected] T 828.236.5797
JEREMY NAESS Manager Tax
[email protected] T 828.236.5757
WILL SMITH Senior Associate Tax
[email protected] T 828.236.5786
North Carolina 500 Ridgefield Court Asheville NC 28802 828.236.2254
