Regarding Health Issues in Natrona County - Casper Hospital

Community Conversation

Regarding Health Issues in Natrona County

Community Health Needs Assessment 2016

Community Conversation Regarding Health Issues in Natrona County Final Report ? December 2015

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Table of Contents

Executive Summary ................................................................................................................... 3 Prior Community Health Efforts .................................................................................................. 5 The Problem Ahead ................................................................................................................... 7

Healthcare Transformation ..................................................................................................... 7 Employer Health Benefits at Risk for 48% of Americans......................................................... 7 No Unified Approach to Health in Natrona County .................................................................. 8 System-wide Change is Necessary to Move Forward ............................................................. 8 Challenges ............................................................................................................................. 9 Public Health Accountability ................................................................................................... 9 Geographic Area and Population ..............................................................................................10 Community Health Indicators ....................................................................................................11 Community Conversation Process and Results.........................................................................18 Resources .................................................................................................................................21 Next Steps ................................................................................................................................23 About the partners ....................................................................................................................24 Casper-Natrona County Public Health Department................................................................24 Wyoming Business Coalition on Health (WyBCH) .................................................................24 Wyoming Medical Center and Wyoming Health Medical Group .............................................24 Appendix 1 ? Attendees ............................................................................................................25 Appendix 2 ? Agenda................................................................................................................27 Appendix 3 ? Meeting Handouts ...............................................................................................28 Facilitator Bio.........................................................................................................................28 National Healthcare Transformation Presentation .................................................................29 The Value of Prevention, Public Health, and Community-Based Interventions Presentation..33 A Community Conversation: Natrona County, Wyoming ? Facilitator Slides ..........................40 Community Conversation Survey Results..............................................................................48 Appendix 4 ? Natrona County Demographic Summary .............................................................75 Appendix 5 ? Natrona County Health Indicators........................................................................76

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Community Conversation Regarding Health Issues in Natrona County Final Report ? December 2015

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Executive Summary

This document provides the details and findings of the Community Conversation Regarding Health Issues in Natrona County. The Community Conversation is a partnership of the CasperNatrona County Health Department, the Wyoming Business Coalition on Health, and Wyoming Medical Center.

Twenty-three community leaders responded to a survey on current health topics and later met on May 28, 2015 to identify the most important health issues for Natrona County. Further data was gained from publicly available community health indicators.

The Community Conversation revealed concerns about community health issues and changes occurring in the local health care industry. Community leaders presented a certain level of enthusiasm and commitment to address the issues in new and different ways realizing that a highly collaborative environment is needed to affect system-level changes.

The Community Conversation process identified the following four priorities:

1. Unhealthy behaviors associated with substance abuse, obesity and suicidality. 2. Lack of needed infrastructure related to mental health and primary care. 3. Health care system cost. 4. Lack of coordination of care.

Small groups then met to discuss and provide general guidance for each priority. The following are the starting thoughts from each group:

Group 1: Unhealthy behaviors associated with substance abuse, obesity and suicidality.

a. Obesity i. Focus on children and families. Develop Safe Routes to School for physical activity and injury prevention.

b. Substance abuse i. Partner with the Natrona County Prevention Coalition and its programs to address underage drinking and prescription drug abuse.

c. Suicide i. Develop a multiagency approach to educate employers on how they can implement programs within their own organizations. ii. Develop screening mechanisms for healthcare providers to recognize the signs of someone in crisis as well as the appropriate interventions.

Group 2: Lack of needed infrastructure related to mental health and primary care. a. Research and define the barriers to accessing mental health and primary care. Identify gaps. b. Develop strategies to overcome barriers, either real or perceived, to accessing mental health and primary care services. c. Develop strategies to enhance the coordination of care for individuals including compliance with treatment plans and other health-related issues such as jobs, housing, and other needs.

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Community Conversation Regarding Health Issues in Natrona County Final Report ? December 2015

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Group 3: Health care system cost and lack of coordination of care.

a. Develop strategies to enhance price and quality transparency among providers to increase understanding and value in their services.

b. Research and identify gaps in care that can be improved from the patients perspective (Patient-Centered Care). Develop patient advocacy strategies or methods to address gaps when they occur. Include patients at every level know as Voice of the Customer/Patient.

c. Research and share successful community strategies that improve the coordination of care and health care cost. Invest in community partnerships that can address these issues.

A review of community health measures found similar results to the survey of leaders including the following measures where Natrona County was significantly different from Wyoming or the United States:

Chlamydia and Gonorrhea Incidence Rates

Mothers Who Received Less Than Adequate Prenatal Care

Age-Adjusted Death Rate Due to Suicide

Adults Who Smoke Low-Income Persons Who are

SNAP Participants Children with Low Access to a

Grocery Store

Fast Food Restaurant Density Grocery Store Density Low-Income and Low Access to a

Grocery Store People 65+ with Low Access to a

Grocery Store SNAP Certified Stores Alcohol-Impaired Driving Deaths

Next steps include the formation of a Steering Committee and four action teams tasked with developing implementation plans that address the concerns found in the Community Conversation. Following the release of the CHNA, strategies and implementation plans will be finalized and published in the Community Health Improvement Plan (CHIP). Improvements will be measured, evaluated and reported over the long-term with adjustments in strategy being made as needed.

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Community Conversation Regarding Health Issues in Natrona County Final Report ? December 2015

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Prior Community Health Efforts

The most recent Community Health Needs Assessment was published in August and October 2011, in two parts, from which an implementation plan was released in 2012. A coalition consisting of Wyoming Medical Center, the Wyoming Business Coalition on Health, the Community Health Center, Wyoming Kids First-Natrona County, and the City of Casper led the assessment. A randomized survey of 800 residents focused on access to local health services, community health factors and demographics of respondents. The survey was followed by a series of focus groups1. The results of the assessment were narrowed to four distinct goals:

Goal 1: Better communication between healthcare providers/agencies would improve overall health.

Strategies: Casper Community Coalition Charter (care transitions) addresses care transitions from hospital to home, skilled nursing care, home health or hospice. The grant made it possible for WMC to hire several transition coaches. WMCs participation in the health information exchange will make it possible to disseminate data to a patients provider(s) wherever they may be. All strategies are implemented.

Impact: Transition nursing services are continuing to expand with inpatient care, in the outpatient clinic setting and recent efforts of the Casper-Natrona County Health Department to build community-based transition services. WMCs CEO holds quarterly focus groups with a randomly selected group of patients each quarter. The health information exchange ended due to funding issues. Since that time, Wyoming Medical Center installed and is operating a new electronic medical record with access being made available to health care providers throughout the state. The system also offers a patient portal and a new service, through the CommonWell Alliance, that allows broader access to important patient information. Although a picture archiving and communication system (PACS) has been fully implemented across the state and region, Wyoming Medical Center is now building laboratory interfaces with key health care providers in the community and state.

Goal 2: Access to health care and health insurance are primary factors for a healthy community.

Strategies: Community education on options through the ACA for purchasing insurance accessing subsidies.

Impact: In response to the Affordable Care Act, Wyoming Medical Center has committed itself to educating the community on options for accessing health insurance. In addition to financial counselors being available, WMC has become a Certified Application Counselor Organization for the Health Insurance to help people navigate the complicated process. Wyoming Medical Center will continue to offer these services, especially during open enrollment.

1 No written comments were received.

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